Continuous care from community-based midwives reduces risk of preterm birth by 45%

Continuous care from community-based midwives reduces risk of preterm birth by 45%

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21 January 2026

Continuous care from community-based midwives reduces risk of preterm birth by 45%

Women who receive continuous care from community-based midwives have a significantly reduced risk of preterm birth in comparison to those who receive standard care.

45%

reduction in risk of preterm birth for women receiving community-based midwife continuity of care

This care model also significantly reduced risks of preterm births in women who are at greatest social risk of adverse outcomes. The research was carried out by ARC South London’s maternity and perinatal mental health theme at King’s College London and published in BJOG: An International Journal of Obstetrics & Gynaecology.

The study looked at data from 6,600 pregnancies in south London — an area with high ethnic diversity and social disadvantage.

Community-based midwife continuity of care vs. standard care

The researchers analysed data from 2018–2020, where a quarter of the women received community-based care from midwives and the others received standard care.

Community-based midwife continuity of care (CMBCOC)

The same team of midwives provides care to a woman throughout her pregnancy, birth, and postnatal care. These midwives work across community and hospital settings, in partnership with women and multidisciplinary teams. When complications arise, women are referred for obstetric care while continuing to receive midwifery care from the team.

Standard care

Midwives, GPs, and obstetricians share the responsibility for the organisation and delivery of care throughout the initial booking to the postnatal period, provided in both hospital and/or community settings.

Key findings: benefits for all women, including high social risk groups

Black, Asian & minority ethnic women
9.5% → 6.4%
preterm birth risk reduced
Most socially deprived areas
8.2% → 5.1%
preterm birth risk reduced

Researchers also found that in the CMBCOC group, women had:

An increased rate of spontaneous vaginal delivery

Were less likely to miss antenatal appointments

Were more likely to receive necessary referrals to mental health support

“Our study demonstrates the potential of locality-based interventions integrating community-based care and midwife continuity. This approach significantly reduces risk of preterm birth compared to standard care and may help reduce health inequities for high social risk groups.”

Dr Cristina Fernández Turienzo
Lead author, King’s College London

Community-based midwife continuity of care and population health

In September 2022, NHS England announced that their plan to deliver midwife continuity of carer nationally was on hold due to insufficient staffing levels. Women are currently not able to choose which care pathways they are placed in, and the CMBCOC model is currently only available in some NHS Trusts.

“Our findings provide a potential solution to mitigating inequities in maternity care. Women get to know the small team of midwives, receive care close to home, and know that their midwives will coordinate with the wider health team when needed. One of the priorities in the NHS 10 Year Health Plan for England is shifting care from hospital to community, and our findings are supportive of this plan.”

Professor Jane Sandall CBE
Senior author; Professor of Social Science and Women’s Health, King’s College London; NIHR ARC South London maternity and perinatal mental health theme lead

This study used data from the eLIXIR Partnership, linking healthcare information from various providers in south London. The strength of this study is the availability of robust and continuous maternity, neonatal and mental health data, and the diversity of the south London population, representing worldwide demographics.

“Future trials will be crucial, but need to be done carefully to include the women who are at a greater social risk, who have also been historically underrepresented, in such trials.”

Dr Cristina Fernández Turienzo
Lead author, King’s College London

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Read the full paper

‘The Impact of Community-Based Midwife Continuity of Care Models for Women Living in Areas of Social Disadvantage and Ethnic Diversity in the United Kingdom: A Prospective Cohort Study’

BJOG: An International Journal of Obstetrics & Gynaecology

Related content

Original source: arc-sl.nihr.ac.uk — NIHR ARC South London legacy content archived May 2026.