Services Provided by Midwives

Midwives practise in different settings and in different ways. They work in the community and in hospitals. Services provided by midwives include some or all of the following:

• Preconceptual advice
• Free pregnancy testing
• Antenatal care and assessments throughout your pregnancy with visits at home or at the midwife’s clinic. This includes arranging any necessary blood tests or investigative procedures.
• Consultation with an obstetrician or other specialist if complications arise at any time during pregnancy, labour and birth or the weeks following.
• Information and education on a one-on-one basis and for groups
• Time for questions and planning to meet you and your family’s needs
• Support and professional care throughout labour and birth in the place of your choice
• Labour and birth pool hire
• Support, advice and professional care after your baby is born and for 4 – 6 weeks afterwards
• Early discharge home if you birth in hospital
• Support, advice and assistance with breastfeeding and caring for your baby
• Contraceptive advice
• Discharge from midwifery care when you are ready at about 4 – 6 weeks and referral on to the Plunket nurse, iwi provider, other well child provider or general practitioner. These practitioners can provide support and assist with ongoing care such as immunisation and well child checks.

Lead Maternity Carers (LMCs)

Lead Maternity Carers are contracted through the Ministry of Health to provide a complete maternity service to you.

When you choose a midwife as your LMC, you can expect the following from her.

On booking:

• a copy of your clinical notes (updated at each visit)
• information regarding the role of the LMC and contact details including arrangements for ‘cover’ if unavailable
• information about the standards of care to be expected, possible interventions and possible outcomes
• information about the availability of Pregnancy and Parenting Education courses
• information about Paid Parental Leave
• a comprehensive pregnancy assessment including physical examination, assessment of general health, family and obstetric history and screening for infectious diseases
• development and documentation of a Care Plan to be used and updated throughout your pregnancy, birth and after birth. (Your LMC will keep a copy and will give you one.)

In the second trimester (12 to 28 weeks of pregnancy):

• monitoring of your progress including early detection and management of any problems
• updating your Care Plan
• one-to-one education regarding healthy pregnancy, childbirth and parenting preparation
• booking into a Maternity Facility or Birthing Unit unless you are planning a Homebirth

In the third trimester (28 weeks until labour begins):

• monitoring of your progress including early detection and management of any problems
• updating your Care Plan
• one-to-one education regarding healthy pregnancy, childbirth and parenting preparation
• specific education for labour and birth including role of your support people, coping with the pain of labour, options for the birth itself, care of the afterbirth, immediate care of the baby and breastfeeding
• instructions for making contact when labour begins
• arranging for you to meet any other maternity carers who may be involved with your care

Labour and birth:

• initial assessment at home (preferable) or at a Maternity Facility
• regular monitoring of you and your baby’s progress
• all your primary care during your labour and the birth of your baby
• all your primary care immediately following the birth including initial examination and identification of your baby, initiation of breastfeeding, care of the placenta, any suturing required and notifying your baby’s birth to the Registrar of Births

If you are having your baby at home:

• arranging for a second practitioner to be available to attend the birth
• maintaining the necessary equipment including neonatal resuscitation equipment
• providing the delivery pack and other supplies

If you are having your baby in a birthing unit:

• arranging for a second practitioner to be available to attend the birth
• ensuring a practitioner remains with you until you are discharged

 After your baby is born (from the birth until your baby is 4-6 weeks old):

• detailed clinical examination of your baby within the first 24 hours
• if you are in hospital, a daily postnatal visit prior to your discharge (unless another arrangment is made with you and with the facility)
• one home visit within 24 hours of your discharge from hospital
• a further detailed clinical examination of your baby within 5 days of the birth
• a total of 5 – 10 midwifery home visits and more if clinically needed
• a minimum of seven postnatal visits in total
• assistance with and advice about breastfeeding and nutrition for mother and baby
• assessment for risk of postnatal depression and/or family violence with appropriate advice and referral
• provision of the Ministry of Health information on immunisation
• access to screening programmes for your baby as outlined in the Well Child Tamariki Ora National Schedule
• advice about contraception
• parenting advice and education
• a final detailed clinical examination of the baby prior to transfer to the Well Child Provider (Plunket or other service)
• a postnatal physical examination of you prior to discharge from the LMC service
• transfer of your baby’s care from the LMC to the Well Child provider at a date agreed with you between 4-6 weeks after the birth, and formal notification of this transfer to the Well Child provider 
• notification to your General Practitioner of your discharge from LMC services

Are You Happy With The Care You Received?

Each region of the New Zealand College of Midwives has set up a Resolutions Committee to help women resolve concerns or questions they may have about their midwifery care. The Committee consists of a representative of consumers of midwifery services nominated by local consumer groups and a midwifery representative nominated by the local region of the College.

The Resolutions Committee provides a neutral, accessible, confidential and supportive service where women can resolve issues with the midwife concerned. It is a free service.

The Resolutions Committee is not a disciplinary body and does not have the ability to punish or take away a midwife’s right to practice. It can recommend that a midwife undertake professional development including Midwifery Standards Review. The Committee can advise women about other avenues to direct their concerns if necessary.

For further information about your nearest Resolutions Committee contact:

New Zealand College of Midwives (Inc)

PO Box 21 106

Christchurch

Telephone (03) 377 2732   Facsimile (03) 377 5660

Email midwiferyadvisor@nzcom.org.nz