What matters most to midwifery clients? Exploring continuity of care preferences through a cross-sectional survey in Ontario, Canada
Bibliographic record
Abstract
BACKGROUND: Continuity of care in midwifery is associated with improved outcomes for childbearing people and newborns. Despite its integration into the Ontario midwifery model, there is limited understanding of how clients perceive and value different aspects of continuity. This study aimed to explore midwifery clients' definitions, experiences, and perceptions of continuity to identify priorities and opportunities for refining midwifery care. METHODS: This mixed-methods study was part of a larger project examining continuity. Data were collected through an online survey administered via REDCap, with midwifery clients who gave birth in Ontario on or after January 1, 2018. The survey included quantitative and qualitative questions, data were analyzed using descriptive statistics and thematic analysis. RESULTS: A total of 514 participants completed the survey. 93% had a known midwife at their birth, and most received care from a team of 2-3 midwives. Regardless of number of midwives met and whether or not a known midwife attended the birth, respondents were highly satisfied with their midwifery care, particularly valuing communication, choice and continuity of carer. Having a known midwife was important during home births, emergencies, and postpartum care. Participants highlighted the multi-factorial nature of continuity involving not only a relationship based approach, but coordinated care and seamless information transfer. Trust and emotional safety were significantly enhanced by genuine relationships with midwives. Consistent communication and documentation were crucial in reducing anxiety and ensuring preparedness. CONCLUSION: Continuity of care is a foundational element of midwifery in Ontario, with clients highly valuing relational, management, and informational continuity. The study highlights the importance of trust, personalized care, and consistent communication in enhancing client satisfaction.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.007 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".