Content area
Aim
This study aimed to explore midwifery students’ thoughts on midwifery continuity models of care and the benefits for women and midwives.
Background
The World Health Organization recommends continuity of care for pregnant women because it leads to favorable outcomes such as a higher likelihood of having a spontaneous vaginal birth and a positive birth experience. However, midwifery continuity models are rare in Sweden and few midwifery students are exposed to such models during their clinical placements. Therefore, students’ attitudes towards these models are largely unknown.
Design
A qualitative Swedish national study.
Methods
Digital interviews involving 16 midwifery students were carried out in 2023. Data were analyzed using reflexive thematic content analysis according to Braun and Clark.
Results
The study revealed the main theme: “Midwifery continuity models of care are a perfect complement for women, families and midwives in Swedish maternity care”. This main theme was supported by the following themes: Increased knowledge of midwifery continuity of care would strengthen interest; Working in a midwifery continuity model of care should be based on midwives’ preferences; and Convincing evidence of midwifery continuity of care for women.
Conclusions
The study highlighted the importance of offering women and midwives the opportunity to participate in a midwifery continuity care model and providing support for midwifery students to feel prepared for this approach. Continuity of care was seen as the future model of care. Midwifery students expressed a desire for better conditions for women in maternity care and a sustainable way of working for midwives.
1 Introduction
The World Health Organization [WHO] recommends continuity of care for pregnant women due to favorable outcomes ( World Health Organization WHO, 2024). Despite the benefits of Midwifery Continuity models of Care (MCoC), in terms of better health outcomes and increased satisfaction ( Sandall et al., 2024; World Health Organization [WHO], 2024; Perriman et al., 2018; Aune et al., 2023), such models are still rare in Sweden, despite some local initiatives in urban ( Lundborg et al., 2025) and rural areas ( Hildingsson et al., 2021).
MCoC is usually defined as care from a known midwife or a group of midwives providing antenatal, intrapartum and postpartum care to a pre-defined number of pregnant women ( Sandall et al., 2024). Studies have shown that midwives working in MCoC models are more likely to stay in the profession ( Fenwick et al., 2018; Dixon et al., 2017) and are less likely to suffer from burnout ( Dawson et al., 2018; Dixon et al., 2017; Fenwick et al., 2018), despite the challenges associated with on-call schedules and work-life balance ( Kashani et al., 2021).
Midwifery education in Sweden builds on a 3-year nursing degree at a Bachelor’s level. The midwifery program is 18 months with half of the time allocated to clinical placements. Students have clinical placements mainly in labor wards and antenatal clinics and they need to assist in 50 births during their education. After graduation, the students are licensed to practice as midwives, having completed both their midwifery exam and master's degree ( Hermansson and Mårtensson, 2013). Swedish midwives work in a variety of areas within sexual and reproductive health, with the most common being within antenatal, intrapartum and postpartum care.
Some countries have adopted an embedded practice for midwifery students to gain knowledge about the work in MCoC models. In Australia, midwifery students need to have at least ten continuity experiences ( Australian Nursing and Midwifery Council [ANMC], 2021), but in the UK the numbers are not specified ( Nursing and Midwifery Council [NMC], 2023), but outlined by NMC as ‘provide students with learning opportunities to enable them to achieve the proficiencies related to continuity of midwifery carer across the whole continuum of care for all women and newborn infants’ ( Nursing and Midwifery Council [NMC], 2023). Midwifery students in Australia who have had the ‘follow-through’ opportunity reported that practicing in MCoC benefited the learning outcomes and promoted confidence ( Carter et al., 2015). This is a complex intervention as shown in an integrated review based on 12 scientific articles, mainly from Australia ( Moncrieff et al., 2021). Another integrated review of nine scientific articles demonstrated that students acknowledged the experience as positive in gaining knowledge about woman-centered care and the importance of developing a trustful relationship. However, the results also pointed out students' challenges in fulfilling the requirements of the number of continuity experiences. Another challenge was the on-call periods with long working hours ( Carter et al., 2020).
