Midwives' burnout and continuity of care

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Abstract
This study aimed to examine the impact of Changing Childbirth (Department of Health, 1993) on midwives' work and personal lives. It reports findings from a multiple site case study of community-based maternity care. Each site represented a model of continuity of carer along a continuum from complete one-to-one continuity to continuity within a team. The three sites represented the traditional model of GP-attached community midwives, a community team and a community-based group practice. Three key themes emerged from the data relating to sustainable practice, the avoidance of burnout and the provision of flexible woman-centred care. These were occupational autonomy, social support and developing meaningful relationships with women. Control over work and continuity of care are as important to midwives in how well they balance their work and home life as they are to women experiencing childbirth. Models of care such as personal caseloads that incorporate these factors may be more sustainable in terms of less burnout and greater personal accomplishment than team caseloads.