What services do 1st Choice
Midwives offer?
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Free Pregnancy Testing
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Friendly, supportive, flexible and professional care throughout
pregnancy, labour and birth (including water birth) at
Home,
Birthcare Huntly
or Waikato Hospital
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Post-natal care for 4 weeks after birth (a minimum of seven postnatal visits)
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Prescriptions relating to the pregnancy and post-natal period,
including some contraception options
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Referrals for pregnancy testing (such as blood tests &
ultrasounds)
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Information and resources to help you make a birth plan
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Referral to other health care practitioners, medical specialists
and support agencies if / when required
All our midwifery services are fully funded by the Ministry of
Health (if you are a NZ citizen, resident or have a work visa).
However during your pregnancy you may need to pay for additional
services such as ultrasound scans, prescription part charges,
childbirth education classes and optional tests at private
laboratories.
Our philosophy of care:
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We
believe that pregnancy is a normal and special part of a woman’s
life and that most woman can and will give birth without
complications or interventions.
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We
acknowledge that research shows outcomes improve when women
birth in an environment that supports and protects normal birth
so we encourage low-risk women to plan to birth either at home
or in a primary maternity unit.
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We
believe that in a usual progression of pregnancy and birth we
have a responsibility not to interfere with the physiological
(natural) process unless there is a medical indication.
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We
believe that with the right support most women experiencing a
normal labour are able to give birth without the use of
pharmaceutical drugs but we will discuss all the options that
are available should you require these or if your labour is
abnormal or complicated.
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We
have the skills required to undertake all aspects of primary
midwifery care, including the management of emergency
situations, however if during your pregnancy or birth you
require additional medical care we will arrange this for you and
continue providing care and / or support where possible.
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We
are pro-breastfeeding, because of the many benefits for both
mother and baby, and will support you in beginning your
breastfeeding relationship. However if for some reason this is
not the right choice for you or your baby then we can discuss
your options and support you with alternatives.
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We
believe that midwives and women should work in partnership, with
women as active informed consenting participants in their care
planning. We base our practice on research and the principles of
informed choice and consent and will assist you in your
decision-making with information and education.
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We
will respect and support your decisions, however there are of
course limits to safe practice and as responsible care providers
we will advise you if these limits are reached.
When will I see my midwife?
Regular antenatal visits are a very important part of your care. Your
partner / family / support people are always welcome and encouraged
to be part of your visits. The schedule of visits will be negotiated
with you but typically we plan our visits based on the recommended
schedule of the NICE (National Institute for Health and Care
Excellence) as follows:
As you can imagine the schedule of a midwife is
frequently unpredictable due to the difficulty of planning
appointments around baby’s births! Due to this there will be times
when your midwife is running a little early or late, or needs to
reschedule your appointment. Your midwife will make every effort to
keep you informed if she cannot make an appointment and will arrange
to reschedule. To assist with this please ensure we can always
contact you by letting your midwife know if you change your phone
numbers or address.
If you are not able to keep your appointment please contact us well
in advance and we will do our best to arrange a new date and time.
Please be aware that if you do not cancel and then miss an
appointment you may have to wait for our next clinic day to see us.
We are also required to document in your notes that you ‘did not
attend’ a booked appointment as research shows that non-attendance
or under-attendance for pregnancy care carries a substantially
elevated risk of severe adverse pregnancy outcomes which puts
yourself, your baby and us as midwives at risk. If appointments are
frequently missed we will ask you to make other arrangements for
your on-going maternity care.
What happens if my pregnancy or
birth becomes complicated?
As community midwives, we specialise in providing maternity care
within the "primary” (normal) scope of practice. Although we all
hope everything goes smoothly for you a vital part of our role is to
recognise when aspects of your pregnancy, labour, birth or postnatal
care may have deviated from normal. If this occurs, in consultation
with you, we will arrange a (free) referral to the medical /
obstetric team at the hospital.
