Continuity of carer: what matters to women? A review of the evidence

Women׳s views about maternity care: How do women conceptualise the process of continuity?

“…Women in our study highlighted the importance of relational and informational continuity, previously identified by others (Baker et al, 2007;Freeman & Hjortdahl, 1997;Green et al, 2000;Haggerty et al, 2003;Hatem et al, 2008), but also the importance of continuity across pregnancies and across location, reflecting not only relational aspects but also systems of management continuity.…”

“…Primiparous women were more likely to identify the importance of relationship during pregnancy (Dahlen et al, 2008); multiparous women emphasised the importance of these relationships continuing across pregnancies, particularly for women with a complex pregnancy history (Fleming et al, 2011). A woman's desire for continuity across pregnancies is a likely extension of wanting relational aspects and systems of care continuity including good communication within the system, health providers and consistent policies (Green et al, 2000;Haggerty et al, 2003;Lees G, 1997). Rural women were more likely to report a desire for continuity of staff than urban women which may reflect the experiences and perceptions of limited choice regarding place of delivery in rural settings (Kornelsen & Grzybowski, 2006).…”

“…It is seen as a mechanism for overcoming fragmentation (Green et al, 2000), inconsistency (Brown & Lumley, 1994), long waiting times (Green et al, 2000) and insensitive caregivers (Garcia et al, 1998). In Australia, current maternity care policy is grounded in a commitment to woman-centred care and a philosophy aimed at "ensuring that a woman knows her maternity care provider/s and receives care from the same provider, or small group of providers, who are responsible for providing the care that is appropriate, safe and effective, based on her identified needs and individual circumstances" (NSW Health Primary Health and Community Partnerships, 2010).…”

The motivation and capacity to go ‘above and beyond’: Qualitative analysis of free-text survey responses in the M@NGO randomised controlled trial of caseload midwifery

“…Women do not value continuity of carer for its own sake; quality of care is just as important (Green et al, 2000). Fragmented midwifery often sacrifices the relationship element of care (Fahy and Parratt, 2006) for a technocratic approach developed to enhance throughput and reduce system errors whilst treating all births in a standardised way and normalising intervention (Romano and Lothian, 2008).…”

Factors associated with changes into public or private maternity care for a second pregnancy

“…providing antenatal, intrapartum and postpartum care 14,15 and this may have influenced choice of subsequent care. Having a single care provider throughout pregnancy, childbirth and the postpartum period is a key feature of private care.…”