More mothers-to-be than ever before are receiving continuous support both during and after their pregnancy from the same midwives, thanks to the expansion of a scheme from Stockport NHS Foundation Trust’s maternity department.

The ‘continuity of carer’ scheme ensures an expectant mother receives the support of a principle named midwife who together with a ‘buddy’ works within a dedicated small team & coordinates care throughout their pregnancy birth and in the postnatal period.  This encourages the development of relationships both during and after the period of pregnancy. By February 2021, 43% of local pregnant mothers were either receiving or were on a plan to receive continuity of carers, achieving well above the national target of 35%.

The new scheme to provide safer and more personalised care to women in Stockport   was first promoted nationally in 2018 following the publication of the Better Births national review of 2016.

The project works on the basis that for expectant mothers, becoming comfortable with a midwife and building a relationship with them which grows over time, enables greater trust to develop.  Mothers are then more likely to start to share their deeper anxieties and insecurities, as well as enjoying the more positive aspects of growing knowledge and confidence through their journey of pregnancy.

Results from the review showed that mothers got a consistently better experience from continuity of carers. They were 16% less likely to lose their baby, 19% less likely to lose their baby before 24 weeks, and 24% less likely to experience pre-term birth. The supported approach also produced better outcomes for mothers from Black, Asian and Minority Ethnic or deprived communities, who have traditionally had poorer outcomes in pregnancy.

Continuity of carer continues to be rolled out in trusts including Stockport NHS Foundation Trust.  During the COVID-19 pandemic progress was delayed.  However despite the pressures of the pandemic the maternity department and community teams remained committed to the implementation of continuity to improve the overall care they provide.

There are currently five teams based within the community.  This includes an enhanced team which focuses on vulnerability and those families requiring additional help and support during pregnancy. The midwives within the team have relatively smaller caseloads to ensure they have the capacity to coordinate early help working with additional support.  All community teams provide women with options for birth including home birth.  The new structure and the COVID-19 pandemic has seen a rise in women choosing to birth at home, and being attended by a midwife from their assigned team and who they know. 

One of the mothers to be to benefit from the scheme was Sarah Rock, 30 from Heaton Norris, who gave birth to baby Toby in January this year. Sarah had her birth at home with the support of her named midwife Danielle Kennedy and the carer team. When she found out she was expecting in April 2020 she thought the pandemic would have passed by the time she gave birth, but this was not to be.

Sarah said “At first, I was upset to learn I’d have to attend antenatal appointments alone but my amazing midwife Danielle, who became like my guardian angel, made me feel so comfortable and well informed that I was confident attending alone. We decided early on that a home birth was the right choice for us - as a first time mum, I was apprehensive, but Danielle was so supportive and encouraging from the start. We eventually welcomed our little boy into the world at home in January - I achieved the water birth I wanted and did not require a transfer - it was the birth I had dreamed of! The community midwives that attended my birth were outstanding - they all took the time to understand my birth preferences, were incredibly supportive, patient and kind - I could not have felt in safer hands. The care I received postnatally continued to be great - I was provided with extra breastfeeding support and knew I could contact my midwife at any time during those first few weeks of the unknown.”

Midwife Danielle Kennedy said “Continuity of care has amazing health benefits for mums and babies, but it also has great outcomes for us as midwives too; it’s wonderful experience emotionally. You are involved right from the first booking, up to the birth of the baby and then with their postnatal care too. I like to call it becoming a ‘professional friend’, giving mums like Sarah all the support they need throughout this time. It’s a great experience helping to give babies the best possible start in life in this way.”

For more on Sarah`s experience and Danielle`s support, see the short film below.