Is caseloading Sustainable? 25-year History of Caseloading at King’s College Hospital

Abstract

Caseload midwifery is defined as follows: When a midwife carries a caseload she is the primary provider of midwifery care (the named midwife) during pregnancy, birth and the early postnatal days for an agreed number of women. She may be providing care to women wherever they are: at home, in the community or in a maternity unit. She has responsibility for the planning and monitoring of care throughout for the women on her list. She liaises with medical colleagues and social agencies as appropriate (National Childbirth Trust 1995). Caseloading is a relational model of care provided by a small team of midwives who do on-calls in order to provide a 24/7 service. Midwives have autonomy over their workload, allowing them to respond to the individual needs of women and their families. Mixed-risk caseloading has been an important element of maternity care at King’s College Hospital for 25 years, where currently almost 20 per cent of the 5-6,000 women who give birth there each year receive caseloading care.