Getting to know your midwife can be beneficial for you and your baby. Here we explain the impact it can have and how you can improve your chances of knowing your midwife.
Having a midwife who you’ve got to know during your pregnancy with you during labour can have a positive effect on your birth experience and lead to fewer medical interventions.
Women who know their midwives before giving birth are less likely to use an epidural or have an episiotomy, according to the Cochrane Collaboration who reviewed 15 studies into midwife-led care in 2016. In a 2017 survey of 2,500 women, the NCT found that around two-thirds of the women who did know their midwife said that knowing their midwife allowed them to feel more relaxed, more confident, and safer.
Whether you will get to know your midwife will depend on what is available in your local area as well as where you give birth. If you’re having a hospital birth, booking with a hospital whose catchment area you live in can increase your chances of getting to know your midwife.
What does continuity of care mean?
When having a baby, continuity of care means that you get to see the same midwife or small group of midwives throughout your pregnancy and the same midwife is also with you during labour and birth. This gives you the chance to get to know each other and to develop a relationship. Being looked after by one midwife is often referred to as ‘caseload midwifery’ and if you see a small team of midwives this is usually called ‘team midwifery’.
In practice, if you’re told that you’ll be offered continuity of care this usually means that rather than being looked after by one midwife throughout pregnancy and birth, you’ll see one midwife during your pregnancy and a different one for the birth. In order to feel prepared for what will happen, ask your midwife if you can expect your antenatal midwife to be present at the birth.
Are there any medical benefits to knowing my midwife?
For women having a straightforward pregnancy at low or medium risk of complications, being looked after in labour by midwives they got to know during pregnancy was found to have a number of medical benefits in the Cochrane Collaboration’s review. The women were:
- less likely to have had an assisted birth, such as a forceps or ventouse birth, and no more likely to have had a caesarean
- less likely to have used an epidural for pain relief
- less likely to have had an episiotomy
- less likely to have lost their baby
- less likely to have given birth to a premature baby.
While the review didn’t find a simple explanation for why these benefits are associated with being looked after by midwives that you know, being looked after by midwives rather than doctors was found reduce the chances of using pain relief which we know can lead to fewer interventions. For example, epidurals can slow labour down which in turn can increase the need for medical interventions to help you give birth to your baby. Therefore, this might be one of the reasons why fewer interventions were experienced by these women who knew the midwives looking after them during pregnancy and birth.
Will I have a better birth experience if I know my midwife?
Women who see between one and four midwives during the antenatal period report a better quality of antenatal care than women who see five or more, according to a 2017 survey by the NCT .
In the survey, women were asked whether knowing the midwife who was with them during labour made a difference:
- Two thirds of women who already knew the midwife who looked after them when they gave birth said that it allowed them to feel relaxed, more confident and safer.
- 15 in 100 (15%) said it made no difference to them.
- 5 in 100 (5%) said that it made them feel worse.
However, many women reported that not knowing their midwife didn’t matter. Out of the women who were looked after by a midwife they didn’t know during labour, around half (52%) said that it made no difference. Many of the women who expressed indifference left feedback explaining that the professionalism and competence of the midwives more than made up for the lack of familiarity. NCT explained that working coherence and tools such as birth plans can help midwives to quickly build a sense of rapport with the women they are caring for.
Women were most likely to say that not knowing their midwife made them feel frustrated as they had to keep repeating themselves to staff (22%), 12% of women said it made them feel alone and vulnerable, and 6% said it made them feel unsafe.
Will I know my midwife?
Whether you know your midwife will depend on the system of care provided locally and also where you choose to have your baby. Don’t forget to use our Which? Birth Choice tool to see individual pages dedicated to your local units where you can find out how many midwives you are likely to see during your pregnancy.
The NHS policy is that every pregnant woman should have a ‘named midwife’ who can make sure that you get personalised, one-to-one care throughout your pregnancy, birth and postnatal period. However, this is not necessarily the same as seeing the same midwife at every appointment.
According to a 2018 survey by the Care Quality Commission (CQC), four in ten women see the same midwife for all their antenatal check-ups.
However, only 15% of the women who responded to the survey said that they had met the midwife who looked after them during the birth before they went into labour or gave birth.
After coming home with their new baby, just over a quarter of women saw the same midwife for all their postnatal appointments.
How can I improve my chances of getting to know my midwives?
Wherever you’re thinking of having your baby, it’s worth asking who will be providing your antenatal care during your pregnancy and whether you’ll have the opportunity to get to know them.
- If you have a choice of hospitals, you could be more likely to get continuity throughout if you plan to give birth at a hospital in your catchment area and whose community midwives cover your address. You can call the community midwives at your local hospitals to find out which areas they cover, or use our Birth Choice tool to see detailed information on your local units including their catchment areas.
- Planning to have a home birth also increases your chances of knowing the midwife who is there when you give birth, as the NCT survey showed.
- If you book with a non-NHS midwife, such as a private or independent midwife, you will usually be looked after by one or possibly two midwives who will deliver all your care. However, you will have to pay for this service. Read more about care from non-NHS midwives.
More from Which?
- Use our Birth Choice tool to help you find the right place for you to give birth.
- Find out what to expect with different birth environments – be that a labour ward, birth centre or at home.
- Find the best car seat to take your new baby home in with our reviews.
These are the sources of information used in this article:
Care Quality Commission, Maternity services survey 2018 (2018)
Plotkin, L, Support Overdue: Women’s experiences of maternity services, National Federation of Women’s Institutes/NCT: London (2017)
Sandall J, Soltani H, Gates S, Shennan A, Devane D, Midwife-led continuity models versus other models of care for childbearing women, Cochrane Database of Systematic Reviews 2016, Issue 4. DOI: 10.1002/14651858.CD004667.pub5