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What_is_a_midwife_and_lmc

When you find out you’re pregnant it’s perfectly normal to start thinking about a long list of things to do. After you’ve dealt with the initial surprise and maybe even shock of your news, it’s important to prioritise decisions about your maternity care.

Maternity care is one of the most crucial aspects of your pregnancy. It’s important that your and your baby’s physical and emotional health are cared for every step of the way.

What is a Lead Maternity Carer?

Start looking for a Lead Maternity Carer (LMC) as early as possible. Typically, it's best to arrange an appointment with your chosen LMC during weeks 6 – 8 of your pregnancy.

In New Zealand, you can choose the LMC who will look after you and your baby while you’re pregnant, during labour and birth and for 4–6 weeks after your little one is born.

There are two main choices of LMCs:

  1. A midwife or specialised GP
  2. A specialist obstetrician

Most women in New Zealand choose a midwife one reason is because the service is subsidised by the government. This means that you don’t have to pay for any general care you receive related to your pregnancy.

Choosing the best LMC to suit your needs may be a confusing process. It’s important to remember that whoever you choose is completely your choice. It’s important to feel comfortable with the healthcare professional you choose and the best way to do so is to be open and honest from the beginning. Try to be as clear as possible when you share your personal preferences, health history and any concerns you may have.

There are many options available to help choose a LMC who you feel comfortable with. If you have friends or relatives who have recently had a baby, ask them for some tips. Your regular GP may also be able to give you some good recommendations for local midwives and obstetricians.

Another good place to start looking is New Zealand's College of Midwives website: http://www.findyourmidwife.co.nz

Choosing a midwife or GP

If your pregnancy is normal a qualified midwife can provide you with the necessary care and support throughout your pregnancy and birth.

In New Zealand, midwives are either self-employed or employed by a district health board. Both types of midwives offer the same maternity care however, midwives from district health boards typically work in pairs. This is so one is on call at all times and can provide maternity care 24 hours a day.

The costs of choosing midwives or GPs for maternity care

In New Zealand maternity care with a midwife or GP is free to all women who are citizens or permanent residents of New Zealand or who have a permit to stay in the country for more than two years.

However, even if you choose a midwife, there are some services you may be required to pay for, including:

  • Electing the services of private obstetrician, paediatrician or anaesthetist without referral
  • Ultrasound scans
  • Extra pathology tests on top of those routinely necessary during pregnancy
  • Ambulance costs
  • GP visits unrelated to your pregnancy
  • Some antenatal classes
  • Choosing a caesarean without a medical reason

Services offered by midwives and GPs

Midwives and GPs are qualified to provide all the services required during a normal pregnancy, including:

  • Routine tests and examinations
  • Providing advice and information about
  • Nutrition, diet and lifestyleoYour baby’s development
  • Any concerns may you have
  • Your birth plan
  • Ordering ultrasound scans with a qualified sonographer
  • Local antenatal classes
  • Regular support and monitoring during your pregnancy, birth and labour
  • Delivering your baby

Midwives are also qualified to provide postnatal care for up to six weeks after childbirth. Your postnatal care will begin in the hospital or birth centre unless your baby is born at home. Your midwife will then continue to visit you at home as often as you need. Once your baby is 6 weeks old, your midwife will refer you to a local Plunket nurse who will provide you with support and assistance as your little one continues to grow.

Choosing an obstetrician

An obstetrician is a qualified doctor who specialises in caring for pregnant women. One reason you may consider using an obstetrician rather than a midwifeor GP is if you have complications with your pregnancy or problems with fertility.

If you would prefer to give birth in a private hospital and use your private medical care is another reason you might choose an obstetrician.

The costs of choosing obstetricians for maternity care

Complete private obstetric care may cost you between $3,800 - $4,200 (as a general guide).

You may be referred to an obstetrician if you develop any pregnancy related complications or there are concerns about your baby’s growth. In a public hospital, this consultation will be free.

Services offered by obstetricians

In the public sector, obstetricians generally care for women who are experiencing a complex pregnancy. In the private sector, obstetricians are engaged as an alternative to seeing a midwife or GP for pregnancy care. The services they may provide include:

  • Specialist assessment and management of pregnancy complications such as gestational diabetes, placenta praevia
  • Assisted birth using forceps or ventouse
  • Caesarian sections (both elective and emergency)

If you select an obstetrician as your LMC, they will also provide you with all the general services that a midwife offers. The only exception may be support during labour. At the hospital your labour will be monitored by a midwife who will liaise with your obstetrician about your progress. When you are ready your obstetrician may help to deliver your baby.

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