Why continuity of care matters: it’s not a luxury, it’s the foundation

Something has been rattling around my brain lately, and I honestly can’t shake it.

Think about this for a minute.

How many of us will only let one person cut our hair? We book the same hairdresser every single time because they know our hair. They remember what we talked about at our last appointment. They understand what we want without us having to explain it all over again.

We take our pets to the same vet because we trust them, because they know Fido’s history, because the relationship matters when our furry family member is unwell or anxious.

We use the same mechanic, the same accountant, the same family-run businesses because that personal connection and continuity makes us feel safe, valued, understood.

We actively SEEK OUT continuity in so many areas of our lives. We recognise its value instinctively.

So why on earth do so many maternity care models act like it doesn’t matter when you’re growing and birthing a human being?

Why is seeing a different midwife at every appointment considered completely normal? Why do strangers walk into labour rooms to support one of the most intimate, transformative moments of your life? Why isn’t building a relationship with the person caring for you through pregnancy, birth, and the postnatal period seen as absolutely essential?

It genuinely blows my mind.

Because here’s what I know after sixteen years of midwifery: continuity isn’t a luxury add-on. It’s the absolute foundation of good care.

What continuity actually means

When I talk about continuity of care, I mean having the same midwife (or small team of midwives) supporting you throughout your entire journey from early pregnancy, through labour and birth, and into the postnatal period.

It means when you have an antenatal appointment at 28 weeks, it’s the same person who saw you at your booking appointment, who knows your medical history, who remembers that you mentioned feeling anxious about birth, who knows your partner’s name and asks how they’re doing.

It means when you ring with a concern at 35 weeks, you’re speaking to someone who already knows you, your pregnancy, and your circumstances. You’re not explaining everything from scratch to a stranger.

It means when you go into labour, the person walking through your door is someone you’ve built a relationship with over months. Someone who knows your hopes, your fears, your birth preferences. Someone you trust.

And it means in those vulnerable early postnatal weeks, when you’re exhausted and learning to feed your baby and wondering if you’re doing anything right, you have someone who knows you checking in, someone you feel comfortable asking the “silly” questions to, someone who can spot when something’s not quite right because they know what’s normal for you.

Why continuity builds better care

I recently shared a poll on Instagram asking whether knowing your midwife mattered. The results were striking: 80% said “absolutely,” and 20% said “a million percent.” Not one single person said they’d never thought about it before.

People know this matters. They feel it instinctively.

Trust takes time

You can’t build genuine trust in a 10-minute appointment with someone you’ve never met before. Trust is built through repeated interactions, through consistency, through someone showing up for you again and again.

When you trust your midwife, you’re more likely to share your real concerns, not just the “acceptable” ones. You’ll mention the anxiety that keeps you awake at night. You’ll talk about the relationship tension. You’ll ask the questions you worry might sound stupid.

And that’s when I can actually support you properly, because I’m seeing the whole picture, not just the clinical snapshot.

I can spot when something’s not quite right

When I’ve been seeing you throughout your pregnancy, I know your baseline. I know what’s normal for you.

So when you seem quieter than usual, or your blood pressure is slightly higher than it’s been tracking, or you mention something in passing that doesn’t quite fit with what I know about your circumstances, I notice.

That’s when I can ask the follow-up questions, dig a bit deeper, offer support before things become urgent. Continuity gives me context. And context is everything in maternity care.

Your story matters

Every pregnancy exists within the context of your life. Your previous birth experiences, your losses, your family situation, your work pressures, your support network, your hopes and fears. All of it matters.

When I know your story, I can care for you as a whole person, not just a pregnant body. I can understand why certain situations trigger anxiety. I can celebrate milestones that might seem small to others but are significant to you.

And here’s the thing: you shouldn’t have to retell your story at every appointment. You’ve already lived it once. Having to repeatedly explain your previous traumatic birth or your pregnancy losses to different healthcare providers is exhausting and retraumatising.

Continuity means you tell your story once, and then we build on that foundation together.

Informed decision-making requires relationship

True informed consent isn’t just about information. It’s about understanding, context, and trust.

When we’ve built a relationship over time, I understand what’s important to you. I know which aspects of care you want to be involved in deciding and which you’d prefer guidance on. I know how you process information and make decisions.

That means when we’re discussing options, whether it’s screening tests, birth place, pain relief, or feeding choices, we’re having a real conversation, not me delivering information to a stranger. You can ask questions without feeling judged. You can change your mind. You can explore options that feel right for your family.

Labour and birth with someone you know

Imagine this: you’re in labour. Contractions are building. You’re nervous, excited, working hard.

In many care models, you call a number. You speak to someone you’ve never spoken to before, who asks you a series of questions to decide whether you’re “in labour enough” yet. They tell you to stay at home a bit longer, or to come in, but you have no idea who will actually be there when you arrive. It might be someone lovely. It might be someone having a terrible day. You won’t know until a stranger walks into your labour room.

Now imagine calling me.

You tell me your contractions have started. I know you, I know your pregnancy, I know this is your second baby and your first labour was quick. I say “I’m on my way.”

