Major model category

Each maternity model of care in the MoC NBPDS is grouped into one of 11 major model categories, based on its specific characteristics. The 11 different categories broadly describe the intent of the model of care, although not all women in a model of care will necessarily follow the same journey or receive the same care pathway as the model intends (or was designed for). This information sheet describes each major model category (PDF 203kB).

The most common major model category is public hospital maternity care with 41% of all models of care falling into this category. This is followed by midwifery group practice caseload care (15% of models), shared care (15%) and private obstetrician (specialist) care (11%). Public hospital high risk maternity care is the major model category for around 5% of models. Other, less common major model categories include General Practitioner (GP) obstetrician care (4%), combined care (3%), team midwifery care (2%) and private midwifery care (2%).

It is important to note that there may still be differences between models of care with the same major model category. Public hospital maternity care is the major model category with the most variation (Donnolley 2017). It broadly describes a model of care where antenatal care is provided by midwives and/or doctors in onsite or outreach clinics. Intrapartum (labour and birth) and postnatal care is provided in hospital by midwives in collaboration with doctors as needed. This category is used for models that cover a range of clinics, from those run by midwives targeted at low risk women, to those led by public specialist obstetricians for women with specific obstetric complexities such as gestational diabetes, multiple pregnancy or next birth after caesarean section. Three-quarters (76%) of models classified as public hospital maternity care are targeted at a specific group of women, compared with 61% of models overall.

In comparison, models classified with a major model category of midwifery group practice caseload care have less variation. This category describes models where antenatal, intrapartum and postnatal care are provided within a publicly funded caseload model by a known primary midwife, with secondary backup midwives providing cover and assistance, and collaboration with doctors in the event of identified risk factors. Antenatal care and postnatal care is usually provided in the hospital, community or home with intrapartum care in a hospital, birth centre or home. By definition, this model category has a midwife—public as the designated carer and continuity of carer for the whole duration of maternity care. It is also more likely to have a target group of low risk or normal pregnancy (39%, compared with 21% overall) and to provide residential postnatal care (100%, compared with 71% overall).

A shared care major model category describes models where antenatal care is provided by a community maternity service provider (doctor and/or midwife) in collaboration with hospital medical and/or midwifery staff, under an established agreement. It can occur in the community and in hospital outpatient clinics. This would usually include an agreed schedule of antenatal care between the two providers. Intrapartum and early postnatal care usually takes place in the hospital, by hospital midwives and doctors, often in conjunction with the community doctor or midwife (particularly in rural settings). Around half (51%) of models of care in this category are targeted to a specific group of women, compared with 61% overall, and 29% have a target group of low risk or normal pregnancy.

Public hospital maternity care is the most common major model category in all states and territories, except the Northern Territory where shared care is more common (29% of models). Queensland has a relatively high proportion of models of care classified as midwifery group practice caseload care (26%). The data visualisation below shows maternity models of care by their major model category for each state and territory.

Proportion of models of care, by major model category, Australia, 2021.

The bar chart in the data visualisation shows the proportion of maternity models of care, by each major model category, for Australia and in each state and territory. It shows that public hospital maternity care is the most common model category in Australia (41% of maternity models of care). This is true for all states and territories, except the Northern Territory where shared care is the most common model category (29%).

References

Donnolley NR, Chambers GM, Butler-Henderson KA, Chapman MG & Sullivan EA 2017. More than a name: Heterogeneity in characteristics of models of maternity care reported from the Australian Maternity Care Classification System validation study. Women and Birth 30(4): 332–341.