If you then require ongoing “secondary” care (also known as
“complex” or “high risk” care) then after discussing this with you
and the hospital team it will be agreed who is best to now provide
your maternity care. For minor concerns your midwife is likely to
remain your main carer, working together with the hospital team.
However if your needs are more complex then responsibility for your
care may be transferred to the hospital team. Your midwife will then
take on the role of providing support and advocacy working closely
with the hospital team and / or remaining in regular contact with
yourself and hospital team so she can maintain your continuity of
care.
All midwives are trained to provide emergency care should this
become necessary.
How do I contact my midwife?
URGENT CONTACTS: (e.g. You are concerned about you
or your baby’s well-being or you are in labour)
To ensure you have access to URGENT midwifery care please always
call your midwife’s mobile phone number.
Your phone call will be automatically redirected to your backup
midwife if your midwife is “off-call”. If your call is answered by
voicemail please leave a message. If you do not receive a reply
within 5 – 10 minutes (which can happen if we are on another call,
busy with another client or visiting clients in areas with poor
mobile phone coverage) please call your backup midwife.
DO NOT text us with urgent queries as there are frequently long
delays in text messages being received, texts can not be diverted to
your back up midwife so may go unanswered, and urgent medical advice
can’t be given via text due to the risk of misunderstandings.
NON-URGENT CONTACTS
Before contacting us please consider if your question or request
could wait until your next appointment? If not please remember that
we also have families and personal lives outside of midwifery and
restrict all non-urgent calls / texts to within business hours e.g.
Monday to Friday: 9am - 5pm.
If you have a lingering problem please contact us during normal
office hours and don’t wait until 10pm on a Saturday night to tell
us of a problem which has been bothering you for several days.
Please remember it is YOUR responsibility to ensure you are always
able to contact us. This means making sure you always have enough
money on your phone to call us!! It is not acceptable to text us
asking us to phone you back.
What is your backup support
system? What happens if my midwife is off-call or busy with another
woman in labour?
Our midwives each maintain their own caseloads,
with the benefit of working closely together in pairs so we can
support each other when required.
When your midwife is busy or has time “off-call”
your back-up midwife and / or the other midwives in the group
practice will provide all the care that is required including labour
and birth care. From time to time we may also have locum midwives
working with us to ensure we can always offer you the safest
possible care.
To provide optimal continuity of care our
midwives share a computer system which allows us all to access
client maternity records whenever required. We also meet regularly
to keep in contact and update each other about the clients our care.
Most clients will meet their backup midwife at some time during the
pregnancy. Please let you midwife know if you would like the
opportunity to meet the other midwives in our group.
“Off-call”: What does it mean
for us and for you?
As midwives we often work long unpredictable hours so it’s
essential that we have regular time off to rest and recuperate. This
is important not just for our own health and wellbeing but also to
ensure that we do not become too fatigued to care for you safely.
Some of our time “off-call” is planned in advance, such as alternate
weekends off (typically from Thursday 5pm to Monday 9am), annual
leave or attending meetings / study days for our required continuing
education (which ensures our clinical and professional skills are
always up to date). At other times we might need to go “off-call”
unexpectedly, if for example we are fatigued after a long birth, are
unwell, or have a family commitment or emergency.
We understand that it can be disappointing when your own midwife is
“off-call” but it is important that you consider this possible
scenario. We ask that you please respect our own self-care and
understand that we have lives and families outside of our work, just
like you do. “Off call” time means that we can do our best for you
and your baby when we are on call.
Midwife Safety
Sadly many health professionals, including
community midwives, are increasingly being subjected to incidents of
intimidation, threatening and abusive behaviour from both clients
and support people.
There is never an excuse for aggressive bad
behaviour. We understand that stress, anxiety, grief and fear can
cause people to act in a way they wouldn’t normally. However all
forms of violence (both words and actions) will not be tolerated and
depending on the level of violence we will withdraw from your care
and the Police may be involved.
Please also ensure that when we visit you at home that your home is
a safe environment for us. This includes making sure that any
animals are tied up.