To foster a healthy midwifery workforce that will stay in the profession, midwifery students must be confident in their forthcoming professional development. Satisfaction with the clinical placement and having the theoretical foundations are crucial for students to gain confidence ( Bäck et al., 2025). Exposure to different models of care, such as MCoC, during midwifery education has been shown to increase confidence ( Carter et al., 2015).
1.1 Problem area
Midwifery continuity models of care are rare in Sweden and few students are exposed to such models during their clinical placements. Students’ attitudes about such models are largely unknown. The aim of this study was to explore midwifery students’ thoughts about midwifery continuity models of care and the benefits for women and midwives.
2 Methods
2.1 Design
A qualitative inductive exploratory design with semi-structured interviews of midwifery students in Sweden was adapted. The study procedure followed the Consolidated criteria for reporting qualitative research ( Tong et al., 2007) (Supplementary files 1 and 2).
2.2 Data collection and participants
A purposive sample was applied to recruit participants from different universities in Sweden. To be included in the study, participants were required to be midwifery students in Sweden, nearing the completion of their studies. Written information about the research project was sent to coordinators at all Swedish midwifery education programs. In addition, information about the study was posted on closed social media platforms (i.e. Facebook and Student Section via the Swedish Midwifery Association) for midwives and midwifery students. Midwifery students were invited to complete an anonymous survey on their experiences, perceptions and interest in midwifery continuity models of care. If interested in being part of an interview, they could contact the research team with their contact details. All 16 midwifery students who expressed interest in participating in an interview were included in the study, as they represented various universities (
Students were informed both in writing and orally about the study, emphasizing that participation was voluntary and that they could withdraw at any time. However, there were no dropouts. Written consent was received before the start of the interview. The research subject was not sensitive and therefore ethical approval was not necessary to be obtained, however, the ethical principles of the Helsinki Declaration and the General Data Protection Regulation were followed as outlined by the International Committee of Medical Journal Editors (ICMJE). Data were collected through individual semi-structured interviews, which were audio-recorded using secure video conferencing tools Zoom or Teams. Three of the authors (ML,SH,LS) conducted the interviews, with one interviewer per participant. The authors used a pre-designed, pilot-tested interview guide (
Box 1). After conducting ten interviews, no new insights into the phenomenon under study were discovered. As a result, data collection was concluded after six more interviews, as data saturation had been achieved. Audio recorded interviews were carried out between January and December 2023. The interviews lasted between 24 and 47 min (mean 35 min).
Interview guide.
1. If you could dream freely, how would you like to work as a midwife?
2. What is your view on midwifery continuity models of care during pregnancy, childbirth, and the first period with the newborn?
3. Do you have clinical experience within midwifery continuity models of care?
4. What education have you received regarding midwifery continuity models of care during your midwifery training?
5. Have you gathered information about midwifery continuity models of care from elsewhere?
6. What, if any, do you think could be the positive aspects of care models with midwifery continuity?
7. What, if any, do you think could be the negative aspects of care models with midwifery continuity?
8. Would you like to work in a midwifery continuity model of care?
9. How interested would you be in working in a midwifery continuity model of care if an introduction program for newly graduated midwives was offered? What do you think should be included in such a program?
2.3 Data analysis
All 16 interviews were transcribed verbatim by the authors. Reflexive thematic analysis was conducted according to
Braun and Clarke (2021), a suitable and systematic reflexive method for developing, analyzing and interpreting patterns in qualitative data. The transcribed interviews and field notes were thoroughly read to gain a comprehensive understanding of the data and initial patterns were identified. The next phase involved manually generating codes from the data (MJ), highlighting sentences or paragraphs relevant to the aim of this study. In the subsequent step, codes were grouped based on similarities and reviewed to ensure their relevance and coherence in relation to the aim. Initially, ten preliminary themes were developed and cross-checked with the transcripts for accuracy. Themes with overlapping or similar content were combined to maintain clarity and relevance. Finally, one main theme emerged, including three themes and six subthemes, describing midwifery students’ thoughts about MCoC and its benefits for women and midwives (
3 Findings
The main theme was labeled as; Midwifery continuity models of care are a perfect complement for women, families and midwives in Swedish maternity care; and was described by: Increased knowledge of midwifery continuity of care would strengthen interest; Working in a midwifery continuity model of care should be based on midwives’ preference; and Convincing evidence of midwifery continuity of care for women ( Table 2).
