Reflective clinical supervision in midwifery continuity models: A cross-sectional survey of Australian midwives

Reflective clinical supervision is a strategy to support midwifery workforce sustainability, however little is known about supervision in continuity models, especially for midwives who care for First Nations women.

To explore and describe reflective clinical supervision in midwifery continuity models in Australia, including models accessed by First Nations women.

A national online cross-sectional survey through targeted social media platforms was conducted between June and October 2025. Data were collected via Qualtrics® using a study-specific survey informed by a prior scoping review, with 31 closed items (including Likert) and 4 open-ended questions. Quantitative data were analysed using descriptive statistics and open-ended responses were analysed using qualitative content analysis.

There were 155 respondents contributing survey data, with 136 (88%) completing the survey. In the last 10 years 36% (n = 53) received reflective clinical supervision, compared with (25%, n = 27) among those caring for First Nations women. Most respondents experienced < 10 supervision sessions (72%, n = 38), monthly (64%, n = 34), in a group (60%, n = 32), face-to-face (57%, n = 28) and at their workplace (63%, n = 31). Supervisors often had a midwifery background (42%, n = 21). Overall, respondents reported supervision positively impacted well-being, professional practice and teamwork. However, respondents perceived that the effectiveness of supervision was dependent on supervisor expertise alongside organisational support.

While survey respondents described meaningful benefits to their practice, access to reflective clinical supervision in midwifery continuity models is not widely implemented. It requires specific funding within maternity services for regular protected time, clear quality and access standards and formalised supervisor training.