There is something rather lovely about being known.
Not recognised.
Not remembered from a note in a computer.
Known.
The kind of known where someone knows that you always arrive five minutes late because getting out of the house with a toddler takes longer than you thought it would. They know that you are actually quite worried about the thing you keep saying you’re not worried about. They know that you don’t like being rushed. They know about the birth you had before. They know why you are hoping for something different this time. They know that when you go quiet, you are usually thinking rather deeply. They know what makes you laugh. They know what frightens you. They know your hopes for this baby. And when you walk into the room, you don’t have to begin at the beginning. You can simply say,
“I’ve been thinking about what we talked about last time…”
And they know exactly what you mean.
There is a particular kind of safety in this. Pregnancy asks us to hand over an extraordinary amount of ourselves. Our bodies become public in a way they have never been before.
Our blood is tested.
Our urine is tested.
Our blood pressure is taken.
The care of someone who has enough time to notice when something is slightly different. The care of not having to repeatedly explain who you are, what matters to you and what has brought you to this point. The care of being able to say, “I’m not sure about this,” without feeling that you are being difficult. Or,“Actually, I think I want something different.” And knowing that the conversation can begin there.
I think this is one of the more precious gifts of continuity We talk a lot about continuity of care in maternity. It is a phrase that can sound rather clinical. Continuity of carer. Continuity of care. Care pathways. Models of care. But underneath all of that is something very human.
Relationship. The relationship between two people who have spent time together. The midwife who has sat with you on your sofa while your toddler climbs over the furniture. The midwife who has listened to you talk about the birth you are hoping for. The midwife who has heard you change your mind. The midwife who knows that you are excited and frightened in equal measure. The midwife who has met your partner. The midwife who knows what happened last time. The midwife who knows that you have been reading everything you can possibly find about birth at two o’clock in the morning. And then, when labour begins, she isn’t meeting you for the first time. She already knows you. You already know her. There is no need to establish a relationship in the middle of one of the biggest experiences of your life. You have already built it.
Perhaps this is why birth stories matter so much I have always loved birth stories. Long before I became a midwife, I was drawn to them. I think part of this came from my own childhood. My mum kept the stories of our births. She remembered them. She talked about them. They weren’t brushed aside as something that happened and was over. They were part of the story of our family. I think there is something powerful in this. Because birth is not simply an event that happens to a body. It becomes part of the story we tell about ourselves. Sometimes that story is joyful. Sometimes it is complicated. Sometimes it carries grief. Sometimes it is full of pride. Sometimes it takes years before we can understand what happened. And sometimes what makes the difference is not whether everything went according to plan, but whether we felt that we were there for it. Whether we were listened to. Whether we were respected. Whether we had someone beside us who knew us.
Being known doesn’t mean nothing difficult will happen This is important too. Knowing your midwife doesn’t make birth predictable. It doesn’t remove uncertainty. It doesn’t mean that there will never be a transfer, a change of plan, a medical intervention or a difficult conversation. Birth can still surprise us. Babies have their own ideas. Bodies have their own wisdom and their own limits. Sometimes things don’t unfold as we imagined. Continuity isn’t a promise that everything will go according to plan. I think it offers something more useful than that.
Someone who can stay with you when the plan changes. Someone who knows where you started. Someone who understands what this particular decision means to you. Someone who can help you find your feet again. Someone who can sit quietly when there isn’t anything to fix. Someone who can explain what is happening without making you feel that your body has suddenly become a problem to be solved. Someone who can say,
“Let’s take a breath. Let’s look at what is happening. Let’s work out what you need now.”
And sometimes that is what care really is.
There is something beautiful about a familiar face at the birth of your baby I don’t think I will ever become blasé about this part of my work. I have sat in kitchens at three in the morning. I have watched women move through their homes in labour. I have drunk cups of tea that have gone cold and eaten toast at all sorts of times of day and night. I have watched partners watch their partners in awe and wonder and even with a little bit of awe driven fear at the power they are witnessing. I have watched partners find parts of themselves they didn’t know were there. I have seen women roar. I have seen them laugh. I have seen them doubt themselves and then find themselves again. And I have been there when a baby arrives and the whole room changes. There is a particular tenderness in those moments when everyone is quiet for a second. The baby is here. The mother is looking. The partner is looking. And I know these people. I know the conversations that brought them here. I know what this baby means to them. I know what they hoped for. I know what they were afraid of. And sometimes I think this is one of the greatest privileges of being an independent midwife. Not simply being there for the birth.
Being there for the story.
Perhaps this is what we are missing We live in a time when so much of life has become efficient. A world of AI, google searches for everything and so little time left over after scrolling. We can shop at the supermarket without having to even say hello to a cashier anymore. We can book appointments online through BOTS. We can communicate without seeing one another. We can carry hundreds of people’s lives around in our phones and still sometimes go a whole day without anyone really knowing how we are. Pregnancy feels different. Or at least, I think it can. It asks us to slow down. To listen. To notice. To become acquainted with our changing bodies. To prepare for a person we have never met. And perhaps it is fitting that the care around pregnancy should make room for relationship too. Not because relationship replaces clinical care. It doesn’t. But because good care is more than a checklist. The research supports the value of continuity again and again. Women receiving midwife continuity models generally report more positive experiences, and the evidence suggests some important differences in interventions and mode of birth too. But statistics can’t quite capture the feeling of walking into a room and seeing a familiar face. They can’t measure the exhale. They can’t measure the relief of not having to explain. They can’t quite capture what it means to look across the room in labour and see someone who has known you for months. And perhaps that is why I keep coming back to relationship. Because underneath all the words we use about maternity care, underneath homebirth and hospital birth, physiology and intervention, birth plans and policies, there are simply people. A woman. A baby. A family. And the people they have chosen to surround them.
I think we all deserve to be known Not just during pregnancy. But in all the important thresholds of life. To have people who know our stories. Who remember where we have come from. Who notice when something has changed. Who can sit beside us when we don’t know what comes next. Pregnancy and birth are enormous thresholds. They deserve care that recognises that. For me, this is at the heart of independent midwifery. I don’t want to be the midwife who simply knows your blood pressure. I want to know you. And I want you to know me. Because when the time comes, and your baby is making their way into the world, there is something very powerful about looking across the room and seeing a familiar face. A face that says,“I know you. I’ve got you. I’m here.” And sometimes, that is where safety begins.
RachelOur babies are measured and monitored.
We are asked questions about our health, our history, our bodies and sometimes our most private experiences. And much of this is important. But there is another kind of care that cannot be measured quite so easily. The care of being known.