3.1 Theme one: increased knowledge of midwifery continuity of care would strengthen interest
The theme included midwifery students’ reflections on their interest in MCoC models. Some students were not ready to start working in MCoC as newly qualified midwives due to a lack of work experience, but if there was an introductory program available in MCoC models, it would support the decision. Two subthemes mirrored these reflections.
3.1.1 Readiness as a decisive factor
The midwifery students were ‘ interested, curious and positive’ about working in MCoC. This was described as ‘ attractive, nice, great, fantastic, lovely, exciting, fun and a cool way' to work instead of working in fragmented care. The students expressed their desire to work in MCoC, with two saying, ‘ Of course, I want it, there's no doubt in me’ #9… ‘It's been my dream all along’ #16.
Some students who had learned about MCoC during midwifery education wanted to start working in MCoC as newly qualified midwives. They felt they had basic knowledge to build on and perceived that they would receive support from colleagues. Students without children considered themselves flexible. Students with children mentioned needing help in childcare from friends and support from their partners, to work in a MCoC model. When partners have shift work, it would require more adaptations, as one student explained: ‘ It would have been tricky, but it would have worked out, it's only the labor and birth that require on-call’ #3. Another challenge was described as: ‘My husband has a job with a long travel distance. It’s a disadvantage to be on standby and not to plan’ #16.
All students expressed interest in working in labor and birth care in the future, under changed circumstances compared with the care provided today. Working with home births and in a small-scale, midwifery-led unit was also seen as positive for developing good relationships with women and their partners, ensuring the best care. It was considered important to provide safety in midwifery care and provide care based on women’s wishes. However, most students described challenges in MCoC as newly qualified midwives due to a lack of experience in all parts of maternity care. They indicated that it would be ‘ difficult, overwhelming, hard and nerve-wracking’ and they would feel lost, with one student saying, ‘ I don't dare to do it now, it's a new job and that's hard enough’ #16.
Challenges in working in MCoC as a newly graduated midwife were explained by the need for autonomy, the ability to trust one's competence and to make their own decisions. Therefore, they needed to develop competence to feel ‘ proud, capable and secure’ in their complex professional role.
3.1.2 Enhancing educational factors for working in a continuity model
Students also provided suggestions about the introduction to new models of care. If there was an introductory program available in MCoC models directed towards newly qualified midwives, the students would be very interested in applying for such work. An introductory program would make them feel safe and less stressed. One student said, ‘If there is an introductory program, then it's okay that I don't know everything at once … but on the other hand that’s an unreasonable expectation, that I should know everything’ #14.
The students considered it important to have a clear description of MCoC, i.e. how the organization is structured, the expectations of them as midwives and how such models differ from traditional care. They articulated a need for an extensive individualized introduction to the care model. Furthermore, they wanted guidance from an experienced, easily accessible midwife who knows the work and who they could discuss and ask their questions to. A student added: ‘ I need to focus on one thing at a time, but … I don't know if that’s the best or if it could be good to start right away if I have a good introduction’ #1.
3.2 Theme two: working in a midwifery continuity model of care should be based on midwives’ preferences
This theme mainly covered the benefits and sometimes challenges for midwives to work in MCoC. The theme consisted of two sub-themes reflecting the importance of freedom to choose a work model. Continuity of care was described as giving the best conditions for providing quality maternity care.
3.2.1 Freedom of choice for midwives
The students believed that midwives in general have a great interest in MCoC, especially midwives who are used to working irregular hours, have hourly employment, or already have a position with rotation between different workplaces. One student noted that: ‘This model may attract competent midwives back to maternity care when offered a better working model’ #8. However, the students believed that working in MCoC would not suit all midwives. The reasons were mainly because midwives may not always want to work with all parts of midwifery care, they may want to have a regular life, work in one workplace, have highly intense work at a labor ward, or prefer a physician to make decisions with them. Therefore, the students felt that it should be optional for midwives to work in MCoC. One student regarded that MCoC would ‘suit more midwives than they may understand, many don’t know about the advantages’ #8.
