Children’s Experiences of Midwives Working in Aotearoa New Zealand’s Continuity of Care Model

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.