What Is It About Antenatal Continuity of Caregiver That Matters to Women?
Abstract
ABSTRACT: Background: Continuity of care and of caregiver are thought to be important influences on women's experience of maternity care. The aim of this study was to analyze the influence of two aspects of continuity of caregiver in the antenatal period on women's overall rating of antenatal care: the extent to which women saw the same caregiver throughout pregnancy, and the extent to which women thought that their caregiver knew and remembered them and their progress from one visit to the next. Methods:An anonymous, population‐based postal survey was conducted of 1,616 women who gave birth in a 14‐day period in September 1999 in Victoria, Australia. Multivariate methods were used to analyze the data. Results:Most women saw the same caregiver at each antenatal visit (77%), and thought that caregivers got to know them (65%). This finding varied widely among different models of maternity care. Before adjustment, women were much more likely to describe their antenatal care as very good if they always or mostly thought the caregiver got to know them (OR 5.86, 95% CI 4.3, 7.9), and if they always or mostly saw the same caregiver at each visit (OR 2.91, 95% CI 2.0, 4.3). Adjusting for sociodemographic factors, parity, risk status of the pregnancy, and several specific aspects of antenatal care revealed that seeing the same caregiver was no longer associated with rating of care (adjusted OR 0.65, 95% CI 0.3,1.2), but women who thought that caregivers got to know and remember them remained much more likely to rate their care highly (adjusted OR 3.18, 95% CI 2.0, 5.1). Conclusions:These findings suggest that changing the delivery of antenatal care to increase women's chances of seeing the same caregiver at each visit is not by itself likely to improve the overall experience of care, but time spent personalizing each encounter in antenatal care would be well received. The analysis also confirmed the importance that women place on quality interactions with their doctors and midwives. (BIRTH 32:4 December 2005)
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These findings are in keeping with many of the RCTs, other studies, and the Cochrane review of midwife-led care.
“These findings are in keeping with many of the RCTs [4–6, 14], other studies [4, 6, 8–14], and the Cochrane review of midwife-led care [7].”
It is not clear whether continuity of carer per se is more important to women than consistent and personalised care, even if it is provided by a number of care-givers.
“It is not clear whether continuity of carer per se is more important to women than consistent and personalised care, even if it is provided by a number of care-givers [ 26 , 48 ].”
From COSMOS: COmparing Standard Maternity care with One-to-one midwifery Support: a randomised controlled trial (2008) · cites this paper as [48]
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Forster, D. A., McLachlan, H. L., Davey, M.-A., Biro, M. A., Farrell, T., Gold, L., Flood, M., Shafiei, T., & Waldenström, U. (2016) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-016-0798-y · Cited by 251 · see citing works
“respectful, kind, empathetic) [8–11], being remembered between visits [12], having an active say in decision making [13], having enough information [8, 10, 13], perceiving care providers as helpful [13], and a consistent philosophy of care [11].”
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“It is not clear whether continuity of carer per se is more important to women than consistent and personalised care, even if it is provided by a number of care-givers [26,48].”
Self-citationAune, I., Dahlberg, U., Backe, B., & Haugan, G. (2013) · Nordic Journal of Nursing Research · doi:10.1177/010740831303300304 · Cited by 5 · see citing works
- Authors
- Davey, M., Brown, S., & Bruinsma, F.
- Affiliations
- La Trobe University (AU)
- Venue
- Birth
- Publisher
- Wiley
- Published
- 2005-11-25
- Volume
- 32
- Issue
- 4
- Pages
- 262-271
- ISSN
- 0730-7659 (ISSN-L)
- 1523-536X
- OpenAlex
- W2062502811
- Cited by
- 46
- References
- 10
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 1 · 2020: 3 · 2019: 4 · 2018: 1 · 2016: 3 · 2015: 3 · 2014: 2 · 2013: 1 · 2012: 5
- FWCI
- 3.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Birth (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
- Keywords
- continuity of care, prenatal care, patient satisfaction, individualized care, physician-patient relationship, midwife-patient relationship, Victoria, Australia
- MeSH terms
- Adolescent, Adult, Australia, Continuity of Patient Care, Educational Status, Ethnicity, Female, Humans, Middle Aged, Midwifery, Nurse-Patient Relations, Physician-Patient Relations, Postnatal Care, Surveys and Questionnaires, Socioeconomic Factors, Multivariate Analysis, Patient Satisfaction
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