PURPOSE:
Midwifery Continuity of Carer (MCoC) model is a relationship-based model in which a known midwife, supported by a small team, provides care from booking to the postnatal period. Although recommended internationally and prioritised within English maternity policy, implementation and sustainability remain challenging. This scoping review synthesises international evidence on how MCoC is defined, operationalised and implemented across maternity services.

DISCUSSION:
A structured search of PubMed, CINAHL and the Cochrane Library identified studies published between 1993 and 2026 relating to MCoC implementation. Included studies were charted and analysed thematically using the COM-B framework. Capability related to midwives’ preparation, skills and confidence to deliver continuity care. Opportunity referred to organisational factors including staffing, workload, leadership, funding, rostering and multidisciplinary support. Motivation related to professional identity, autonomy, morale and willingness to work within continuity models. This framing conceptualised implementation as both a behavioural and organisational challenge.

EVIDENCE WHERE RELEVANT:
The review identified 29 relevant studies from diverse international settings, including Australia, Canada, the United Kingdom and New Zealand. MCoC was most commonly organised through caseload or small-team models across antenatal, intrapartum and postnatal care. Reported benefits included improved maternal satisfaction, stronger relationships and, in some studies, improved care experiences and clinical outcomes. Facilitators included supportive policy, protected implementation time, training, manageable caseloads and linked obstetric support. Barriers included workforce shortages, unsupportive workplace cultures, burdensome on-call arrangements and wider system pressures affecting sustainability.

KEY MESSAGE:
This review identifies an important organisational evidence gap. Applying the COM-B framework demonstrates that successful implementation depends on aligning workforce capability, organisational opportunity and professional motivation. The review provides a foundation for future research examining how MCoC is operationalised and sustained within contemporary maternity services. Workforce - MMOC