A Continuing Labour of Love

A Continuing Labour of Love
Caroline Flint describes her pilot for a scheme where three midwives cooperate in providing continuity of care for their patients - who would benefit from knowing the midwives who gave antenatal care and deliver the baby. The scheme would also improve the midwives' job satisfaction
Continuity of care is something we pay lip service to as being `a good thing', something our patients desire very much', something only community midwives can achieve nowadays - but I believe continuity of care is far more important than we have so far realized.
With the use of ever more sophisticated monitoring of both the pregnant and the labouring woman in an attempt to lower the perinatal mortality rate, I think we may have lost sight of the most simple fact of all - that the same hand on the same abdomen every month (and then every week) picks up discrepancies which the usual medley of people who examine a pregnant woman easily miss.
We know the perinatal mortality rate rises with women who default from antenatal clinic attendance. One of the bonuses of continuity of care is that very few women miss an appointment; in my experience, if a woman does miss an appointment, she will turn up the following day or in a couple of days.
Why don't women miss antenatal visits when they are seeing a continuous person? Why do women want continuity of care? When they have it, why do they love it so? My proposition is that in this situation the continuous person (that is, the midwife) can get to know each woman as an individual.
When the patient comes into the room, she can be addressed by name, her worries or joys of the previous visit can be remembered. `Hello, Joan, how did your move go?' or: `Hello, Rachel, did your boyfriend get the job?' is a very different approach from: `In here please, mother, and onto the scales.' Women appreciate being treated as individuals and respond with regular attendance.