Why continuity of carer matters in group care: a qualitative analysis of women’s experiences of Pregnancy & Parenting Circles in England
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Authors
Horn, Anna
Antonioli, Eleonora
Wiseman, Octavia
Leister, Nathalie
Knight, Michelle
Rodriguez, Amaia
Bradley, Susan
McCourt, Christine
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Issue Date
2026
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Article
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BACKGROUND: Group Care, here described as Pregnancy and Parenting Circles (PPC), is a holistic model of maternity care characterised by a facilitative and interactive approach. Evidence indicates positive outcomes and experiences for women who participate. Its potential to enhance women's empowerment, health and wellbeing as well as their relationships with healthcare services positions group care as an innovative model warranting further investigation. RESEARCH QUESTIONS: This study examined: 1). the extent to which the PPC model adhered to the core values and components of Pregnancy Circles; 2). how fidelity to the model influenced women's experiences of care; and 3) how established mechanisms of effect operated within PPC. METHODS: We draw on UK data from an implementation study, Group Care in the First 1000 Days (GC_1000). Data were generated through meeting notes, group session observations, semi-structured interviews and focus groups with service providers and users. A UK group care randomised controlled trial, REACH (trial registration no: ISRCTN91977441), provided a framework of core values and components utilised in an abductive analytical approach for examining model fidelity. RESULTS: Findings highlight 'relational continuity' as a central component of group care. Relational continuity functioned as a key lever, enabling mechanisms such as enhanced engagement and active participation in health. Lack of fidelity to continuity disrupted the model's mechanisms, weakening its positive effects on women's experiences of care. CONCLUSION: Relational continuity is critical to operationalising the mechanisms underpinning group care. Attention to model fidelity is essential to optimise women's experiences of group care.
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Midwifery
Volume
156