Midwifery Continuity of Carer has been a significant part of maternity policy for more than a decade, but putting the principle into practice has proved complex. As maternity services face workforce shortages, changing expectations and continuing operational pressures, the experiences of midwives themselves are increasingly important. A new national survey from researchers at King’s College London is exploring what attracts midwives to different ways of working, what makes them sustainable and what gets in the way. The M-WAPS study is inviting registered and student midwives across England and Wales to share their experiences and views.
Few areas of maternity care have generated as much discussion in recent years as Midwifery Continuity of Carer (MCoC).
The principle is simple: women and birthing people receive care from a midwife, or a small team of midwives, throughout pregnancy, birth and the postnatal period. The aim is to build trusting relationships, provide more personalised care and improve outcomes for women, birthing people and their babies.
But making continuity work in practice has proven far less simple.
For more than a decade, MCoC has featured prominently within maternity policy across England and Wales. Research has demonstrated benefits for women and birthing people, including improved experiences of care, while national maternity policy has identified continuity as an important approach to improving safety, personalisation and equity.
However, translating policy into practice has been complex.
Across England and Wales, maternity services have introduced, adapted, paused and redesigned continuity models in response to local circumstances. Some midwives have found these ways of working professionally rewarding. Others have raised concerns about workload, staffing, on-call commitments, fatigue and work-life balance.
All of this has taken place during a period of significant pressure on maternity services, including workforce shortages, retention challenges, increasing complexity of care, growing demand and the continuing impact of national maternity reviews.
These challenges lead to an important, but straightforward, question: What makes a way of working work for midwives?
We want to hear from midwives
Researchers at King’s College London are undertaking the Midwives Working Arrangements and Practice Survey (M-WAPS) to better understand what influences midwives’ willingness and ability to work in different models of maternity care.
This includes Midwifery Continuity of Carer and homebirth services, but the study is not seeking to establish whether one particular model is “good” or “bad”.
Instead, we want to understand the reality behind different ways of working.
What attracts midwives to particular models of care? What makes these models sustainable? What gets in the way? What would need to change for midwives to feel both able and willing to work differently?
These questions matter because the maternity workforce has changed.
Expectations around work-life balance and wellbeing continue to evolve. New generations of midwives are entering the profession, bringing their own expectations and priorities. At the same time, maternity services are adapting to ongoing workforce, safety and operational pressures.
Despite considerable debate about how maternity care should be organised, there is still limited contemporary evidence about how midwives themselves feel about different ways of working.
M-WAPS aims to help fill that gap.
Your experience matters, whatever your view
We want to hear from midwives with a wide range of experiences and perspectives.
You might currently work in a continuity team or homebirth service. You might have worked in one previously. You might be interested in working in these models in the future, or you might know that they are not right for you.
All of these perspectives are valuable.
The survey is open to registered midwives currently practising in England and Wales, as well as student midwives undertaking their training in England and Wales.
We are particularly keen to hear from people working across the full range of maternity settings and roles, including:
- Labour wards
- Community maternity teams
- Homebirth services
- Continuity teams
- Birth centres
- Specialist services
- Education and research
- Leadership and management roles
Student midwives are equally important. The ways in which the next generation of midwives wants and expects to work will inevitably influence the future maternity workforce.
What will the research explore?
The national survey will explore the organisational, professional and personal factors that influence how midwives think and feel about different ways of working.
The research is informed by implementation science and behavioural methodology, including the COM-B model and the Theoretical Domains Framework. These approaches help us move beyond asking whether a model has or has not been implemented. Instead, they allow us to explore the wider factors that make different ways of working possible, attractive and sustainable.
The survey will consider the barriers and facilitators influencing midwives’ willingness and ability to work within different models of maternity care.
Ultimately, the findings will help build a clearer picture of what supports, and what hinders, the successful implementation of different maternity care models. This could help inform future workforce planning and the development of implementation strategies that better reflect the needs and experiences of the maternity workforce.
The study has received ethical approval from King’s College London Research Ethics Committee, reference LRU-25/26-57297.
Can you help?
The online survey takes approximately 10 minutes to complete and participation is entirely voluntary.
If you are a registered midwife or student midwife in England or Wales, we would really like to hear from you.
You can support the study in three ways:
- Take part
If you are eligible, please consider completing the survey and sharing your views and experiences. - Share the survey
The success of the study depends on hearing from a broad and diverse range of midwives and student midwives. Please consider sharing the survey with colleagues, students and professional networks. - Help promote the study
You can help raise awareness by sharing the study through social media, professional forums, maternity networks and relevant organisations.
Even if you cannot take part yourself, sharing the survey could help us reach someone who can.
Conversations about the future of maternity care need to include the people who will actually deliver it.
Please click below to complete the survey or scan the QR Code.
Whether you currently work in a continuity model, have worked in one previously, would like to in the future, or would prefer not to, your perspective matters.
The future of maternity services will be shaped not only by policy, but also by the experiences, views and expertise of the workforce itself.
M-WAPS is an opportunity to make sure those voices are heard.
Sophie Hicks, Principle Investigator, King’s College London, RM, MSc
Dr Claire Feeley, King’s College London, PhD, MSc, BSc (Hons), RM, HEA Fellow
Dr James Harris, Nursing and Midwifery Council (NMC), RM, PhD
September 2026