Midwives as the primary providers of maternity care for women during pregnancy, labour, birth and postpartum period provide significant support for women and their families/whanau. An understanding of the dynamics which influence the sustainability of LMC practice is important to providers, as well as women and their families/whanau, for the long term provision of LMC care in New Zealand. A strong sustainable midwifery workforce is central to the long term wellbeing of mothers and their babies and their families/whanau.

In 2008 I completed a research dissertation 'The experience of midwives leaving Lead Maternity Carer (LMC) practice’ to fulfill the requirements of a Masters of Health Science at Auckland University of Technology. The findings were informed by the narratives of three midwives and their experiences of leaving their Lead Maternity Carer (LMC) practices.

The themes developed from the LMCs’ experiences recognise the degree to which the autonomy of LMC practice, of taking responsibility and being accountable, sustained the LMCs. Over time the lack of responsibility and accountability shown towards them and their clients in their professional relationships undermined the sustainability of their practices.

The implications of findings identify the lack of professional support available to LMCs. The Midwife First Year in Practice programme provides invaluable support for new graduates. Professional supervision, where it is available, provides excellent support however cost could be a factor for midwives. An on-line support for LMCs, similar to the NZCOM Resolutions Committee for consumers, and education in undergraduate programmes are two recommendations.