Types of Maternity Care

Midwives

Midwives provide care during pregnancy, labour and after birth. Care through midwives is free for NZ residents or those with certain visas. They are experts at recognising problems when they occur and will refer you on to a consultant or other health care staff, when appropriate. Midwives can attend your birth at home, in a primary setting or in a hospital. Midwives in New Zealand must hold a current practicing certificate. The regulatory body for midwives in NZ is the Midwifery Council. Midwives can be registered with the New Zealand College of Midwives (NZCOM). NZCOM represents more than 90% of all practicing midwives and works in partnership with maternity consumer groups such as Plunket, Parents Centre New Zealand, the Home Birth Association, the Ministry of Health and La Leche League to ensure high quality maternity services in New Zealand. The NZCOM also provide practice support for midwives. The NZCOM website has a great section for woman to read. 

Obstetric Care

An obstetrician is a doctor who specialises in pregnancy and birth; usually based in hospitals. Obstetricians are involved in pregnancies or labours needing special care. There is no charge for this if it is clinically indicated. Your LMC will refer you if needed. 

Specialist Obstetric Care 

You may want to have private specialist care throughout your pregnancy, birth and afterwards. Private obstetricians, anesthetists and paediatricians charge a fee for their care. Obstetricians are registered doctors with the Medical Council of New Zealand. This option is not available in many parts of NZ. Some obstetricians work with their own midwife and they provide a midwife/postnatal care option too. Some women may not have all the caregiver options available to them. Your LMC will discuss this with you, so you fully understand the reason for these limitations. 

Hospital based pregnancy care

Hospital-Based Pregnancy Care 

The hospital team of midwives, specialist obstetricians, and doctors work together to look after you throughout. Sometimes due to availability you may not be able to find an LMC midwife. In some areas you may be able to receive care from a group of midwives through your local hospital. Generally your care will be shared between a few midwives. 

GP

Your General Practitioner (GP) is your family doctor. They will provide care for any medical conditions, pre-exsisting or arising during your pregnancy that do not require obstetric involvement. 

General Practitioner Care 

There are only a few GPs who are involved as a LMC. Your family GP will liaise with your midwife during your pregnancy should it be necessary. 

Some questions you can ask when booking your LMC

  • What birthing services does the LMC offer and how do they provide care? e.g. do they provide full continuity of care for their client? 
  • Do they provide/continue care if labour becomes complicated or you need to be induced? 
  • Do they provide care for people choosing home birth, hospital birth, and water birth? 
  • Which hospital(s) do they have access to? 
  • Who is their backup midwife? What practice are they part of? 
  • Are their beliefs about pregnancy and childbirth etc compatible with yours? 
  • How many women do they book a month? 
  • How many weeks do they visit after you give birth? 
  • Do they have plans to go on holiday during the months you will be needing their services? 
  • Are they a member of the New Zealand College of Midwives? When was their practice last reviewed? 

Your LMC will act at all times in partnership with you and assist you to make the best decisions for you and your baby. Maternity notes are documents that contain information about your antenatal appointments, your birth, and postnatal appointments. Your Lead Maternity Carer (LMC) is responsible for recording this information, which can be done either electronically through platforms like Expect or Badger Net, or on paper through the MMPO pink book. Some LMCs may use their own booklets for note-taking. Throughout your pregnancy and postpartum period, you might encounter medical jargon in these notes. If you have any uncertainties or questions about your maternity notes, don’t hesitate to discuss them with your LMC. 

Routine Visits

You are likely to be asked to visit your LMC: 

  • every four - six weeks until the 20th week 
  • every four weeks until the 28th week 
  • every two weeks until the 36th week 
  • weekly until you go into labour 

At each visit, your blood pressure and urine are checked. These are monitored for signs of high blood pressure, diabetes, kidney problems and pre-eclampsia. Clinical checks include palpation of your abdomen to monitor your baby’s growth, a check for oedema (excess fluid in tissues) in your body, and perhaps a weight check. Unless there is some reason for an additional check you are not likely to have a vaginal examination (internal examination). 

Between visits, make a note of any minor problems arising during the interval, and discuss these with your LMC.

Your Rights During Pregnancy and Birth

You have the right: 

  • To be treated with dignity, cultural sensitivity and respect at all times 
  • To choose your place of birth 
  • To choose your caregiver/s and to change your caregiver/s at any time 
  • To choose who will be present at your birth and to ask others to leave 
  • Before agreeing to any procedures, or being given any drug, medication or test, to ask about any side effects or risks to yourself or your baby. You can accept or refuse any treatments 
  • To choose how you will give birth and to feel free to follow your feelings and instincts during birth 
  • To have the placenta/whenua handled with cultural sensitivity 
  • If transferred to a large maternity hospital, to be accompanied by your primary caregiver and support people of your choice 
  • To refuse to allow your baby to be fed infant milk formula if you choose to breastfeed 
  • Not to be separated from your baby 
  • To make a complaint and receive satisfactory explanations from your caregiver/s and others involved with your care 
  • To read, or have a copy of your medical records and your baby’s medical records 
  • To have a trained interpreter if English is not your first language 
  • To refuse to take part in any research project or to withdraw from a research project at any time 
  • To refuse to allow student health professionals to provide care for you or your baby 

For more information please view the Health and Disability Commissioner website.