O25 - Stronger Connections: exploring the views of midwives working with First Nations families in an all-risk, culturally responsive caseload model

Background Caseload midwifery is associated with positive outcomes for midwives, however most studies focus on models for women with low medical, obstetric or psychosocial complexities. Little is known about midwives’ experiences working in an all-risk, culturally responsive caseload model. Between March 2017 and December 2020 three maternity services in Victoria, Australia implemented caseload models for women having a First Nations baby. Aims To explore the views and experiences of midwives working in caseload model implemented for First Nations families. Method Data were collected from midwives working in the culturally responsive model six-months after commencement, and after two years or upon leaving the model. Online surveys explored midwives’ experiences, intentions for continued work in the model, and measures of satisfaction and burnout. An exploration of the views and experiences of caseload midwives were explored concurrently using semi-structured interviews. Results 0Of 22 eligible midwives, 18 (82%) completed the baseline survey, four completed a two-year survey, and 4/10 who resigned completed the exit survey. Midwives reported positive attitudes towards their role, valuing close relationships with women, although around half reported difficulty maintaining a work-life balance. Overall, mean scores for the group showed no burnout, although there were some individual midwives with burnout in each subscale. Fifteen midwives participated in semi-structured interviews. The global theme ‘Stronger connections for better outcomes’ encompassed strong connections between women and midwives, that the model was key in facilitating support and navigation of internal and external systems and services; however, issues of resourcing, lack of recognition of workload and non-responsive systems and management were considered to potentially jeopardise these connections. Conclusion Caseload midwives were highly satisfied, and relationships were key to the stronger connections and better outcomes for women having a First Nations baby. Culturally responsive models require adequate support and resourcing to optimise model functioning and improve outcomes.