Evaluation of the enhanced midwifery continuity of carer model (EMCoC)

Background 

Pregnancy and birth experiences for women from deprived socioeconomic backgrounds and minority ethnic groups are 50% more likely to result in poor outcomes, with five-fold difference in maternal mortality rates for women from Black ethnic backgrounds.

Midwifery Continuity of Carer (MCoC) aims to provide personalised and safe care to women and their families via provision of the same midwife, supported by a small team of midwives, throughout pregnancy, birth and the post-partum period.

The enhanced model of MCoC aims to provide extra support to women and their families in the most deprived areas of England, in order to reach the target of providing continuity of care for 75% of women from Black, Asian and minority ethnic and women from the most deprived groups by March 2024. 

What we are doing

Our aim is to undertake a rapid formative evaluation of enhanced MCoC implementation. We will generate rapid insights into the format of care delivery and the experiences of those delivering and receiving enhanced MCoC to assess its early impacts.

We will conduct a multi-site, multiple methodologies study, conducting interviews with staff, stakeholders and service users who are delivering or in receipt of the enhanced MCoC model, across nine case study sites.

Our research questions include:

1. What are enhanced MCoC service delivery models and how have these been developed in response to service model guidance and related policies, existing MCoC services, high-priority issues and specific local needs?
2. What are the barriers and facilitators to the implementation of enhanced MCoC models of care from a staff perspective and can fidelity to the model envisaged be maintained?
3. What are staff views on the acceptability of the enhanced elements of MCoC models and their experience of these, including how staff interface with other health and social care teams?

What evidence is there that delivery of enhanced MCoC is resulting in purposeful improvement to care delivery or leading to unintended consequences, including any early benefits or risk as judged by staff?