Your Lead Maternity Carer

Your Lead Maternity Carer (LMC) will provide you with all or most of your antenatal care and will continue to look after you and your baby for 4-6 weeks after the birth. This is a very intimate and special time in your life, and you will want a supportive relationship with an LMC you can trust. You may rely on a recommendation from a friend to find an LMC, or you may need to interview several to find someone who matches your personality and birthing philosophy. Whomever you choose, remember that proper antenatal care is recommended for a successful and healthy pregnancy. Your midwife or doctor will be looking after the physical health of you and your developing baby, but will also be there to support your emotional and mental health through pregnancy and the first several weeks postpartum.

This partnership is meant to be in the best interest of you and your baby–your midwife or doctor should also include your whānau or other support person in this process if this is what you want. If, for any reason, you are unsatisfied with your LMC you can find someone new! However, it is recommended that if you decide to change your LMC it is best to do so early in the pregnancy to maintain continuity of care. If your LMC feels you need a higher level of care, she may refer you to a specialist.

In New Zealand, the costs for antenatal care are covered by the Ministry of Health (MOH) for primary maternity care.   Specialist Obstetricians are NOT covered, unless you are referred to one due to complications in your pregnancy. Currently, about 80% of Lead Maternal Care in New Zealand is provided by midwives.

 

Midwives

An Independent or Hospital Midwife is an LMC who is qualified to provide care for a woman during a normal pregnancy and birth. The vast majority of pregnancies and births fall in the “normal” category, and it is likely that yours will be no different! You may have an individual midwife assigned to you, or you might work with a group of midwives who share a common practice. Your midwife will be your primary carer through all stages of pregnancy, delivery and the first several weeks postnatal.

If you don’t already have one in mind, you can find a Midwife in your area using this website http://www.findyourmidwife.co.nz/

Your midwife may visit you in your home, or may see you at a hospital or clinic. In addition to being your primary carer, she is your best advocate for you and your baby. Midwives are educated to detect any abnormalities in your pregnancy. It is always best to assume that you will have a normal pregnancy, but if complications are expected or become evident during pregnancy, your midwife may refer you to a public or private obstetrician. There are national guidelines regarding conditions that may warrant referral to an Obstetrician. These include:

• Underlying adverse medical conditions in the mother, like diabetes or hypertension
• Previous complications during pregnancy, like placental abruption or Cesarean-section
• Complications with the fetus, such as breach position or multiple babies

Many concurrent medical conditions, such as asthma or thyroid disease, will not necessarily result in a complicated pregnancy. It is important to discuss with your midwife any medical conditions you are experiencing, whether or not they are related to pregnancy. She will work with your general practitioner (family doctor) to jointly ensure the best possible care for you and your baby.

General Practitioners (Family Doctors)

Your family doctor may be able to provide antenatal care initially during your pregnancy. This is a good choice if you already have a positive, trusting relationship with this doctor and he or she is familiar with your medical history. This is known as “non-LMC first trimester care.” The MOH will cover the first 12 weeks of care with this doctor before you register with an LMC. This choice is meant to give you time to find an LMC, and is not meant to be your final carer. You may continue seeing a GP for any non-pregnancy-related care during your pregnancy, but there are no GPs who offer maternity care in the Hutt Valley.

General Practice (Private) Obstetrician

General Practice Obstetricians are fully qualified General Practitioners who have had additional education and training in obstetrical care. They are trained to handle the most common adverse situations during pregnancy, however they may need to refer you to a Specialist Obstetrician if further complications arise. A GP Obstetrician will work with a midwife or group of midwives to provide care during your pregnancy, labour, delivery and after your baby is born.

There are three private obstetricians in the Hutt Valley, and their clinics are at Boulcott Hospital. Private obstetrician services are not covered by the MOH. Charges vary widely, so please discuss the costs with any Private Obstetrician before deciding on this type of care.

 

Specialist (Hospital) Obstetrician

Care from a Specialist Obstetrician may be necessary if you have complications with your health during pregnancy. In this situation, referral to a specialist will be paid for by the MOH at the Secondary Care clinic at Hutt Valley Hospital (HVDHB). They are fully qualified to deal with adverse scenarios in pregnancy, including Cesarean Section. They generally do not assist with home births, and are employed in a hospital setting because their practice involves abnormal pregnancy and complicated births.

 

Your Rights

If at any time you are unhappy with your care, your midwife or doctor should be the first person to whom you speak! In New Zealand, by law, you have the right to professional care from a competent, skilled carer who respects your opinions, values, culture, customs, privacy and confidentiality. You have the right to have every service or option explained to you, and the right to refuse any service or option. If you have any complaints that have not been resolved after discussing them with your carer, you may visit:

The New Zealand College of Midwives website or call 03 377 273.

The Health and Disability Commissioner’s website or call 0800 11 22 33.

These organizations will help you understand your right and what steps can be taken to improve or change the situation.