Why Continuity of Midwifery Care is the Best Start

Starting on the journey of becoming a parent is both exciting and, can be at times, overwhelming. We are often not told we have options in where we can birth and who can support us. As a birthing parent, understanding the options available to you is known to have an impact on your experience of pregnancy, birth and postpartum.

One model that stands out for its proven track record is continuity of midwifery care.

What Is Continuity of Midwifery Care?

When a woman or birthing parent is cared for by the same midwife, or a small team of midwives, throughout your pregnancy, birth, and the early weeks of motherhood. The care is based on building a relationship between mum and midwife, mutual trust, respect and the midwife has an understanding of the birthing parents wishes for birth and postpartum, history and where the midwife is culturally responsive, will facilitate cultural practices.

Hold up, hold up… this might seem basic but, what is a midwife?

Midwives have been attending and supporting births since the beginning of human existance. From traditional midwives or birth attendants with knowledge and experience education passed down, midwives, are highly-educated and trained professional who will:

1 in 3 women experience birth trauma - does the continuity of ccare model make a difference?

Yes, it is the most influential way to reduce birth trauma.. So let’s break it down… Think about what it would be like to see the same midwife throughout your whole pregnancy, when they support you during labour and birth and in the first 6 weeks of postpartum when you have your new tiny baby.

Now think about attending appointments and seeing a different midwife or doctor each time, when you go into hospital in labour and have your baby, that there are strangers in the birth suite and when you are in your most vulnerable state.

Which situation will make you feel at ease, confident, trusting, informed and supported?

Most of the time your midwife will support your choices. this however doesnt always happen. It is difficult if you have paid for a private midwife or have accessed the sought after public hospital Midwifery Group Practice.

Birth trauma is in the eye of the beholder. Research shows that more than 70% of the birth trauma is due to the “care” provided by the healthcare provider. Continuity of midwifery care plays a pivotal role in mitigating or preventing such trauma by:

  • Building Trust: A continuous relationship with your midwife allows for open communication, addressing fears and anxieties proactively.

  • Personalised Support: Understanding your history enables the midwife to tailor care, reducing the likelihood of traumatic experiences.

  • Advocacy: Your midwife can advocate for your preferences during labor, ensuring your voice is heard and respected.

In 2024, the NSW Health Minister acknowledged shortcomings in maternity care, emphasising the need for trauma-informed practices and improved continuity in care.

I want to be listened to and respected, will continuity of midwifery care guarantee that?

The Birth Trauma Inquiry exposed the widespread and unacceptable disrespect in maternity care. Women going through the fragmented hospital system are more likely to experience this. Women in MGP are less likely but it doesn’t mean it wont happen. Informed consent is fundamental in healthcare, ensuring you understand and agree to the proposed interventions. Continuity of midwifery care enhances this by:

  • Education: Your midwife provides information, helping you make informed decisions about your care.

  • Empowerment: With a trusted midwife, you feel more confident to ask questions and express concerns and share your history, fears and hopes

  • Respecting Choices: A consistent midwife you have built a relationship with is more likely to understands and respects your birth plan and preferences.

Fast Facts:

  1. Reduced Interventions: Women under continuity of midwifery care are less likely to require inductions, epidurals or medically assisted births.

  2. Happier and more satisfied: Mothers report greater satisfaction with their birth experiences.

  3. Enhanced Breastfeeding Rates: Mothers are more likely to initiate and sustain breastfeeding.

  4. Improved Mental Health: Continuous support is linked to lower rates of postnatal depression.

  5. Cost-Effective: This model can lead to fewer medical interventions and shorter hospital stays, reducing costs to the healthcare system.

Top Outcomes for Mothers and Babies:

  1. Higher rates of vaginal births: Higher likelihood of spontaneous vaginal births.

  2. Reduced preterm births: Lower rates of babies born before 37 weeks.

  3. Fewer NICU admissions: Decreased need for neonatal intensive care.

  4. Lower Cesarean rates: Reduced necessity for surgical births.

  5. Better maternal mental health: Lower incidence of postnatal depression and anxiety

  6. Higher breastfeeding rates: Increased rates of mothers starting and continuing breastfeeding.

  7. Greater maternal satisfaction: Mothers feel more empowered intheir birth experiences

what kind of contnuity of midwifery care models out there?

Here is a list of models, however different regions and states will call continuity of midwifery care different things:

  • Homebirth with a Privately Practicing midwife

  • Midwifery Group Practice (MGP) through the public maternity system

  • Publicly funded homebirth

    IMPORTANT: We have NOT included MAPS (Maternity Antenatal and Postnatal Service) in this list because it is not continuous care. You midwife in pregnancy and postpartum may not be rostered on when you give birth therefore the continuity is broken.