When I arrive, there’s no awkward introduction period. No explaining your birth preferences to someone who’s reading them for the first time. No wondering if this person will respect your choices. I already know you’re worried about tearing because it happened last time. I know you wanted to stay mobile as long as possible. I know you find it hard to advocate for yourself when you’re stressed. I know your partner gets anxious and needs clear information.

I can read your body language. I know when you need encouragement and when you need quiet. I can support you in the way you need.

It’s a bit like your wedding photographer. Can you imagine meeting them for the first time on your wedding day? Not discussing your vision beforehand, not knowing their style, not building any rapport? You’d want to meet them beforehand, talk through what matters to you, feel confident they understand what you’re hoping for. Labour is infinitely more intimate and vulnerable than a wedding. Why would we accept less preparation, less relationship?

Or imagine hiring someone to renovate your kitchen but not discussing any of the planning until the day they arrive to start work. No conversations about what you want, no understanding of your style, no relationship built on trust. Just a stranger turning up with tools expecting to transform one of the most important spaces in your home.

That’s essentially what fragmented maternity care asks of you. And it makes no sense.

The postnatal period: when continuity really shows its worth

If continuity matters during pregnancy and birth, it matters even more in the postnatal period.

Those early weeks are intense. You’re healing, establishing feeding, navigating sleep deprivation, and adjusting to your new identity as a parent. You’re vulnerable, exhausted, and often overwhelmed.

When I’m providing your postnatal care, I already know how your birth went. I know what you were hoping for and how it actually unfolded. I can support you in processing that experience without you having to retell the entire story.

I know your feeding plans and can support you without judgment, whatever method you’re using. I can help you troubleshoot issues because I understand your particular circumstances.

And here’s what’s really valuable: you have my WhatsApp. You can message with questions at 2am when you’re worried about your baby’s nappy output or wondering if your bleeding is normal. You’re not trying to decide if something is “serious enough” to bother a stranger about.

You know me. You trust me. And that makes asking for help so much easier.

What the evidence says

There are decades, literally decades, of research demonstrating that continuity of care leads to better outcomes for families and babies, higher satisfaction with care, better experiences of birth, improved wellbeing for mothers, and better job satisfaction for midwives.

The evidence is so strong and so consistent that it genuinely blows my mind we’re still having to make the case for it in 2026.

If you’d like the references to specific studies and systematic reviews, please get in touch and I’m happy to share them. But honestly, you probably don’t need research to tell you what you already know instinctively: relationships matter in healthcare, especially in maternity care.

What continuity looks like in practice

So what does continuity actually look like when you’re under my care?

It starts with our first meeting, your booking appointment. This isn’t a rushed tick-box exercise. We take time. I want to know your story, your hopes, your concerns. I want to understand what matters to you.

Throughout your pregnancy, you see me for all your antenatal appointments. We build on conversations we’ve had before. I remember what we discussed last time. We develop a relationship, not just a series of isolated appointments.

You have my contact details. If you have a question or concern between appointments, you can reach me directly. You’re not navigating a complicated system or speaking to someone different every time.

When you go into labour, you contact me. I support you through labour and birth, either at home or accompanying you to hospital, depending on your plans. There are no strangers in your birth room.

After birth, I visit you at home. We check on your recovery, establish feeding, answer all your questions. And in the weeks that follow, I’m available for ongoing support, whether that’s scheduled visits or WhatsApp messages when you need reassurance.

The relationships I’m building

What I love most about continuity care is the relationships.

I remember the family who was terrified about birth after a previous traumatic experience. We spent months working through their fears, building trust, creating a plan that felt safe. When they called me in labour, they weren’t calling a service. They were calling someone who understood their journey. Their birth was beautiful, healing, and powerful.

I think about the mum who was struggling with breastfeeding at 2am and messaged me in tears. Because we already had a relationship, she felt comfortable being vulnerable. We worked through it together, and feeding became the positive experience she’d hoped for.

I remember the couple navigating difficult decisions about their pregnancy. They didn’t have to explain their values and priorities to me because I already understood. We could focus on supporting them through the decision-making.

These relationships aren’t just professionally satisfying. They result in better care.

You deserve this

Continuity of care isn’t some premium add-on that only certain families deserve. It should be standard. It should be the default, not the exception.

You deserve a midwife who knows your name without checking your notes. Who remembers what you talked about at your last appointment. Who you can call when you’re worried. Who walks into your labour room and already knows your hopes and fears.

You deserve the same continuity you’d expect from your hairdresser.

Because growing, birthing, and nurturing a new human is infinitely more significant than a haircut. And if we recognise the value of relationship and continuity in so many areas of our lives, why wouldn’t we expect it in our maternity care?

Every family I work with teaches me something. Every relationship deepens my understanding of what truly supportive care looks like. I’ll learn your story. I’ll remember the details. I’ll show up for you, from the first appointment to the last postnatal visit and beyond.

Because that’s what continuity means. And it’s what you deserve.

You know where to find me if you’re thinking you’d like to explore this type of care.

Sally x

P.S. If you’re reading this and thinking “I wish I’d had this,” whether about a current pregnancy or a past experience, please know that your feelings are valid. The fact that continuity isn’t standard doesn’t mean your expectations were unreasonable.