Women and babies who experience social disadvantage face significantly higher risks of maternal and perinatal morbidity and mortality, alongside poorer care experiences and reduced choice. Midwifery continuity of carer (MCoC) has been promoted as a model of care that improves outcomes and satisfaction for the general maternity population; however, its impact for women and babies affected by social disadvantage is less clearly understood.

This article presents a critical review of the literature exploring the impact of MCoC on health care inequalities, care experiences and selected birth outcomes for women and babies experiencing social disadvantage. A systematic search of six health care databases identified nine UK and comparable primary studies employing qualitative, quantitative and mixed methods designs.

Four key themes were identified: improved access to maternity care through flexible and coordinated services; enhanced engagement and psychological safety through relational continuity; improved communication and personalised care enabled by informational continuity; and a positive association between MCoC and increased vaginal birth rates alongside reduced caesarean section rates.

The findings suggest that MCoC offers meaningful benefits for women and babies affected by social disadvantage, particularly in improving access, engagement, safety and experience, with some evidence of improved birth outcomes. Targeted and proportionate implementation of MCoC may contribute to reducing maternity care inequalities. Further inclusive research is required to strengthen the evidence base and inform sustainable service design.