Table 1.
Type of hospital | Caseload model Funding | Scale of model | Caseload midwifery targets | Caseload details* |
---|---|---|---|---|
Highly specialised university hospital | Funded by reduced staffing of ward midwives from: | 4 caseload groups | Nulliparas + women who plan early discharge + planned homebirths in hospital catchment area (1 %) | • 120 births per annum per group |
8 a.m. | (1 group with 2 midwives, 3 groups with 3 midwives) | • Mixed risk status | ||
Obstetric unit with 4900 births | 8 p.m. | • Max 50 % nullipara | ||
7 p.m-7 a.m. | ||||
7 p.m. | ||||
Neonatal intensive care unit | ||||
7 p.m. | ||||
Specialised mid-level hospital | Funded by reduced staffing of ward midwives from: | 8 caseload groups | Nulliparas | • 120 births per annum per group |
Obstetric unit with 2400 births | 6 a.m. | (6 groups: 1 with 2 midwives, 5 with 3 midwives) | • Mixed risk status | |
6 p.m. | • 100 % nullipara | |||
5 a.m-5 p+a.m. | Vulnerable and/or socially dis-advantaged mothers ** | • 120 births per annum per group | ||
Neonatal intensive care unit | 5 p.m. | (1 group with 3 midwives) | • Mixed risk status | |
4 a.m. | Twin pregnancy or women with fear of childbirth | • Mixed nulli- and multiparas | ||
(1 group with 2 midwives) | ||||
Community hospital | Earmarked funding for pilot project | 2 caseload groups | All women from local area | • 140 births per annum per group |
Obstetric unit with 1900 births | (2 groups, each with 3 midwives) | • Mixed risk status | ||
No neonatal intensive care unit | • Mixed nulli- and multiparas |
*Groups consisted of two full-time midwives (37 h/weekly average) or three midwives working either part-time (e.g. 30 h/week) or full-time, divided between caseload (e.g. 25 h/weekly average) and ordinary ward shifts (e.g. 12 h/weekly average)
**Pregnant women, e.g. who are young (<20 years) and/or affected by mental health or social problems