Perth Birth Nerd

The Homebirth Series, Reason # 5: In planning a homebirth, I received the best maternity care available: Continuity of Care with a midwife.

When I started this blog, the topic at the top of my list to write about was the different types of maternity care providers. Having just finished up with care from my privately practicing midwife, I was totally in awe of the thorough clinical care I had received throughout pregnancy, birth and postpartum. I certainly had not experienced that for my first birth in hospital, even though I had stayed in for four nights. So I wrote two articles about this topic, an informative one, and one that described the details of my personal experiences. 

Continuity of Care with a Midwife: What’s all the hype?

At the beginning of my second pregnancy, homebirth was the goal, but having my care led by a midwife, the same midwife who would attend me during and after birth, was a non-negotiable.  And that is because, in the maternity care world, it has long been accepted that this type of care is the gold standard, resulting in the very best outcomes for mothers and babies across all settings, and for all risk levels. 

Continuity of Care with a midwife has been shown to:

• Be safer and more cost-effective, with women of all risk levels, compared to standard care (Tracey et al, 2013)
• Reduce the likelihood of Cesarean section, instrumental birth and episiotomy in low-risk women, compared with other models of care (Sandall et al, 2024). 
• Increase the likelihood of spontaneous vaginal birth in low-risk women (Sandall et al, 2024)
• Result in better outcomes for women planning a VBAC (vaginal birth after caesarean) (Keedle & Schmeid et al, 2020)
• Result in a more positive and satisfying birth experience (Sandall et al, 2024)
• Provide many more hours of direct, postnatal care for women. (Schmied et al, 2024). 

Further to that, one of the recommendations of the NSW Legislative Council’s Inquiry into Birth Trauma (2024) was that all women should have access to continuity of carer models in order to reduce instances of preventable birth trauma. 

To read more about women’s reported experiences in different models of care, check out this study from Pelak, Dahlen & Keedle (2023), which came out of the Birth Experiences Study. It gives an overview of the reported strengths and limitations of different models, including continuity of care with a midwife. 

It is a total mystery to me that this is common knowledge in the medical world, and yet women are not told about this by their GP’s when they fall pregnant. Someone needs to make a pamphlet, for heaven’s sake! 

Not just an option for homebirthers!

Now, you don’t have to give birth at home to access continuity with a midwife! You could go through MGP/CMP, which are publicly funded programs where women can give birth in hospitals or birth centers. You could go through organisations that are semi-funded, like Western Obstetrics here in Perth, and also choose hospital birth. You could even hire a Privately Practicing Midwife who has admitting rights at a hospital. 

I would encourage EVERYONE, no matter their situation, to consider midwifery care as an absolute baseline for their pregnancy and birth. I truly believe that, even in the case of complexity, having a midwife oversee your care, drawing on obstetricians and other clinicians as necessary, will result in a healthier mum and bub at the end than simply leaning on obstetric care. The benefits speak for themselves!

So, that’s my plug for model of care, but read on to learn more about my choice in birth location. 

See References

Keep Reading: Reason #6 Homebirth has much better outcomes for mothers. 

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