Maternity models of care in Australia, 2023

The major model category is the overarching category or group that a maternity model of care belongs to. While there may be differences between models of care, each one can be grouped into one of 11 categories based on its specific characteristics. Note – while the major model category describes the overall intent of a maternity model of care it does not necessarily mean that all women in a model of care will follow the same journey or receive the same care pathway as the model was designed for.

The 4 most common model categories

Most maternity models of care in Australia fall into one of the following 4 model categories:

Public hospital maternity care

• Antenatal care is provided in hospital outpatient clinics (either onsite or outreach) by midwives and/or doctors. Care may also be provided by a multidisciplinary team.
• This is the broadest model category and includes a range of models of care from those led by midwives that target low risk women to those led by obstetricians that target women with obstetric risk factors such as diabetes.
• Intrapartum and postnatal care is provided in hospital by midwives and doctors in collaboration.
• Postnatal care may continue in the home or community by hospital midwives.

Shared care

• 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.
• Can occur both in the community and in hospital outpatient clinics.
• Usually includes 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).

Midwifery group practice caseload care

• Antenatal, intrapartum and postnatal care is provided within a publicly funded caseload model by a known primary midwife with secondary backup midwives providing cover and assistance, in 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.
• This category provides continuity of carer across the whole maternity period.

Private obstetrician specialist care

• Antenatal care is provided by a private specialist obstetrician.
• Intrapartum care is provided in either a private or public hospital by the private specialist obstetrician in collaboration with hospital midwives.
• Postnatal care is usually provided in the hospital by the private specialist obstetrician and hospital midwives and care by midwives may continue in the home, hotel or hostel.
• Most models in this category provide continuity of carer across the whole maternity period.

Other model categories

Maternity models of care that fall into the following model categories are also available at some maternity services, however these are less common:

Public hospital high risk maternity care   

• Antenatal care is provided to women with medical high risk/complex pregnancies by public hospital maternity care providers (specialist obstetricians and/or maternal-fetal medicine subspecialists in collaboration with midwives).
• Intrapartum and postnatal care is provided by hospital doctors and midwives.
• Postnatal care may continue in the home or community by hospital midwives.
• This category is not used for obstetric-led clinics (models of care) such as those designed for women with diabetes or with risk factors such as high BMI. Models requiring obstetric input but not multi-disciplinary specialised care are classified as public hospital maternity care.

General practitioner (GP) obstetrician care

• Antenatal care is provided by a GP obstetrician.
• Intrapartum care is provided in either a private or public hospital by the GP obstetrician in collaboration with the hospital midwives.
• Postnatal care is usually provided in the hospital by the GP obstetrician and hospital midwives.

Remote area maternity care

• Antenatal and postnatal care is provided in remote communities by a remote area midwife (or nurse) or group of midwives, sometimes in collaboration with a remote area nurse and/or doctor.
• Antenatal care may also be provided via telehealth or fly-in-fly-out clinicians in an outreach setting.
• Intrapartum and early postnatal care is provided in a regional or metropolitan hospital (often involving temporary relocation prior to labour) by hospital midwives and doctors.

Combined care

• Antenatal care is provided by a private maternity service provider (doctor and/or midwife) in the community.
• Intrapartum and early postnatal care is provided in a public hospital, by hospital midwives and doctors.
• Postnatal care may continue in the home or community by hospital midwives.
• Usually exists without a shared care agreement, so there is no agreed schedule of visits between providers and the private provider does not provide any care in hospital.

Private midwifery care

• Antenatal, intrapartum and postnatal care is provided by a privately practicing midwife or group of midwives in collaboration with doctors in the event of identified risk factors.
• Antenatal, intrapartum and postnatal care could be provided in a range of locations including the home.
• This category is used when the designated maternity carer is a privately practicing midwife but is not used if the model of care is shared care between a private midwife and a hospital as part of a formal arrangement.

Team midwifery care

• Antenatal, intrapartum and postnatal care is provided by a small team of rostered midwives in collaboration with doctors in the event of identified risk factors. 
• Intrapartum care is usually provided in the hospital or birth centre.
• Postnatal care may continue in the home or community by the team midwives.

Private obstetrician and privately practising midwife joint care

• Antenatal, intrapartum and postnatal care is provided by a privately practising obstetrician and midwife from the same collaborative private practice.
• Intrapartum care is usually provided in either a private or public hospital by the privately practising midwife and/or private obstetrician in collaboration with hospital midwifery staff.
• Postnatal care is provided in hospital and may continue in the home.