title: Understanding the 'work' of caseload midwives: A mixed-methods exploration of two caseload midwifery models in Victoria, Australia.
abstract: BACKGROUND
  Caseload midwifery models are becoming more common in Australian maternity care. Little is known about how caseload midwifery compares with mainstream models of midwifery care in terms of both the organisation of the work and the meaning of the work for caseload midwives.
  
  
  OBJECTIVE
  To explore caseload and standard care midwives' views and experiences of midwifery work in two new caseload models in Victoria, Australia.
  
  
  METHODS
  A mixed-methods approach was used. Quantitative data were collected using two cross-sectional surveys of midwives at the two study sites at the commencement of the caseload model and after two years. Qualitative data were collected using in-depth interviews with caseload midwives six months and two years after commencing in the role. Content analysis was used to analyse open-ended survey questions, and interview data were analysed thematically. Themes arising from these data sources were then considered using Normalization Process Theory.
  
  
  RESULTS
  Two themes emerged from the data. Caseload midwifery was a 'different' way of working, involving activity-based work, working on-call, fluid navigation between work and personal time and avoiding burnout. Working in caseload was also perceived by caseload midwives to be 'real' midwifery, facilitating relationships with women, and requiring responsibility, accountability, autonomy and legitimacy in their practice. Perceptions of caseload work were influenced by understanding these differences in caseload work compared to mainstream maternity care.
  
  
  CONCLUSIONS
  Increased understanding of the differences between caseload work and mainstream maternity models, and introducing opportunities to be exposed to caseload work may contribute to sustainability of caseload models.
authors.affiliation: School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia; Judith Lumley Centre, La Trobe University, 215 Franklin St, Melbourne, VIC 3000, Australia. Electronic address: michelle.newton@latrobe.edu.au.
authors.forename: Michelle S
authors.initials: MS
authors.lastname: Newton
authors.affiliation: School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia; Judith Lumley Centre, La Trobe University, 215 Franklin St, Melbourne, VIC 3000, Australia.
authors.forename: Helen L
authors.initials: HL
authors.lastname: McLachlan
authors.affiliation: Judith Lumley Centre, La Trobe University, 215 Franklin St, Melbourne, VIC 3000, Australia; The Royal Women's Hospital, Cnr Grattan St & Flemington Rd, Parkville, VIC 3052, Australia.
authors.forename: Della A
authors.initials: DA
authors.lastname: Forster
authors.affiliation: Faculty of Health Sciences, Australian Catholic University, 215 Victoria Parade, Fitzroy, VIC 3065, Australia.
authors.forename: Karen F
authors.initials: KF
authors.lastname: Willis
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D008880:Midwifery / Q000379:methods*; D009774:Obstetrics / Q000458:organization & administration*; D011247:Pregnancy; D011795:Surveys and Questionnaires; D014739:Victoria; D055815:Young Adult
keywords: Caseload; Continuity of care; Midwifery; Midwives’ experiences; Qualitative research