Importance of continuity of carer in labour and birth

Emotional support, reassurance, and reduced anxiety

Familiar presence during contractions, with a carer who understands personal cues and coping strategies

Consistent emotional support can help normalize fears, manage fatigue, and maintain motivation

Partners feel more engaged and confident when they recognize the same carer, facilitating shared decision-making under stress

Trust-building and relationship continuity

Ongoing relationship fosters trust, which can lower perceived pain, reduce sense of danger, and improve overall experience

A known carer can interpret non-verbal cues and subtle preferences, making care feel individualized

Reduced need to repeat histories or recount preferences with new team members

Enhanced communication and informed decision-making

Clear, consistent messages about care plans, options, risks, and benefits across all stages of labour

Carer acts as a reliable single point of contact for questions, preferences, consent, and updates

Partners can accurately relay information to family and support networks, decreasing miscommunication

Better communication around intervention thresholds, pain relief choices, and labour progression

Clinical benefits for the mother and baby

Increased likelihood of spontaneous, uncomplicated labour and vaginal birth when care is aligned with the mother’s history and preferences

Earlier recognition of deviations from expected labour patterns due to an ongoing relationship and familiarity with baseline

Timelier management of complications with an integrated understanding of the birth plan and prior medical conditions

Potential reduction in unnecessary interventions when the care plan is coherent and trusted

Improved monitoring of fetal well-being through consistent interpretation of findings over time

Better coordination of care and system efficiency

Streamlined handovers with a documented birth plan and preferences, reducing delays

Improved coordination between midwives, obstetricians, anaesthetists, and neonatal teams

Clear accountability lines, making it easier for women and partners to know whom to contact

Enhanced documentation practices that capture evolving preferences and clinical changes

Positive effects on the birth experience and autonomy

Greater sense of control and active participation in decision-making

Increased satisfaction with the birth experience when expectations are met by a familiar team

Reduced fear of being a passive patient; partners feel empowered to support choices aligned with values

Impact on the birth partner and family involvement

Partners understand the carer’s approach and rationale, which supports collaborative decision-making

Clear guidance on how to support the birthing person during each labour stage

Builds confidence in the care system, reducing anxiety about potential disempowerment or miscommunication

Continuity across the perinatal period and postnatal transition

Smoother transitions to postnatal care with a familiar clinician involved in both labour and early postnatal period

Early detection of maternal mood concerns, bonding challenges, and infant feeding issues through ongoing observation

Consistent discharge planning and follow-up recommendations tailored to the family’s context

Equity, access, and inclusivity considerations

Strategies to ensure continuity models reach diverse populations, including those with language barriers, precarious housing, or irregular schedules

Culturally respectful care that honors individual preferences and birth traditions

Flexible models (e.g., caseload midwifery, dedicated teams) designed to minimize wait times and geographic barriers

Models of continuity and implementation options

Dedicated midwife or midwifery caseload models: one named midwife or small team responsible for a group of women

Assigned obstetrician and midwife pair: consistent medical and midwifery oversight

Team-based continuity with stable, trained personnel sharing responsibilities and robust handover

Use of digital tools to maintain updated birth plans, preferences, and real-time communication with the family

Practical planning and birth planning integration

Early conversation about birth preferences, pain relief options, and contingency plans in the first trimester or early second trimester

Written birth plan accessible to all care providers, with updates as labour approaches

Clear handover protocols to preserve continuity when shifts change or staff are unavailable

On-call arrangements and 24/7 access to the same carer or predictable alternatives

Potential challenges and strategies to address them

Staffing constraints: implement small, stable teams or shared responsibilities to maintain continuity

Emergencies: maintain transparent handovers and explicit consent processes to preserve continuity wherever possible

Resource limitations: allocate priority to continuity models for high-risk pregnancies while offering feasible alternatives for low-risk cases

Patient expectations vs. feasibility: set realistic expectations early and document birth preferences clearly to avoid misunderstandings

Evidence and outcomes to consider

Improved maternal satisfaction, sense of control, and perceived quality of care

Potential reductions in instrumental births and cesarean rates in certain contexts

Better maternal-infant bonding and early detection of neonatal issues due to consistent observation

Communication and education for families

Provide clear, jargon-free explanations of what continuity means in practice and what to expect

Offer informational materials (leaflets, PDFs, or short videos) detailing the care model, contact points, and what happens if staff change

Encourage questions and values-based conversations to align care with family preferences.

If you are having independent midwife care you will have care provided by the same midwife all the way through your pregnancy. There will be personalised birth plans that your midwife will be fully aware of every nuance providing the care you really desire. She/he will be on call 24/7 from 37 weeks until babies birthday. If you are having a homebirth there will also be a second midwife on call for you too who you meet at 34-36 weeks, no strangers in your birth space.

By the time you get to your birth you will know your personalised midwife so well she'll be a friend. As a clients husband said to me today I am part of the family now.

If you like to discuss how we can work together click on the discovery call button or give me a call.