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When I read a new book, it is with a mixture of curiosity, anticipation, and hopefulness and ultimately with the questions:

As I began to read the ‘Preface’ I was drawn in to a world of midwifery that resonates with midwives’ like me around the world. This book makes the case that midwives must create an optimal relationship and environment where women feel strong and empowered: only then will women believe in their unique abilities to undertake the transitional journey of Motherhood.¹

The first two chapters discuss the context for Midwifery Continuity of Care. In these chapters the research evidence to support models of midwifery continuity are presented in terms of the foundations, rationale, principles of sustainability and outcomes for women. The implications of providing midwifery continuity models are considered from the perspective of both the women and the midwives.

In the following chapters the authors, using their collective national and international experiences, walk the reader through the intricacies of mapping, planning, implementing and evaluating midwifery continuity models in practice. Numerous strategies and tools are offered such as: gaining managerial and medical support; recruitment and up skilling of suitable midwives; remunerations and working conditions; multi-disciplinary collaboration; structure and infrastructure; politics, policies and the press.

In the Western World, the majority of midwifery care occurs in a medicalised environment. Constructive experiences and challenges are highlighted within real life summaries and vignettes from medicalised maternity units. This is highlighted in Chapter 6: Planning and implementing mainstream midwifery group practices in a tertiary setting. This chapter shows that although it took 9 years from conception to implementation, Midwifery Continuity of Care was successfully put in to practice. The constraints of compressing 9 years work in to 19 pages, regrettably limits greater exploration of the stakeholders lived experience which I would have found very useful.

Chapter 7 considers issues of safety and quality, governance within an Australian, UK and New Zealand setting. Chapter 9 explores the challenges of evaluating this model of care. Political and social implications and ramifications are discussed in Chapter 11. The final chapter challenges midwives to re-think the major way in which midwifery care is provided today, reconceptualising maternity care for the future.

The ethos of this book clearly reflects what I, like many other midwives believe midwifery is or should strive to be. The continuity of care model expounded within this book demonstrates how this can be achieved. National and international diversity of midwifery practice settings, the type of women who access it and their individual experiences are acknowledged. Working and sustaining Midwifery Continuity of Care is brought to life through multiple vignettes demonstrating the lived experiences of midwives and managers. The book provides practical guidance on how to plan, implement and evaluate Midwifery Continuity of Care. At times it is repetitive, but as Homer, Brodie and Leap note “diversity of interpretation is useful especially as we all learn and understand concepts in different ways” (pxviii).

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Reference 

1. International confederation of midwives 2005 definition of a midwife. ICM Council Meeting 19 July Brisbane Australia. Online http://www.international midwives.org.
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