ArticleBMC pregnancy and childbirth2025
What matters most to midwifery clients? Exploring continuity of care preferences through a cross-sectional survey in Ontario, Canada.
Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundContinuity of care in midwifery is associated with improved outcomes for childbearing people and newborns. Despite its integration into the Ontario midwifery model, there is limited understanding of how clients perceive and value different aspects of continuity. This study aimed to explore midwifery clients' definitions, experiences, and perceptions of continuity to identify priorities and opportunities for refining midwifery care.
methodsThis mixed-methods study was part of a larger project examining continuity. Data were collected through an online survey administered via REDCap, with midwifery clients who gave birth in Ontario on or after January 1, 2018. The survey included quantitative and qualitative questions, data were analyzed using descriptive statistics and thematic analysis.
resultsA total of 514 participants completed the survey. 93% had a known midwife at their birth, and most received care from a team of 2-3 midwives. Regardless of number of midwives met and whether or not a known midwife attended the birth, respondents were highly satisfied with their midwifery care, particularly valuing communication, choice and continuity of carer. Having a known midwife was important during home births, emergencies, and postpartum care. Participants highlighted the multi-factorial nature of continuity involving not only a relationship based approach, but coordinated care and seamless information transfer. Trust and emotional safety were significantly enhanced by genuine relationships with midwives. Consistent communication and documentation were crucial in reducing anxiety and ensuring preparedness.
conclusionContinuity of care is a foundational element of midwifery in Ontario, with clients highly valuing relational, management, and informational continuity. The study highlights the importance of trust, personalized care, and consistent communication in enhancing client satisfaction.
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