The research, led by the University of Leeds in collaboration with ARC South London researchers at King's College London and NHS England, examined the impact of being placed in a continuity of midwife care scheme on stillbirth and breastfeeding rates in over 922,000 women who became pregnant between 2020 and 2022.
Under continuity of midwife care, women are supported by the same midwifery team throughout pregnancy, labour and postnatal care. Comparing women placed in a continuity of midwife care scheme by 24 weeks gestation with those placed in standard care, the researchers found that women on the continuity of care pathway were significantly more likely to initiate breastfeeding.
The researchers also found that while there were no differences in stillbirth rates between women on the continuity of midwife care pathway and standard care in the overall population, Black women placed on the pathway were significantly less likely to experience stillbirth compared with Black women receiving standard care.
These findings are significant given the disparities in UK maternity outcomes. Black women have higher maternal death rates than white women, and an increased risk of miscarriage, premature birth and stillbirth. With around 60,000 babies born prematurely each year in the UK - a higher rate than in many other European countries - improving care for populations at risk is crucial.
This is the largest real-world study of its kind, examining outcomes for nearly a million childbearing women. Our findings provide valuable insights to inform the targeted rollout of enhanced continuity of midwife care in underserved and ethnically diverse areas
Continuity of midwife care was introduced by NHS England in 2017, informed by an international evidence review led by researchers at ARC South London. Continuity of midwife care is designed to build stronger relationships between women and their care teams, creating a safety net that enables women to raise concerns more comfortably and ensure they are listened to.
The ARC’s maternity researchers have been investigating the potential benefits of continuity of care models for diverse groups of women, including women at risk of preterm birth, women living with social risk factors, and women belonging to ethnic minorities or living in disadvantaged areas.
This new research suggests that continuity of midwife care could be an important tool for addressing maternal health inequalities, particularly when targeted towards population groups that face greater risks.
Further research is now needed to better understand barriers to timely antenatal care and the specific benefits experienced by Black women on this pathway