Most midwives want to work in continuity of care models, but inflexible work practices and narrow role definitions are limiting their work opportunities, the report notes.

“I previously worked in Midwifery group practice in Coffs Harbour, but I got burnt out in the role of an MGP midwife, as the workload is very high,” says Amanda, who now works in the Coffs Harbour hospital maternity ward.

As an MGP midwife, when “you can be needed for any length of time, and you never know how long your work is going to take. And we certainly worked and pushed ourselves hard to ensure our colleagues and the women were looked after.”

The report calls for flexible part-time and job share arrangements to ease burdens on midwives who want to stay in MGP. It also calls for reforms to allow midwives to use the full scope of their practice skills.

“I think there are a lot of midwives who feel like they are obstetric nurses, rather than truly being able to practice midwifery because we have a fairly medicalised model in NSW,” Amanda says.

“A lot of the care is led by the obstetric team rather than midwifery-led, and there is also input from paediatric doctors, who are often reluctant to give a lot of consideration to women’s choices when it comes to birth.

“Evidence shows midwifery-led approach is the gold standard. Those models increase satisfaction for women, but they also increase satisfaction for midwives.”

Nichole Flegg, a midwife and President of NSWNMA Macarthur branch, has noticed significant changes in the profession in the nearly 24 years she has been practising.

“Everything is on computer now: no one sits down and does face to face care that we once had time for.

“I was recently told my time management is terrible because I spend too much time with patients.

“We’ve gone from being human beings talking to human beings, to ticking off a checklist on a computer. You don’t use your clinical judgement as often and we are losing our clinical skills and critical thinking.”

“It is not actually personalised care it is generic care.”