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Evidence tells us that continuity of care from a qualified midwife is best practice for the healthy majority of women
Systematic reviews comparing midwifery continuity of care models with standard maternity services from all Australian trials shows that continuity of midwifery care is associated with lower intervention rates and are as safe as the existing standard services.
As technical advances in maternity care have become more complex, care is increasingly controlled by, if not carried out by, specialist obstetricians. Current research confirms this trend should be seriously challenged.
The continuity of carer model of care has been proven to reduce the use of obstetric interventions in labour and birth, including the need for pharmacological pain relief, inductions, augmentations, instrumental deliveries, episiotomies and caesarean sections. Women are also more likely to feel well prepared for labour, feel in control during labour and feel well prepared for childcare.
The effectiveness of midwifery continuity of care largely stems from the relationship of mutual trust built up between a midwife and a woman during the antenatal period. The establishment of this relationship, typically developed through extensive contact in the antenatal period, enables the midwife to provide care in a way that meets the individual woman’s emotional, psychological, cultural and physical needs, as well as her medical needs.
This model of care has also been found to produce better outcomes for both mothers and babies, and to assist in mother/baby attachment or bonding. Further, it has been shown that one-to-one midwifery care is beneficial beyond the birth, assisting in the establishment of long-term breastfeeding and reducing postnatal depression rates.
Such are the demonstrated benefits of one-to-one continuous midwifery care to birthing women and their babies that Chalmers et al* conclude that "it is inherently unwise, and perhaps unsafe, for women with normal pregnancies to be cared for by obstetric specialists, even if the required personnel are available".
*Chalmers I, Enkin M, Kierse M 1996 eds Effective Care in Pregnancy and Childbirth , Oxford University Press, Oxford p.15-16
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