Children’s Experiences of Midwives Working in Aotearoa New Zealand’s Continuity of Care Model
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Clemons, Janine H
Greenslade-Yeats, James H
Jackson, Talei
Mharapara, Tago L
Staniland, Nimbus A
Ravenswood, Katherine
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Elsevier BV
Abstract
Background: Aotearoa New Zealand’s Continuity of Care (CoC) midwifery model is recognised for its nationalised, public provision of one-to-one midwifery care. The model has distinctive pressures associated with workload, 24/7 on-call, and emotional intensity. While research has examined how these pressures affect midwives, little is known about how this model shapes the lives of midwives’ children.
Aim: This study explores how the CoC model of midwifery can influence midwives' children.
Methods: We analysed qualitative interviews from 22 families with children aged 11–19 and adult children aged 20 – 40 + participated alongside a current or former CoC midwife. Iterative thematic analysis and reflexive team interpretation informed theme development.
Findings: The overarching interpretation, 'living in the shadow of the call’, describes how families continually reorganised themselves around unpredictable CoC work. Five themes described these dynamics: (1) Living on Alert–chronic unpredictability shaping family life; (2) When Work Enters the Home–emotional spillover and blurred boundaries; (3) Children as Stabilisers–adaptive labour and role reversals; (4) Holding the System Together–reliance on extended networks and shared care; and (5) Growing through the Demands–long-term developmental consequences. Children described the costs of 'living in the shadow of the call’, yet also how these experiences built resilience, independence, emotional maturity, and political awareness.
Discussion: Children perceived that CoC midwifery shaped their everyday rhythms, relationships and developmental experiences. Children’s accounts highlight the growth and strain associated with living amongst unpredictable care work.
Conclusion: Recognising children’s experiences is essential for developing sustainable continuity models that support midwives and the families who enable their practice.
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11 Medical and Health Sciences, Obstetrics & Reproductive Medicine, 3215 Reproductive medicine, 4204 Midwifery, Continuity of care, Midwifery workforce, Work-family conflict, Children's experiences, Qualitative research, New Zealand
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Women and Birth, ISSN: 1871-5192 (Print), Elsevier BV, 39(3), 102211-102211. doi: 10.1016/j.wombi.2026.102211
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© 2026 The Author(s). Published by Elsevier Ltd on behalf of Australian College of Midwives. This is an open access article distributed under the terms of the Creative Commons CC-BY license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. You are not required to obtain permission to reuse this article.
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Except where otherwise noted, this item's license is described as © 2026 The Author(s). Published by Elsevier Ltd on behalf of Australian College of Midwives. This is an open access article distributed under the terms of the Creative Commons CC-BY license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. You are not required to obtain permission to reuse this article.