Continuity of care in maternity services: women's views of one team midwifery scheme.
OBJECTIVE
To describe the views of women using one team midwifery scheme and compare them with women using more traditional models of midwifery care.


METHODS
Postal and interview survey of 1482 consecutive women delivering over a six-month period.


METHODS
Hospital and community in the South-East of England.


METHODS
Three groups of women were surveyed: (1) the Study Group consisted of women who delivered either at Hospital A or at home, and who received their antenatal, intrapartum and postnatal care from one of seven midwifery teams; (2) Comparison Group A consisted of women who received their antenatal and postnatal care from traditionally organised community midwives who were delivered by hospital midwives at Hospital A; and (3) Comparison Group B consisted of women who received their antenatal and postnatal care from traditionally organised community midwives who were delivered by hospital midwives at Hospital B.


METHODS
Postal questionnaires and interviews, and an audit of midwife contacts.


METHODS
Process of care and satisfaction with care.


RESULTS
88% of women responded. Women cared for under the team scheme exhibited no overall advantages in terms of satisfaction with various aspects of their care. Women cared for under the traditional model of care were the most satisfied with antenatal care. They had reported the highest percentage of named midwives, the highest continuity of carer antenatally and were the most likely to say that they had formed a relationship with their midwives. The majority of women who had met their delivering midwives previously did report that it made them feel more at ease, however, the majority of those who had not met their delivering midwives previously reported that it did not affect them one way or the other.


CONCLUSIONS
In the team scheme, attempts to increase continuity of carer throughout pregnancy, labour and the postnatal period appear to have occurred at the expense of continuity in the ante- and postnatal periods. From the women's perspective the findings of this study support the view that the smaller the size of midwifery teams the better. The current focus on continuity throughout pregnancy and childbirth and the postnatal period may be misguided, if it is provided at the expense of continuity of carer in pregnancy and the postnatal period.
Farquhar
M
M
Health Services Research Group, Department of Community Medicine, Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 2SR, UK.
Camilleri-Ferrante
C
C
Todd
C
C
D000293:Adolescent; D000328:Adult; D003266:Continuity of Patient Care / Q000458:organization & administration* / Q000592:standards; D003625:Data Collection; D004739:England; D005260:Female; D006801:Humans; D008430:Maternal-Child Health Centers / Q000458:organization & administration* / Q000592:standards; D008880:Midwifery / Q000458:organization & administration* / Q000592:standards; D010351:Patient Discharge; D017060:Patient Satisfaction; D011247:Pregnancy; D011295:Prenatal Care / Q000458:organization & administration* / Q000592:standards