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Continuity of care while pregnant

This article discusses continuity of care in pregnancy and how one to one midwife led care and caseload midwifery can improve your safety and your personal experience.

Continuity of care in pregnancy is when a woman is supported by a midwife or a small team of midwives that she gets to know and with whom she is able to build a relationship of trust.

This relationship starts in early pregnancy and continues from the antenatal phase to the postnatal period until mum feels settled and confident with her new baby. This type of maternity care was the norm in the 1950s and has been depicted in the BBC’s Call The Midwife TV series.

Women are more likely to mention concerns to someone they trust and it is easier for midwives to spot a problem in someone they have come to know. Research shows that women who receive continuity of care during and after pregnancy are less likely to give birth prematurely and have fewer complications than those receiving standard care.

Improved maternity care with midwifery

Numerous studies have also shown that continuity of care does not cost any more than any other system, partly because of the savings made as a result of more straightforward births.

It also leads to higher levels of job satisfaction for midwives. This is significant as nearly a quarter of the workforce is thinking of getting a job in a different profession. According to the Royal College of Midwives, there are currently around 5,000 fewer midwives than there should be in the UK.

In addition, the roster system used in hospitals means that at times there aren’t enough on duty which results in midwife stress and poor support for parents. At other times there are more midwives than pregnant women.

Caseload midwifery for continuity of care

The best system is known as caseload midwifery, where a midwife cares for an agreed number of women throughout their pregnancies. This type of care gives women a much better chance of giving birth with a midwife they know and the outcomes, in terms of the number of straightforward births and satisfaction rates, are high.

Read more about the role of your midwife and antenatal care.

Page last updated: 3 July 2014

Further information

NCT's helpline offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 0300 330 0700.  We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.

The Nursing and Midwifery Council website gives more information about the role of the midwife as well as a leaflet called Raising concerns about a nurse or midwife, which explains how patients, carers and the public can raise a concern about a nurse or midwife.

You can also get an insight into what midwives do at the Royal College of Midwives website.

The organisation Independent Midwives UK represents the majority of independent midwives in the UK.  

NHS Choices gives a list of questions to ask your midwife or GP.