I am a midwife first.

Although my work now centres on digital transformation, I still assess technology through a clinical lens.

Would it help the midwife meeting a woman for the first time in the middle of the night? Would it make her current risks and agreed plan clearer? Would it help preserve her choices, concerns, and previous experiences? Or would it simply give that midwife another screen to navigate?

Those questions feel particularly important as colleagues from my team prepare to join midwives at the Australian College of Midwives National Conference on the Gold Coast. I will not be at ACM personally, but I am really interested to hear what comes out of their conversations with Australian midwives, particularly what is working well, where information gets in the way of care, and what midwives need from digital systems.

For me, that is where the most valuable conversations about digital maternity begin: not with the technology, but with what midwives and women need it to enable.

A picture of Maggie Reid

Digital Transformation Must Address Real-World Challenges

I will be in Australia in November and look forward to continuing these conversations. Australia’s maternity strategy is rooted in safety, respect, choice, and access, with women supported as active decision-makers in their care. This means having access to evidence-based information, continuity, and care close to home wherever possible.

Yet recent Australian evidence also describes the distance that can remain between policy and everyday experience.

Midwives are working within significant workforce pressures. The Australian College of Midwives has reported that one-third of midwives are considering leaving the profession. Women continue to describe difficulty accessing continuity, feeling unheard, receiving conflicting information, and having to repeat their stories across fragmented models of care (Pelak et al., 2023)

For me, digital transformation matters only if it helps us address that reality.

And we should be honest: not every digital change helps.

Technology Should Support Care, Not Create Burden

An Australian study found that midwives engaged with an integrated electronic medical record for a median of 46% of observed time, with individual observations ranging from 23% to 68% (Kearney et al., 2023). The researchers also identified continuing concerns about data completeness and software usability. Digitising a fragmented process can leave us with a fragmented process on a screen. The aim cannot simply be to remove paper. It must be to make care safer, more connected and more woman-centred while giving midwives more space for judgement, advocacy, and human connection.

Continuity of Information is Not Continuity of Carer

Midwifery continuity of carer remains what many women want, and many midwives strive to provide. However, data from the Australian Institute of Health and Welfare (AIHW) shows that access still varies significantly across jurisdictions and models of care (AIHW, 2025).

Technology cannot manufacture the trust that grows between a woman and a known midwife. But when the same midwife cannot be present, we should not accept that the woman’s story becomes fragmented too. Her current risks, preferences, previous birth experience, mental health needs, results, and agreed plans should be available to the people caring for her. Not as isolated documents or competing versions, but as a current and clinically meaningful story.

That matters in antenatal clinic.

It matters during transfer from a rural service.

It matters when a woman presents unexpectedly to the birth suite.

And it matters after birth, when physical recovery, emotional wellbeing and onward care can too easily become separated.

Respect, Choice and Psychological Safety

Australian women have described safety as more than a physical outcome. They want emotional and psychological safety, to be listened to and heard, and to be supported to make informed choices within respectful relationships with their maternity care providers (Medway et al., 2025). The New South Wales Birth Trauma Inquiry similarly identified lack of continuity, inadequate informed consent, workforce pressure, and women not feeling heard among the factors contributing to preventable trauma (NSW Legislative Council, 2024).

A digital record cannot create respect. But it can either support respectful practice or make it more difficult.

Does the record make the woman’s preferences visible? Can it show what was discussed, what questions she asked and what was agreed? Does a previous traumatic experience inform the current plan, or must she recount it to every new professional?

We should never use digital information to replace the conversation. We should use it to prevent women having to carry the whole burden of keeping the system informed.

Connected Information Matters When Distance is Part of Care

Australia’s geography brings challenges that colleagues in the UK cannot pretend to fully understand. Rural and remote communities want safe maternity care close to home, sustainable local services, culturally appropriate care, and access to continuity. Digital systems cannot replace a local maternity workforce or reopen a service. They can, however, help local midwives, specialist teams, and receiving services work from the same current information. They can support remote review, clearer escalation, and safer handover when transfer is required.

Technology Must Support Culturally Safe Care

Technology must follow culturally safe care, not define it. The same humility is essential when discussing Aboriginal and Torres Strait Islander maternity care. I cannot speak for First Nations women, families, midwives, or communities. Australian policy is clear that culturally safe maternity models should be developed in partnership with Aboriginal and Torres Strait Islander people and communities.

Technology should therefore support locally led models, community relationships, and appropriate information governance. It must not arrive with a pre-written definition of culturally safe care. Our responsibility is to listen, to understand what information sharing should enable or avoid, and to adapt accordingly.

A picture of a midwife team holding a baby.

Information Should Not Stop at Organisational Boundaries

In Wales, I have seen the completion of a national rollout of BadgerNet Maternity across all seven NHS Health Boards, enabling maternity information to be accessed across organisational boundaries and allowing women to view appointments and parts of their record digitally.

In New Zealand, Health New Zealand has combined national implementation of BadgerNet Maternity and Neonatal with the development of the BadgerNet Perinatal Spine. The Spine provides interoperability between hospital and community maternity systems, allowing information from different clinical records to be shared and viewed across care settings. The aim is to reduce duplication, minimise delays in accessing information and support a more complete shared maternity record.

Although each country has implemented this in a way that reflects its own health system, both examples share a common principle: information should not stop where an organisation, geography or software system ends.

My experience with BadgerNet has shown me how these principles can work across different maternity systems. But technology should never be the starting point. The starting point is the woman, the midwife, the maternity journey and the information needed to support safe decisions.

The Question That Matters Most

There is a great deal I want to understand better, particularly where information currently supports good maternity care, where it creates unnecessary burden, and what midwives practicing in Australia would want digital transformation to enable. I am looking forward to hearing what my colleagues learn from their conversations at ACM, and to continuing those conversations myself when I visit Australia in November.

Because however sophisticated technology becomes, I still return to the question I would ask as a midwife:

Does This Help Us Understand This Woman, Respect Her Choices, and Provide Safer, Better Care for Her and Her Baby?

If the answer is yes, digital transformation becomes more than changing how we document care. It becomes one of the ways we help good care remain connected.

Next Steps

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References

Australian Institute of Health and Welfare (AIHW). Australia’s Mothers and Babies: Maternity Models of Care. Canberra: AIHW; 2025.

Kearney, L., Craswell, A., Cole, R., Hadland, M., Smyth, W. and Nagle, C. (2023) Woman-centred care and integrated electronic medical records within Australian maternity settings: Point prevalence audit and observational study. Midwifery, 123, 103718. https://doi.org/10.1016/j.midw.2023.103718

Medway, P., Hutchinson, A.M. and Sweet, L. (2025) ‘Every woman deserves that’: A qualitative exploration of the impact of Australia’s national maternity strategy. Women and Birth, 38(2), 101871.

NSW Legislative Council. (2024). Birth Trauma Inquiry Report. Portfolio Committee No. 2 – Health, New South Wales Parliament.

Pelak H, Dahlen HG, Keedle H. A content analysis of women’s experiences of different models of maternity care: the Australian Birth Experience Study (BESt). BMC Pregnancy and Childbirth. 2023;23:864. DOI: 10.1186/s12884-023-06130-2.