BACKGROUND:
In Ontario, Canada, care is provided almost exclusively in a continuity of care, caseload model. Despite its foundational role, research about client experiences of continuity and its impact on clinical outcomes in Ontario remains limited.

OBJECTIVES:
To examine patterns of continuity of care among midwifery clients in Ontario assessing associations between continuity indicators and clinical outcomes.

METHODS:
A population-based cohort study was conducted utilizing data collected by Ontario’s Better Outcomes Registry & Network (BORN). The cohort included singleton births under midwifery care between April 2015-March 2022. Key measures of continuity include presence of a known midwife at birth, number of midwives providing prenatal, postnatal care, number of visits, transfers of care. Measures of continuity and descriptors of care overall and stratified by time period with respect to the COVID-19 pandemic were included. Multivariable logistic regression was used to investigate the relationship between presence of known midwife at birth and outcomes.

RESULTS:
As a preliminary step, data about the primary exposure of interest, presence of a known midwife at the birth, has been evaluated. Eighty-eight percent of Ontario midwifery clients had a known midwife present at their birth. Further analysis will take place in summer of 2025.

CONCLUSIONS:
This study will contribute insight into key issues of professional sustainability and models of practice by centering the experiences of service users and families in our considerations about the current model of midwifery care.

KEY MESSAGE:
Despite continuity of care being a central component of midwifery since its inception in Ontario, an examination of how it is experienced and the clinical outcomes that are associated with it has not yet occurred, but would help to shape practice and service delivery. Poster session 2 (Group A)