Only a Few Places in the World Do Birthing People Get to Know Their Midwife

It’s easy to assume that getting to know your midwife is a given—that someone who’s going to be with you during one of the most intense and personal moments of your life would, of course, have met you more than once before.

But in most places around the world, that’s not how it works.

For the majority of birthing people, the midwife present at their birth is a stranger. They meet her for the first time while contracting, sweating, roaring. This isn’t because anyone wants it that way—it’s the result of overstretched systems, staff shortages, and models of care that prioritise efficiency over relationships.

In the UK, for example, “continuity of carer”—where one midwife or a small team supports someone across pregnancy, birth and the postnatal period—is recommended by the NHS and backed by decades of research. The evidence is strong: people who receive this kind of care are more likely to have a spontaneous vaginal birth, less likely to need an epidural or instrumental birth, and far more likely to report feeling safe, confident and respected throughout the experience [1][2].

And yet, fewer than 10% of people in the UK actually get access to it [3].

It’s rare, and it shouldn’t be. This kind of care isn’t a luxury—it’s safer, more cost-effective, and more humane. Knowing your midwife means someone walks into the birth room already knowing your fears, your preferences, your name. And that changes everything.

This is why we’re building care differently. Because every birthing person deserves to feel held by someone who really knows them.

So, where do people actually get to know their midwife?

There are only a handful of places in the world where continuity of care is built into the system. Here’s where it’s working—and why it matters.

🇳🇿 New Zealand: A global gold standard

New Zealand leads the way with its Lead Maternity Carer (LMC) model. Around 95% of pregnant people choose a midwife as their LMC, who provides continuous care from early pregnancy through birth and the first six weeks postpartum [4]. These midwives are often self-employed, and women can choose who they work with. Continuity is the default.

Outcomes:

• High satisfaction and trust: 85% of women report knowing and trusting their midwife [5].
• Lower intervention rates and better birth outcomes [6].
• Stronger relationships, more personalised care, and culturally appropriate support for Māori families.

🇦🇺 Rural Australia: Midwifery Group Practices (MGPs)

In parts of rural Australia, public health systems fund Midwifery Group Practices, where women are cared for by the same small team throughout. These programs have been particularly effective in regional areas like Geelong, Warwick, and parts of the Northern Territory.

Outcomes:

• Over 99% normal vaginal births in some models [7].
• Reduced rates of preterm birth (as low as 6%) and low birthweight [8].
• Zero maternal deaths and lower perinatal mortality in Aboriginal communities [8].
• High satisfaction and reduced anxiety [9].
• Cost savings of up to AUD $5,500 per mother–baby pair [10].

🇬🇧 UK: Independent Midwives

While NHS continuity is rare, some people in the UK turn to independent midwives—experienced midwives working outside the NHS, often offering full continuity across pregnancy, birth (including home births), and postnatal care.

Barriers: Independent midwifery has been made harder to access due to regulatory and insurance hurdles, and it’s often an out-of-pocket cost, making it inaccessible for many.

Still, the benefits are clear: true relational care, full choice and control, and deeply personalised support—especially for people whose needs aren’t being met by the system.

🇫🇷 France: Independent Midwives & Birth Centres

France also offers continuity through sages-femmes libérales (independent midwives), especially for those giving birth at home or in one of France’s few maison de naissance (birth centres). These midwives provide antenatal, birth (if home or birth centre), and postnatal care—often as the sole provider.

Outcomes:

• High satisfaction rates and strong continuity for those choosing home or birth centre birth [11].
• Challenges remain: access is limited, and most people still give birth in hospital with on-call staff.

The case is clear

Where people know their midwife, outcomes improve. Trust builds. Birth is safer, calmer, more connected. And yet, in most of the world, this kind of care is the exception—not the rule.

We don’t believe it should be.

We’re working to change that—because knowing your midwife shouldn’t be a privilege. It should be the standard.

Sources:
[1] Sandall J et al. Midwife-led continuity models versus other models of care. Cochrane, 2016.
[2] Homer CSE et al. Midwifery continuity of care: a scoping review. Women and Birth, 2019.
[3] NHS England. Better Births, 2016.
[4] New Zealand Ministry of Health. Maternity care model, 2022.
[5] Donnellan-Fernandez et al. Continuity in New Zealand midwifery care: Perspectives from women. 2021.
[6] Pairman S et al. The New Zealand maternity system: Lessons for others? J Midwifery Women’s Health, 2015.
[7] South Western Sydney LHD MGP Outcomes Report, 2021.
[8] Kildea S et al. Birthing on Country: outcomes for Aboriginal mothers and babies. Birth, 2019.
[9] McLachlan H et al. A systematic review of MGP in Australia. Women and Birth, 2018.
[10] Tracy SK et al. Costing the alternatives: Birth Centres and MGPs vs standard care. Med J Aust, 2013.
[11] Haute Autorité de Santé (HAS). Rapport sur les maisons de naissance en France, 2020.

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