Getting it right from the start: implementing Midwifery Continuity of Carer

By Lia Brigante & Mary Ross-Davie on 30 September 2020 Maternity Services Student midwives

The principles behind midwifery continuity of carer (MCoC) are difficult to argue with: but principles aren’t practicalities. So while, for some, MCoC is already the norm, for others, it still creates anxiety and uncertainty.  

We get it. Change can be challenging, particularly when it’s going on at the same time as you’re trying to deliver a service – and when we’re in the middle of a pandemic. How many of us have said we wouldn’t start from here when looking at reshaping services? Clearly we can’t develop an entirely new system from scratch, but transforming fragmented models of care into small teams of midwives centred around women – rather than the other way round - brings a lot of complexity and raises many questions.

Developing maternity services based on continuity of carer models is supported by the evidence and a strong policy drive across the UK. In the last few years there have been successful implementation efforts in some areas, while other areas are at a much earlier stage. Engaging with the maternity team is vital to implementation working – and it pays to future proof the model from the outset.

Today’s midwifery students are tomorrow’s midwives. They will be staffing our services in the future, their experience of MCoC will shape their education, midwifery skills and philosophy, influencing the kind of midwives they aspire to be.

We have addressed how to embed MCoC in clinical placements and how to support both students and midwives mentoring them in our brand-new publication What if I am a student midwife working in a continuity team. This publication, the latest of the MCoC…What if? series offers information on how students might be best supported within continuity models and insight into the existing evidence base underpinning the experiences of students in such models. It also focuses on how midwifery educators, managers and midwives can best support students in their journey to becoming confident and competent midwives. And to ensure its relevance to these audiences, it was developed with the support of Rachael Dewey, a student midwife and current chair of our Student Midwife Forum, and Sarah Coiffait, a practice development midwife.

Of course, it’s not only students who need to understand the implications and application of MCoC. Pretty much wherever we practice in the UK, some form of MCoC is being introduced. To support you, we have produced a brand new i-learn module focusing on how to plan and implement MCoC models. This new module is aimed at all those midwives, managers and workplace reps grappling with staff engagement, caseload size and how to support flexible working.

Implementation strategies applied to MCoC are also explored and this chapter will hopefully provide a useful guide for developing their services. It is so important to consider the long-term sustainability of MCoC when approaching its implementation. This module will give you the tools and knowledge necessary to co-design a MCoC model that works in your area, based on the local context and needs.

And that’s the key point: a MCoC model that works in your area, based on the local context and needs. You have an opportunity to shape future services that work for the women in your care. It may be anxiety-inducing, but it’s a great opportunity too.


Download a copy of What if...I am a student midwife in a Midwifery Continuity of Carer team?