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Protecting human rights in childbirth

Your right to choose your midwife and doctor

Do I have the right to be cared for by the same midwife during my pregnancy?

Having the same midwife or team of midwives through your pregnancy, childbirth and postnatal care is called ‘continuity of carer’. 

If you have continuity of carer you will see the same midwife, or one of a small team of midwives, at each routine appointment. You may not see one of the team if you receive emergency care.

You do not have a legal right to continuity of carer, but the Governments of England, Scotland, Wales and Northern Ireland want to see everyone being cared for by the same midwife or small team of midwives as soon as possible. In England this means a team of four to eight midwives.

This is important because continuity of carer has been shown to lead to fewer preterm births and fewer people losing their baby in pregnancy or the first month following birth.

NHS England & Improvement had an ambition for most women to receive continuity of carer by March 2021. They are especially committed to providing continuity of maternity carer to people from Black, Asian and minority ethnic backgrounds, and women living in the most deprived areas. The NHS Long Term Plan states that 75% of pregnant people from these backgrounds should receive continuity of carer by 2024.

If you would like to receive continuity of carer ask your midwife who the Trust are currently offering continuity of carer to, and whether you are eligible. You do not have a legal right to this, however.

If the Trust cannot offer you continuity of carer at present, you could ask what plans there are to establish continuity of carer for everyone in the local area and when this will happen. You can ask the Director of Midwifery and/or the local Clinical Commissioning Group (who buy health services on behalf of the local population). If their plans are too late for you, you could think about changing to another Trust who can offer this. You can find their details on your NHS Trust or Board’s website.

You might also find that you would receive continuity of carer if you choose particular options, such as a home birth.

You do not have to agree to procedures simply because they are standard in this particular hospital or birth centre.

Can I see the same doctor and midwife if an obstetrician is leading my care?

If your care is led by an obstetrician (a doctor who specialises in maternity), doctors and midwives will give you care. 

Having obstetric-led care should not stop you accessing midwifery continuity of carer, if you are eligible for it at your Trust. You will still be offered all the routine appointments with your midwife, as well as appointments with your doctor. 

You should know the name of the consultant obstetrician who is responsible for your obstetric care. You may not always see this consultant at your appointments. Sometimes you may see other doctors who are qualified and doing specialist training in obstetrics.

If you want to see the same doctor every time you can ask for this. The Trust should try to make this happen, but they do not have to.

You can ask the hospital to explain who you will be seeing and when. If continuity of carer is important to you, ask if they can provide it.

For example, if you have a long-term health condition or previous trauma and you don’t want to have to keep explaining it, you can ask if you can have continuity of carer.

If you have certain medical conditions, for example a heart condition, you may be advised to have some or all of your care in another hospital where relevant specialist doctors are based. Your care team should still work together even if they are based in different locations. You may need to see a number of different healthcare professionals, but you can ask to see the same specialist heart doctor, the same obstetrician, etc. so that you receive as much continuity as possible.

Am I entitled to see an obstetrician (specialist maternity doctor)?

NHS maternity care in the UK is led by midwives. However, if you have a complication in your pregnancy or have a reason to be worried about your pregnancy or childbirth, you should be able to consult an NHS obstetrician.

Can I ask to change midwife or obstetrician?

Yes. If you are not happy with the care you are receiving or you feel uncomfortable with your midwife or obstetrician (doctor) you can ask to be seen by someone else. You do not have to give a reason for this if you don’t want to.

You can ask your Head of Midwifery if you would like to see a different midwife. You can ask the Clinical Lead for Maternity if you want to see a different doctor. 

If you are not being listened to, you can ask the complaints team to help. The complaints team is often called the Patient Advice and Liaison Service (PALS) team but might also be called their patient experience team or their concerns team. 

  • You can read more about how to get support if you do not feel you are being heard on our factsheet Making a complaint.

Can I change Trust or Board? 

Yes. You can ask to change Trust or Board at any point in your pregnancy. You can choose a hospital or birth centre that is away from where you live. Or you may need to change to a different hospital or birth centre if your circumstances change or you move to a new area during your pregnancy.

Before you ask to transfer, check if the new Trust or Board has a limit on the number of people who can book with them. You need to be sure your chosen hospital or birth centre can take over your care. 

If you move to a new area, then you should be able to book for care even if you are very late in your pregnancy. 

If you want a home birth you need to book with the Trust or Board whose home birth team covers your area. You cannot usually choose which Trust or Board cares for you if you have a home birth.

Be aware that wherever you give birth when you go home with your baby your local Trust or Board will provide your postnatal care.

Can I choose the midwife or doctor who gives me postnatal care?

Postnatal care is usually provided by midwives from your local Trust, wherever you gave birth.

This means that if you choose to have your antenatal care and give birth in a Trust that is not your local one, you may not receive your postnatal care from the same midwife as you saw during your pregnancy.

Your postnatal care may also be offered in a different place such as a different clinic, or in a clinic rather than at home.

Are there alternatives to NHS maternity care?

Yes. You can choose an independent or private midwife. They are trained midwives who work outside the NHS. They may be independent (self-employed although they may work as part of a small team) or work for a private company. You have to pay for this kind of care.

If you have an independent or private midwife, you may also be able to access private blood tests through them.

Choosing an independent or private midwife does not mean you have opted out of NHS care. You can still access scans, blood tests and any specialist or emergency care you need in the NHS. 

If you choose to opt out of some or all of NHS care, this does not affect your right to access emergency care if you need it or to access NHS care if you change your mind later on.

You can also receive some or all of your maternity care in a private hospital or a private wing of an NHS hospital. There are only a small number of private hospitals offering maternity care in the UK.

 You can also pay for private scans if you want, even if you receive the rest of your care on the NHS. 

  • You can read more about your private maternity care options in this Which? article.

About Birthrights

Birthrights factsheets give you information about your human rights when you are pregnant and giving birth.

Birthrights champions respectful care during pregnancy and childbirth by protecting human rights. We provide advice and information to women and birthing people, train doctors and midwives, and campaign to change maternity policy and systems.

We are a charity, independent of the government and the NHS.

Disclaimer: Our factsheets provide information about the law in the UK. The information is correct at the time of writing (May 2021). The law in this area may be subject to change. Birthrights cannot be held responsible if changes to the law outdate this publication. Birthrights accepts no responsibility for loss which may arise from reliance on information contained in this factsheet. Birthrights has provided links to third party websites where these may help provide relevant further information. Birthrights takes no responsibility for the contents of linked websites and links should not be taken as an endorsement.

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