What attributes do Australian midwifery leaders identify as essential to effectively manage a Midwifery Group Practice?

Background: Despite well-known benefits of continuity of midwifery care, less than 10% of women have access to this model of care in Australia. Staff retention and satisfaction are strongly related to the quality of management; however, little is known about the attributes required to effectively manage a midwifery group practice. Purpose: To explore the attributes midwifery group practice managers require to be effective managers and how these attributes can be developed to promote service sustainability. Methods: A qualitative interpretive approach, employing in-depth interviews with eight midwifery leaders was undertaken and analysed using thematic analysis. Results: The overarching theme described the ideal midwifery group practice manager as someone who stands up for midwives and women and is 'Holding the ground for midwifery, for women'. Subthemes demonstrate midwifery group practice management is complex: 'having it', describes the intrinsic traits of an effective leader; 'someone with their hand on the steering wheel' illustrates the day to day job of being a manager and the role of 'juggling the forces' that surround group practice; 'helping managers to manage better' explored the need for managers to be educated and supported for the role. Conclusions: Managers require certain attributes to effectively manage these unique services, whilst also juggling the needs of the organisation as a whole. Having transformational leadership qualities with vision to lead the practice into the future are key. There needs to be better support and preparation for the role if midwifery group practice is to be a sustainable option for women and midwives.