3.2.2 Multifaceted working conditions
Continuity of care, as described by the students, involves providing high-quality women-centered care and was therefore considered ' meaningful and rewarding'. Models of MCoC were seen as enhancing professional development, providing a deeper understanding of all aspects of childbirth care and offering a sense of security and satisfaction. One student expressed: ‘ As a midwife, you gain a deeper understanding of all aspects of childbirth, which provides a sense of security and satisfaction with less stress, as you meet the same woman multiple times instead of constantly building new relationships' #8. However, one challenge noted was the understanding of the increased responsibility placed on a MCoC midwife, especially in cases where a pregnancy does not go as planned, complications arise, or if a midwife overlooks something.
Working in the MCoC model was viewed by the students as requiring a willingness to develop a close, trusting and secure relationship with a woman and her partner, to understand what makes them feel safe and satisfied. A close, long-term relationship between the midwife and the woman was also considered to be challenging and mentally demanding if the relationship was not satisfactory.
MCoC was also seen as creating better conditions for planning and preparing couples for the upcoming birth and providing realistic expectations based on their desires. A student added: ‘Having the opportunity to create trust, respect and confidence can make more women feel comfortable opening up about their situation, allowing midwives to help on a completely different level than we can today’ #5.
Continuity of care was seen as favorable for midwives due to a better understanding of parents’ preferences and more opportunities to make women feel calm and secure. Knowing the women beforehand could make it easier to interpret symptoms, respond to them, enhance the physiological birthing process and create a positive birth experience. All these factors could make the transition into motherhood easier, as the midwife could support this process. One student highlighted: ‘ Imagine being able to contribute to that experience as a midwife and see all the things you have said have helped, how empowering that is for a midwife’ #16.
3.3 Theme three: convincing evidence of midwifery continuity of care for women
The students believed that while a MCoC model had many advantages as shown in the literature it may not be suitable for all women. This belief was reflected in two subthemes.
3.3.1 Freedom of choice for women
The students acknowledged that not all women were aware of MCoC. They also emphasized the importance of providing more options for women to choose from and for midwives to support women in giving birth according to their own preferences. They felt that a MCoC model may not be suitable for all women and should therefore be an alternative to standard care. ‘
Some women may prefer to have a midwife who works at the hospital every day because they believe she is the best!’ #3. However, the students believed that many women would be interested in MCoC and would prefer to have a familiar midwife with them during childbirth. Two students expressed:
Population satisfaction … I think many women may not “buy” our type of maternity care, the way we currently conduct it today #4
People from other parts of the world are unfamiliar with the Swedish healthcare system and for them it's completely incomprehensible that the antenatal midwife shouldn't be present at the birth #3
3.3.2 The meaning of continuity of care for women and their partners was considered diverse
The students perceived significant advantages for women and their partners with MCoC. As the care focuses on each individual, women are cared for by the same midwife for an extended period, allowing them to develop a strong relationship based on trust, calmness and security. Students believed that when women become familiar with the midwife who will be involved in the birth, it reduces anxiety, interventions and complications. The birthing woman can more easily listen to her body and manage pain, which can facilitate a natural birth and lead to a better birth experience, initiation of breastfeeding and overall health when cared for in a continuity model. A student described the benefit of MCoC as: ‘ The midwife knows what she’s afraid of and what makes her feel supported and safe’ #16.
The students emphasized that with MCoC, it may be easier for women to communicate what is important to them, rather than having to explain their preferences repeatedly to different midwives . Additionally, even if the birth does not go as planned, there may be greater understanding when women know their midwife has their best interests at heart. However, challenges for women in MCoC could arise if they feel obligated to be polite or do not feel comfortable with the midwife or satisfied with the care model. Therefore, students believed that women should have the option to change the midwife or care model. Furthermore, women should not expect a specific midwife to be available for the birth, so a team of midwives was considered essential. Women who travel frequently or relocate may also find it challenging to receive continuity of midwifery care.
