Caseload Midwifery: A family friendly way of working

Emma-jane Berridge talks about her journey into midwifery and how working as a caseload midwife gave her more time with family. ''As a full-time caseload midwife, however, I dropped my five-year-old to school every morning. I managed my own diary so that I saw my first client around 9.30, I was usually home for kids' teatime at 5.15, I was able to take my 10 year old to swimming three times a week, I put them both to bed every night, and sometimes I got a call in the evening or the early hours and went out to a home assessment and/or birth.''

Reflections: 3 Months as a Caseload Midwife

3 months into my new job as a caseload midwife and I wanted to share more about the practicalities of this way of working. I have looked back on my diary over the last 2 months to provide a detailed idea of how many appointments are done, how many on calls we have and importantly how many of those we are actually called out. This post is also a reflection of my learning points in terms of self care, things I have picked up on which I am sure are common themes for caseload midwives.

Starting Out As A Caseload Midwife

‘WELCOME HOME’... They were the words of a friend who understands my need to work in caseload midwifery in response to me sharing that I’d been to my 1st birth with my new team back in September. Those words sum it up perfectly because it so feels like home, where I can finally be the midwife I want to be!!! I thought after a month of being with Neighbourhood Midwives NHS team I would share a bit about my experience so far.

Discussion of Risk: How Continuity of Carer Impacts Womens Choices

It is a woman’s human right to make choices about her care (NMC, 2015, Birthrights, 2013) and women must be provided with the information they need to make an informed choice (NMC, 2009), including discussing risks and benefits of the options available to women, which is both the legal and professional responsibility of midwives and obstetricians (The Supreme Court, 2015). It is important to be aware that the way in which risk is discussed can exaggerate risks (Van Wagner, 2016) and that lack of adequate time and follow up when discussing risks with women during pregnancy can direct care towards interventions (Van Wagner, 2016). The provision of relational continuity can counteract this and is shown to improve outcomes for women with perceived risk factors (Sandall et al 2016).

A Caseload Midwife’s Experience Of Being On The Receiving End Of Continuity Of Carer

Chloe Mulholland - Midwife and Hypnobirthing Teacher tells us about her experience of pregnancy with the added insight of having also worked as a caseload midwife, so knowing how important this model of care is. She shares the anxieties she felt knowing this model of care wasn't offered at her local trust and then the impact that continuity had on her pregnancy and birth.

Why Continuity Matters: 1993 to 2017

The evidence for the benefits of continuity of care during pregnancy, birth and during the postnatal period, for both women and midwives is strong (Sandall 2014, Sandall et al 2016a, 2016b, Forster 2016) and repeatedly highlighted in government publications both nationally (Department of Health [DoH] 1993, 2007, 2010, NMR 2016) and internationally (WHO, 2016), it is recommended by both midwifery (RCM 2016) and obstetric trade unions (RCOG 2011), and is within the recommended guidelines for maternity care (NICE 2016, 2017a, 2017b) yet it is still not available in the large majority of the UK.