It’s been over a year and a half since I’ve written on the blog, or even written at all, because 2019-2020 felt like a very sad year with so many losses for midwifery (the closure of Neighbourhood Midwives & One to One Midwives & the loss of My Midwife & Me indemnity insurance for Independent … Continue reading Continuity Matters & So Do You
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.''
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.
Ali qualified as a midwife in the US, where she had her first baby and experienced receiving and providing continuity of care, before moving to the UK where she had her 2nd baby and is now retraining as a midwife.
This is a plea for those who have successfully implemented continuity of carer to get in touch. We have all the literature, government and health policy and union support to start continuity, but how exactly can we start something ourselves? I think inspiration would be helpful from those who have done this already to help others see how achievable it is.
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).