MCoC was also seen as beneficial for the woman's partner as it would be easier to involve, support and include the partner, which could help them work together during the birth. Two students added:
It’s so crucial for partners to have a positive birth experience, to feel secure and to know they are not alone unless they prefer it that way #12
If [the partner] knows the midwife, they trust her; if a woman feels very safe and cared for, [the partner] can also feel calm #2
4 Discussion
The students regarded midwifery continuity models of care as a perfect addition for women, families and midwives in Swedish maternity care. The students expressed interest in working within a MCoC model but emphasized that work experience and an introduction program would enhance work readiness. Working in MCoC was seen as being based on midwives’ preferences. The students believed there was compelling evidence to support the provision of midwifery continuity of care.
According to our study, students believe that MCoC is the future model of care for midwives, women and their partners and that a change in today's maternity care is needed. Similar to other studies on midwives’ and midwifery students’ attitudes toward MCoC models ( Fahlbeck et al., 2025; Lindqvist et al., 2025; Kashani et al., 2021), MCoC is considered the gold standard, at least when considering the future of midwifery ( World Health Organization WHO, 2024). The main theme of our study showed that the upcoming midwifery workforce has positive attitudes and a strong interest in evidence-based work. However, the result also showed some skepticism and certain conditions that need to be met. One of these conditions was found in the first theme, ‘Increased knowledge of midwifery continuity of care would strengthen interest’, where it became evident that MCoC models were attractive to midwifery students, but they lacked the confidence to start their careers in this model on completing their education. This attitude could be explained by the lack of knowledge, development and experience during their clinical placements. In other countries, such as Australia, where students are required to have at least ten ‘follow-through’ experiences during their education, work in MCoC models promotes independent midwives ( Carter et al., 2020, 2015). A literature review has highlighted that independent midwives with autonomy, supportive leadership and a clear scope of practice, along with national guidelines promoting MCoC, are key facilitators for implementing MCoC ( Zarbiv et al., 2025). So, it has been argued that some level of independent practice as a midwife is necessary before entering MCoC ( Kuliukas et al., 2021; Moncrieff et al., 2021; Zarbiv et al., 2025). Such arguments can be understood from a student perspective in Sweden, as they have limited clinical practice in antenatal care. Swedish antenatal care has a broader scope of practice compared with other countries. Antenatal examinations during women’s pregnancies are the main duty in antenatal care, with 9–10 visits during an uncomplicated pregnancy. In addition, midwives in antenatal care also work with pap smear screening, family planning with contraception counseling, vaccines, parent education, screening for fear of birth, depressive symptoms and domestic violence. It takes time to become skilled and confident in performing all aspects of midwifery care. High standards are set for midwifery students in intrapartum care, requiring them to have assisted in at least 50 births and cared for 100 women in labor, during the relatively short education (60 weeks following a nursing education) ( The Swedish Association of Midwives, 2019). Midwives in Sweden have recognized that the education program is too short, leading to significant stress, exhaustion and pressure to meet the 50-birth requirement. This is further exacerbated by declining birth rates, resulting in extended time spent in the labor ward ( Bäck et al., 2025). The challenges for higher education institutions are to revise the curriculum, increase the length of midwifery education and potentially separate it from nursing with direct entrance ( International Confederation of Midwives [ICM], 2025; Bäck et al., 2025). This change could cultivate independent and confident midwives who can lead the future of care towards an increase in MCoC. A high level of confidence in midwifery students has been linked to satisfaction with continuity in supervision during clinical placements, fostering mutual trust, growth and independence. Theory sessions in the classroom and simulation training/demonstration by teacher have also been shown to enhance confidence by allowing students to practice tasks, receive feedback and discuss management strategies ( Bäck et al., 2025). Confidence is crucial for midwives to take a holistic approach in their care, focusing on creating trusting, respectful and personalized relationships with women through continuous midwifery care (ICM, 2025).
