Background: In 2023 our service introduced “OMGP”, a collaborative, woman-centred obstetric-medicine midwifery group practice model of care for women with complex medical care needs.
Aim: This study evaluated the OMGP model for pregnant women with Type 1 and Type 2 diabetes by comparing maternal/neonatal outcomes and women’s experiences with traditional care at a major Queensland hospital. We also qualitatively explored knowledge and expectations of staff prior to its adoption and at a year post-implementation.
Methods: A mixed-methods pre/post design compared traditional care (n56, Mar-Aug 2023) with OMGP (n38, Sep 2023-Feb 2024). Profession-specific focus groups were undertaken with staff at baseline and 12 months post-implementation. Questions focused on understanding of and thoughts about the OMGP model of care, as well as important considerations for managing diabetes in pregnancy. Qualitative responses were thematically analysed.
Findings: The OMGP group experienced a significantly higher mean gestational age at delivery (37.4vs36.0 weeks, p=0.007) and antenatal expressing rate (76.3%vs33.9%, p=0.04). Women in OMGP also reported more positive postnatal home care experiences (p<0.001). At baseline, themes related positive regard for continuity of care, expected benefits from interprofessional collaboration, and diabetes in pregnancy considerations. Initial expectations were broadly positive, but with caution regarding role clarity and adaption to change. A year following implementation, themes identified included: benefits from coordinated care, reflections and realisations, and embedding and strengthening.
Conclusion: OMGP was associated with improved staff and women’s experiences and outcomes. Integrating specialist medical support with continuity of midwifery care enhances the perinatal journey for women with diabetes.