What To Expect With Midwifery Care

How it all works with Fa’atosaga Pasefika Ueligitone

OUR SERVICE

Pasefika Midwifery Wellington

Between 80%-90% of pregnant women in New Zealand are cared for by a lead maternity carer (LMC) midwife. As midwives are in high demand, it is important you find a midwife as soon as you confirm you’re pregnant (whether by a home pregnancy test or your GP).

Maternity care is FREE in the New Zealand public health system, for all New Zealand Citizens and those women who have proof of Permanent Residency or an appropriate New Zealand visa e.g. spousal visa or work visa.

Your midwifery care includes:

– Midwifery care
– Blood tests
– Obstetrics care
– Specialists care

You’ll visit Penina at her office in Newtown for your antenatal appointments

The only items you may be required to pay for, are some of your ultrasound scans. This is dependent on where you attend your scans in the community and if you have a New Zealand Community Servcies Card. Otherwise your midwife visits, blood tests, hospital specialist visits are all free.

Please note if you are with a private obstetrician, there is a cost attached to their service.

If you are a non-resident of New Zealand, midwifery care is not free. There is cost involved for each service used and each region has their own fee structure.

Usually midwives care for women in a specific geographical region and particular hospitals. I care for women who live in the Wellington urban area, and who elect to birth at Wellington Hospital.

If you wish to have a homebirth, I can refer you to a homebirthing colleague.

Types of Midwifery Care

A lead maternity carer (LMC) midwife will provide either a ‘continuity of care’ service or a ‘shared care’ service.

The ‘continuity of care’ model:

One midwife is your dedicated maternity carer during the entirety of your pregnancy. You will attend all your appointments with that midwife. All your blood tests, referrals to specialists, scans will be organized by the midwife. The midwife will monitor you throughout your pregnancy, birth your baby and be with you up until your baby is 6 weeks old. At that stage, your care will be handed over to an appropriate well-child provider, that services your area and which suits your needs; such as Plunket, Ora Toa, Vaka Atafaga, or Thriving Cores.

Usually your midwife will be in a group practice, which enables the midwives to support each other clients. If your midwife is unavoidably unavailable e.g. sick, attending another birth or on bereavement leave, the other midwives will step in to care for you, until your midwife returns.

The ‘shared care’ model:

The midwife may work in a group practice and your care will be shared between the different midwives of the practice. This means even though, you may sign up to the service with one particular midwife, you will be cared for by the whole group. You may have a different midwife at each appointment or at stages of your pregnancy.

I and the midwives, I work closely with follow the ‘continuity of care’ model.

MEETING WITH YOUR MIDWIFE

The Process

Pregnancy Education

You will be provided guidance to help you during your pregnancy. You’ll also be advised on the stages of pregnancy, labour and birth, the postnatal period and baby immunisations.

Appointments

Your first appointment will be 60 minutes and should be within the first 12 weeks. Your initial scans and blood tests will be requested.

Around week 13

Your regular 30 minute antenatal appointments begin. They will include physical exams such as blood pressure and fetal heart rate checks.

Between weeks 25 - 30

You’ll have further blood tests and possibly further scans to monitor the growth of your baby, if there are concerns.

Between weeks 32 - 36

Your appointments will be fortnightly.

From week 36

Your appointments will be weekly and we’ll discuss your birth plan.

YOUR BIRTH PLAN

Deciding what you would like to happen

Around the 36 week mark, we’ll begin creating your birth plan or preference list. We’ll discuss in depth of what you want to happen during your labour such as, but not limited to:

– Who you want in the room
– What type of pain relief you want
– If you want to keep the placenta
– If you want to breastfeed
– If you want skin to skin
– Any cultural considerations

It’s important to note that, not everything you want to happen may be possible so we’ll also create a Plan B.

When creating your birth plan or preference list, flexibility is key for a positive outcome.

RETURNING HOME

What happens after giving birth?

Once you and your baby have been discharged from the hospital, I will visit you at home and do physical checks on you both, for up to 6 weeks.

I’ll assess your recovery by checking any blood loss, your healing, and breastfeeding progress.

I will also carry out regular examinations on your baby on a weekly basis.

During this time, my priority is to check both of you are physically well and thriving. It’s also important for me, to check that you’re well supported and coping, especially with the effects of sleep deprivation. Your mental wellness is just as important as your physical wellbeing, after giving birth.

In the first week, following the birth, I’ll probably visit you approximately 3-4 times. My visits will gradually decrease as the weeks progress.

At the end, I will then say goodbye and refer you to a Well Child service (of your choice) such as Plunket, Ora Toa, Vaka Atafaga etc. They will continue to support you until your baby is 5 years old.

CONTACT PENINA THE MIDWIFE