• Do I have the right to be cared for by the same midwife during my pregnancy?
• Can I see the same doctor and midwife if an obstetrician is leading my care?
• Am I entitled to see an obstetrician (specialist maternity doctor)?
• Can I ask to change midwife or obstetrician?
• Can I change Trust or Board?
• Can I choose the midwife or doctor who gives me postnatal care?
• Are there alternatives to NHS maternity care?

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 care’ or ‘continuity of carer’. 

If you have continuity of care, 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. 

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

You do not have a legal right to continuity of care, but the Governments of Scotland, Wales and Northern Ireland want to see everyone being cared for by the same midwife or small team of midwives as soon as often as possible. NHS England & Improvement had an ambition for most women to receive continuity of carer by March 2021 but this aim has been disrupted by the pandemic and ongoing issues around staffing.  

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

If the Trust cannot offer you continuity of care at present, you could ask what plans there are to establish continuity of care for everyone in the local area and when this will happen. You can ask the Director of Midwifery and/or the local Integrated Care Board (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 or Health Board who can offer this. To write to the Director of Midwifery, send an email to the Patient Advice or Patient support service for the Trust/ Health Board and ask them to forward your email to the Director of Midwifery.  

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

You do not have to agree to procedures simply because they are standard in the local 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), both doctors and midwives will offer and provide you with 

Having obstetric-led care, also called ‘consultant-led care’, should not stop you accessing midwifery continuity of care, if you are eligible for it at your Trust or Health Board. 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 if they don’t have enough staffing and resources. 

You can ask the hospital to explain who you will be seeing and when. If continuity of care 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 care. 

If you have certain medical conditions, for example a heart condition, you may be advised to have some or all 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 several 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. You do not have a specific right to see insist on receiving obstetric-led care.  However, if you have a complication in your health or pregnancy, or if you have a reason to be worried about your pregnancy or childbirth, you should be able to be referred to an NHS obstetrician. Depending on the outcome on your initial appointments with your midwife and/or obstetrician, your care team will recommend that you receive either midwifery-led care or obstetric-led care.  

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

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) the patient experience team or the patient concerns team.  You can also ask PALS to forward emails, and/or provide you with the contact details for the Head of Midwifery or for the Clinical Lead for Obstetrics. 

• 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 Health Board at any point in your pregnancy. You can choose a hospital or birth centre that is further 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. 

• You can read more about choosing a hospital or a birth centre that is in another area in our factsheet  Can I choose where I give birth? 

Before you ask to transfer, you need to be sure your chosen hospital, birth centre or home birth team can take over your care. Check if the Trust or Health Board who run your preferred hospital, birth centre, or home birth service has a geographical catchment area or a limit on how many people it can care for. Generally, Trusts and Health Boards can have proportionate limits on who can book with them, as that allows them to plan and to provide a safe maternity service. These limits are not legal rules though, and you may be able to request an exception.   

If you move to a new area, then you should be able to book for care at the closest Trust or Health Board in your new area, 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.  

Be aware that wherever you give birth, your closest local Trust or Health Board will provide your postnatal care. ever 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 closest local Trust or Health Board. 

This means that if you choose to have your antenatal care and give birth in a Trust or Health Board 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. 

• For more information about your right to care out of your area, see our factsheet Can I choose where I give birth? 

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 directly 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 all 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, mostly in London.  

 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. 

Disclaimer: Our factsheets provide information about the law in the UK. The information is correct at the time of writing (August 2024). 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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