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The interpretation of continuous support during labour has changed over time. Women have been cared for and supported physically and psychologically, across the ages, by other women during childbirth. Changes in models of care during labour have impacted the way women are supported during this life‐changing event. Consequently, a rise in hospital births in the post‐war era has medicalised childbirth and interrupted the relationship of midwives with women in the home environment. However, a move towards provision of continuity of support in labour, by midwives as ‘ritual companions’, over the last few decades, has had an impact on birth outcomes (Reed et al. 2016). Physical, psychological and spiritual support has resulted in a reduced risk of caesarean section, instrumental delivery and need for analgesia (McDonald 2011).

Innovations such as birthing pools, improved equipment and alternative therapies for pain relief used in labour have changed midwifery practices to ameliorate the birthing environment. However, organisational factors such as rising costs, shortage of staff and resources have had an impact on the provision and quality of maternity services. Over time, these have collectively had a significant bearing on women's satisfaction with their childbirth experiences and have ‘cost’ midwives and healthcare professionals in terms of their health and wellbeing (Leinweber and Rowe 2010; Amir and Reid 2018).

The new standards for the midwifery profession (NMC 2019, p. 16) state that a midwife must ‘Provide safe and effective midwifery care: promoting and providing continuity of care and carer’. It is unclear how midwives will be able to fulfil the expectation of continuity of carer when the midwifery workforce is depleted to a risk level that needs addressing urgently. Consequently, midwives are suffering from occupational burnout, experiencing stress and anxiety and need organisational and peer/colleague support (Yoshida and Sandall 2013). The Department of Health has recognised these shortfalls and currently changes are in progress. There is a move to improve and balance life/work conditions (Knapp 2017a) and change to bursaries for students entering the profession as a way forward for those who struggle, at personal cost, to provide safe and effective midwifery care.