Challenges in starting to work in MCoC as a newly graduated midwife were explained by the current study as the need for autonomy and trusting one's competence. According to a review, barriers to implementing MCoC included hierarchical power dynamics, resistance to change, shortage of midwifery workforce and financial and resource shortages ( Zarbiv et al., 2025). However, our results indicated that an introductory program for newly qualified midwives would be necessary. An Australian interview study described a mentorship program for newly qualified midwives in a MCoC model as important for building confidence during the transition from student to midwife ( Cummins et al., 2017). Furthermore, a scoping review on newly qualified nurses suggested that a transition program could have a positive impact on competence, level of confidence and attrition rates ( Aldosari et al., 2021). Similarly, a mentorship for midwifery students has been highlighted as an important aspect of building confidence ( Hughes and Fraser, 2011; Moncrieff et al., 2021) and retaining midwives in the profession ( Cramer and Hunter, 2019). It has been observed that every fourth midwife in Sweden does not work in the health sector ( The Swedish National Health Competence Council, 2023) and studies have shown an increase in levels of burnout among midwives over time ( Hildingsson et al., 2024), with every third midwife considering leaving the profession ( Hensing et al., 2025; Feijen-de-Jong et al., 2022; Hildingsson et al., 2013).
In the second theme, ‘Working in a midwifery continuity model of care should be based on midwives’ preferences’, it was highlighted that midwives’ work preferences were important. Working in MCoC may not suit all midwives due to personal circumstances, long distances to hospitals and the diverse organization of maternity services. In some parts of Sweden, women and midwives must travel long distances from home to reach a hospital with a labor ward, due to the closure of smaller birthing units that have occurred over the last 25 years. These circumstances make it difficult to provide MCoC models, especially in rural areas, creating unequal care. Hence, local projects that have tried MCoC models in rural areas have shown positive birth outcomes for women ( Hildingsson et al., 2021) but challenging working conditions for midwives ( Larsson et al., 2021). A qualitative systematic review on midwives' experiences in providing MCoC described challenges, including a lack of work-life balance and not being financially compensated for the hours and work they put in. A high level of autonomy could also be seen as a professional and emotional burden, with factors such as unpredictability and working in isolation. Other challenges with MCoC included conflicting ideologies, competing responsibilities with the wider maternity team and a lack of support from the organization, which sometimes manifested as hostility and threats ( Pace et al., 2022).
The content of the third theme, ‘Convincing evidence of midwifery continuity of care for women’, can be somewhat unexpected, as it may not be attractive for all women. One key point was that women should be able to choose a model of care and MCoC could be a complement to standard care. This is interesting, as there are currently limited choices in Swedish maternity services, except for a few established continuity models in the capital area aimed at women with a fear of birth ( Lundborg et al., 2025). Otherwise, women are offered only fragmented care without the option to know the assisting midwife. The fact that interest in knowing the midwife who will assist during labor has increased from 52 % to 76 % over the last 20 years, as shown in a study based on two national cohorts of 4873 pregnant women ( Hildingsson et al., 2025), should be a wake-up call. There is no doubt that MCoC models have a future in Sweden and it’s time for stakeholders to listen to what women (and midwives) want.
A scoping review by Hainsworth et al. (2021) included 46 studies from Australia, the UK, Norway, the Netherlands, Canada and Indonesia, aimed to explore continuity of care experiences in midwifery education. The pedagogical intent of the MCoC experience was to help students understand the woman’s experience of childbirth and maternity care, focus on the role and skills of a midwife and incorporate a woman-centered approach to midwifery care ( Hainsworth et al., 2021). It is possible that midwifery students in Sweden need to be exposed to MCoC models during their education to fully grasp the importance of continuity and its benefits. Studies where students have had the opportunity to provide continuity clearly indicate a positive learning outcome ( Foster et al., 2021; Carter et al., 2022), satisfied students ( Carter et al., 2022) and most importantly highly satisfied women ( Aune et al., 2023).
