Children's experiences of midwives working in Aotearoa New Zealand's continuity of care model

Aotearoa New Zealand's Continuity of Care (CoC) midwifery model is recognised for its nationalised, public provision of one-to-one midwifery care. The model has distinctive pressures associated with workload, 24/7 on-call, and emotional intensity. While research has examined how these pressures affect midwives, little is known about how this model shapes the lives of midwives' children.

This study explores how the CoC model of midwifery can influence midwives' children.

We analysed qualitative interviews from 22 families with children aged 11-19 and adult children aged 20 - 40 + participated alongside a current or former CoC midwife. Iterative thematic analysis and reflexive team interpretation informed theme development.

The overarching interpretation, 'living in the shadow of the call', describes how families continually reorganised themselves around unpredictable CoC work. Five themes described these dynamics: (1) Living on Alert-chronic unpredictability shaping family life; (2) When Work Enters the Home-emotional spillover and blurred boundaries; (3) Children as Stabilisers-adaptive labour and role reversals; (4) Holding the System Together-reliance on extended networks and shared care; and (5) Growing through the Demands-long-term developmental consequences. Children described the costs of 'living in the shadow of the call', yet also how these experiences built resilience, independence, emotional maturity, and political awareness.

Children perceived that CoC midwifery shaped their everyday rhythms, relationships and developmental experiences. Children's accounts highlight the growth and strain associated with living amongst unpredictable care work.

Recognising children's experiences is essential for developing sustainable continuity models that support midwives and the families who enable their practice.