Continuity of carer...

Continuity of care…providing the same level of care to each woman you look after. Not to be confused with continuity of carer, which is looking after the same woman on numerous occasions when the situation presents itself. Working on the delivery suite it is hard to provide this type of care, as this placement can feel like a woman and baby conveyor belt. You meet so many amazing women and get to know their families but within no time at all they have delivered and set about their own journey.

As a student we go to various placements, which means we do get the opportunity to meet the same women again and again. For instance, last year I conducted a womans booking appointment in community and then 6 months later when I was working on the delivery suite I delivered her baby. When I saw her name on the board I immediately said to the senior midwife ‘’Please can I look after that woman, I know her’’. Providing continuity of carer has been proven to help women feel more relaxed in labour, which leads to a higher chance of spontaneous vaginal birth without interruption of assisted delivery (forceps or ventouse).

I have seen first hand how providing continuity of carer can impact a woman’s birthing experience. My last placement on the delivery suite (which sadly ended a couple of weeks ago) was the best placement so far because of the mentors I worked with and the amazing women I got to meet. I had the opportunity to spend three days with one woman who was admitted for induction of labour. I stayed by her side for her first cycle of induction and her second cycle. I sat with her while we discussed the pros and cons of having a cesarean section when she just felt like giving up. After many discussions with me and the doctors, she ended up opting to have one more examination to see if her membranes could be ruptured, which was successful. This meant her labour could be augmented with a syntocinon drip to bring on contractions to increase her chance of a spontaneous vaginal birth.

Day three; I stayed by her side and cared for her (with my mentor) from 8:00 am until I delivered her baby at 21:14 that very evening. What an incredible INCREDIBLE woman! Three days she had gone through the exhaustion of induction, she had gone through a whirlwind of emotions and finally she had her little baby and had the normal vaginal delivery she wanted. She couldn’t thank me enough for staying by her side through it all and I left feeling so very thankful that I had the opportunity to provide continuity of carer. The feedback I got from this one woman I will never forget, I will never forget her. Day four, I couldn’t resist I had to visit her on the postnatal ward to see how she was getting on. It was great to see her and her baby one last time.

Better Births (2017) have gathered feedback from women who have stated that they see too many different midwives and doctors throughout pregnancy and labour and do not always know who they are or their role. This information has been gathered so local maternity services can act upon its findings to implement continuity of carer. It will be interesting to see how maternity services adapt to provide this level of care in the future...

You can read more about this:

https://www.england.nhs.uk/wp-content/uploads/2017/03/nhs-guidance-maternity-services-v1.pdf

I am now on my second placement of the year, antenatal clinic. Only two days in but so far it is going really well and I am learning so much. I shall share my thoughts on this placement soon.

Thanks for taking time to read my post.

Much love

JP

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