4.1 Strengths and limitations
Participants in this study may have been overrepresented by individuals with positive thoughts and experiences of MCoC, as they had to actively contact the research team if interested in participating. However, midwifery students from eight institutions offering midwifery education in Sweden were included, resulting in a diverse range of student experiences, including clinical practices and formal education of MCoC. Furthermore, all members of the research group are female midwives by profession, with all but one holding a PhD. We share a philosophical view that childbirth is not merely a medical event but also a profound and significant life experience. This philosophy is closely linked to care models like MCoC with a woman-centred approach and that midwives are the most appropriate care providers during a physiological pregnancy, labor and birth ( International Confederation of Midwives [ICM], 2025). As researchers, we believe that data analysis is subjective and our experiences and values shape how we interpret the themes in this study. The research group has extensive experience within MCoC, both clinically and academically. Since the authors did not know the identity of the participants, no member check was carried out, which can be seen as a limitation of the study. Our reflexivity in the research process was crucial for identifying underlying philosophical assumptions and research values ( International Confederation of Midwives [ICM], 2025; Braun and Clarke, 2021).
5 Conclusions
The students in our study viewed MCoC as a perfect complement for women, families and midwives in Swedish maternity care. They expressed interest in working within a MCoC model, but felt that work experience and an introduction program would support their readiness for work. As a midwife, working in a continuity model was seen as a preference. This study highlighted the importance of offering women and midwives the opportunity to choose different care paths in maternity care. MCoC was seen as enhancing woman-centered care and was proposed as the future model of care.
Contribution statement
All authors contributed to the conception and design of the study, design of the survey, analysis and interpretation of the data, drafting and revising of the manuscript and approval of the final version submitted.
CRediT authorship contribution statement
Ingegerd Hildingsson: Writing – review & editing, Validation, Methodology, Conceptualization. Margareta Johansson: Writing – review & editing, Writing – original draft, Visualization, Validation, Methodology, Formal analysis, Conceptualization. Linnea Sundström: Writing – review & editing, Validation, Methodology, Investigation, Data curation, Conceptualization. Sophia Holmlund: Writing – review & editing, Validation, Project administration, Methodology, Investigation, Data curation, Conceptualization. Maria Lindqvist: Writing – review & editing, Validation, Project administration, Methodology, Investigation, Data curation, Conceptualization.
Ethical statement
Students were informed both in writing and orally about the study, emphasizing that participation was voluntary and that they could withdraw at any time. The research subject was not sensitive and therefore ethical approval was not necessary to be obtained, however, the ethical principles of the Helsinki Declaration and the General Data Protection Regulation were followed as outlined by the International Committee of Medical Journal Editors (ICMJE).
Consent
Informed consent was obtained from all individual participants included in the study.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. No external funding was received for the study.
Declaration of Competing Interest
The authors have no competing interests to declare.
Acknowledgements
The authors want to thank the participating midwifery students for sharing their thoughts.
Appendix A Supporting information
Supplementary data associated with this article can be found in the online version at
Appendix A Supplementary material
Supplementary material
Supplementary material
Table 1
| Midwifery students | |
| n = 16 | |
| (n) | |
| Gender | all females |
| Age (years) | 27–45, mean 33.6 |
| Midwifery education sites | 8 of 11 in total |
| Semester of education (1−3) | |
| Second | 1 |
| Third | 15 |
| Years of being a registered nurse | 2–15, mean 6.25 |
Table 2
| Main theme | Midwifery continuity models of care are a perfect complement for women, families, and midwives in Swedish maternity care | ||
| Themes | Increased knowledge of midwifery continuity of care would strengthen interest | Working in a midwifery continuity model of care should be based on midwives’ preferences | Convincing evidence of midwifery continuity of care for women |
| Sub-themes | Readiness as a decisive factor
Enhancing educational factors for working in a continuity model |
Freedom of choice for midwives
Multifaceted working conditions |
Freedom of choice for women
The meaning of continuity care for women and their partners was considered diverse |
© 2025 The Authors