A Brief History of Midwifery and Continuity of Care

Women have been supporting other women during birth for millennia. The history of midwifery is an interesting and complicated one. Before midwifery became a regulated profession in the UK in the early 1900s, most midwives could be considered to have been ‘independent’ – that is they were self-employed, and women sought their services to assist at births and during the postnatal period. Most births occurred in the home. Birth in the UK began to shift to the hospital for more women in the late 1940s, and by the 1970s it was recommended that all women birth in the hospital. It is important to note that this was not based on scientific evidence, rather a belief that birth in hospital must be safer for all women – more recent evidence has disputed this belief. As a result of this shift, maternity care became centralised and fragmented, with care provided in hospitals and clinics rather than in women’s homes.

Most women and birthing people today are not cared for by the same midwife throughout their pregnancy or for their birth. Julia Allinson wrote a great book documenting midwifery from the Tudors to the 21st Century – a must read for anyone interested in the history of midwifery.

What Is Continuity of Care in Midwifery?

Central to independent midwifery, is the continuity of care model, whereby women see the same midwife throughout their pregnancy and birth journey and during the postnatal period. Continuity of care is a key component of good quality midwifery care. It has been shown to result in better, or at least as good, outcomes for women and babies and in higher levels of satisfaction with care amongst women.

What Are the Benefits of Continuity of Care for Women and Babies?

Research has found several benefits of the continuity of care model for ‘low-risk’ women including: 

• more likely to have a spontaneous vaginal birth
• women were less likely to need regional anaesthesia (i.e. an epidural)
• fewer instrumental assisted vaginal births
• higher satisfaction with birth experience

In addition, research has shown than for women at ‘low’ or ‘mixed risk’ of complications continuity of care, when compared to other models of care, is associated with the following:

• lower rates of preterm birth
• lower rates of losing a baby before or after 24 weeks
• lower rates of neonatal death

Does Continuity of Care Benefit Midwives Too?

Continuity of care models have also been found to be beneficial to midwives, with one research study finding that midwives providing fragmented, shift-based care are at greater risk of psychological distress. Continuity of care models allow midwives to develop meaningful relationships with the women in their care, relationships that are based on trust and mutual respect. Our own personal experience of providing continuity of care has been a joyful one, we leaving appointments feeling satisfied that we have provided excellent care and information and have received extremely positive feedback from our clients.

How Does Continuity of Care Work With an Independent Midwife?

In the context of independent midwifery, continuity of care means that you see the same midwife (and hopefully meet her ‘buddy’ midwife at some point) for all your care. Appointments are not restricted to NHS time frames (which typically only allow 20 minutes for an appointment) and can take place in your own home at a time that suits you, your family, and your midwife. Because your midwife doesn’t have to see multiple other women and birthing people that day, they have the time to give you their undivided attention – to answer your questions, discuss your plans and any fears, do a holistic well-being assessment and more!

Experience True Continuity of Care With an Independent Midwife in Kent

Our care packages include continuity of care as standard – it works for us and it works for our clients and their families. If you’d like to experience the benefits of true continuity of care, get in touch today to arrange your free, no string attached initial consultation.