Abstract
Problem
Continuity of carer models present positives and challenges for midwives working in
them, and are difficult to sustain.
Background
Research shows midwifery continuity of carer improves perinatal outcomes and experiences,
and is considered the optimal model of care.
Aim
To synthesise existing research on midwives’ experiences of providing continuity of
carer and generate further understanding of what sustains them in practice.
Methods
Protocol for the review was developed using PRISMA guidelines and registered with
PROSPERO. 22 studies were included with original themes and findings extracted using
JBI tools and synthesised using meta-ethnographic techniques. GRADE CERQual assessment
of review findings showed high confidence.
Findings
Midwives identified working in continuity of carer models as both fulfilling and challenging.
Professional autonomy and ability to develop meaningful relationships were the most
commonly cited positives, while lack of work life balance and conflict with the wider
maternity team were the main challenges. 15 studies identified strategies employed
by midwives which sustained them in practice.
Discussion
Midwife experiences of providing continuity are impacted by personal and professional
factors. Of paramount importance to sustainability of the model is the support of
the wider organisation, and their alignment with principles of person-centred, relational
care.
Conclusion
Relational models of care are desired by midwives, service users and are recommended
in policy. Relational models of care must be responsive to midwives needs as well
as birthing people, and therefore need to be designed and managed by those working
in them and supported by the whole organisation to be sustainable.
Keywords
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Article info
Publication history
Published online: July 09, 2021
Accepted:
June 21,
2021
Received in revised form:
June 21,
2021
Received:
April 8,
2021
Footnotes
☆The authors present a qualitative systematic review of midwife experiences of providing. The review synthesises previously published research on experiential perspectives of midwives providing continuity of carer and the strategies which sustain them in this model. The subject of this review has not been previously addressed and so provides new and pertinent knowledge for the design and implementation of midwife continuity of carer models, staff retention and sustainability in maternity services. This review was completed by Charlotte Pace with co-authors at Robert Gordon University. Research data including data extraction tables are available on request.
Identification
Copyright
© 2021 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
