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What to look for in a midwife

Publicity – Rosie Moore & Jacqui Anderson April 2013 046

Congratulations – you’re expecting a baby. You’re now looking for the best person to provide you with care as you travel the path of pregnancy, birth and the first six weeks following the birth of your baby.

When you first look for a midwife, it can be confusing as midwives are all different. However, there are certain qualities that you should look for in a midwife and these are described below.

  • Gentle, supportive care that respects you, your family/whanau, your culture and your beliefs
  • Respect for your informed decisions about tests, recommendations and interventions
  • Willingness to support your plans for your pregnancy and birth and afterwards
  • Respect for the birth process as it unfolds uniquely each time. Although amazing, being pregnant and giving birth are actually normal life processes for which a woman’s body is well designed. Each woman’s experience is unique
  • Respectful care regardless of setting
  • Antenatal visits in your own home or at the midwife’s clinic. These visits will allow plenty of time for questions and discussion. Meaningful discussions to explore and help resolve fears and concerns you or your whanau might have.
  • Caring attention to develop a trusting and nurturing relationship with you and your whanau that can help you to labour and give birth naturally and safely and can help you and your partner and whanau with the transition to motherhood and parenting.
  • Plenty of information: about pregnancy, birth and the weeks afterwards, including breastfeeding and care of the baby
  • Suggestions about ways you can take good care of yourself and your baby
  • Encouragement and practical suggestions for you to have good nutrition and make healthy lifestyle choices
  • Full information on any recommended tests, procedures or treatments so you can make informed decisions about your care
  • Regular and thorough check-ups for you and your baby throughout your pregnancy, during labour, and after the birth, to make sure both of you are healthy and doing well
  • Recommendations for diagnostic technology when appropriate
  • Planning with you for the unexpected and rare emergency
  • Consultations with obstetricians if complications arise. If referral to an obstetrician is required midwives will continue to provide you with the important midwifery care you need
  • Expertise in normal and natural childbirth. Because they are experts in normal pregnancy and birth, midwives are experienced in the variations of normal birth and recognise the early signs of conditions that are not ‘normal’ including medical conditions or complications that may occasionally arise during pregnancy or the birth process or afterwards
  • Referral when you are ready (usually about four to six weeks) to the Plunket nurse, iwi provider, general practitioner or other provider. These practitioners can provide support to you and your family and assist you with ongoing issues and care for your baby such as well child checks and immunisation.
  • Confidence in your body and in yourself as a mother
  • Help with discovering your own body’s ability to grow your baby and give birth, in its own way and in its own time.
  • No routine treatments or arbitrary timetables that can interfere with your body’s healthy process of labouring and giving birth
  • Individualised care, privacy and a belief in natural childbirth.
  • Support for doing the work of giving birth. You will be supported and encouraged to give birth to your baby in the way that best suits you and your family.
  • Support with the art of breastfeeding your baby
  • Midwives know that pain is an important part of labour and works to keep you safe. There is normal pain in a labour that is progressing normally. The normal pain of labour comes in waves and builds in intensity. Pain is not continuous but is a pattern of contractions with rest periods in between.
  • Midwives support you throughout labour and help you to cope with the pain you will have in a normal labour
  • For a few women pain can indicate that labour is no longer progressing well. Midwives can recognise when pain is no longer normal as might happen if the baby is not in the usual position. For the small number of women for whom this might occur, midwives can help them access pain relief and additional help if necessary
  • In labour midwives have found that encouragement, massage, privacy, changing positions and labouring in water are effective ways of working with pain
  • Midwives help you avoid risks (to yourself and your baby) that are associated with the unnecessary use of technology
  • Midwives offer care right through, from your pregnancy test up to four to six weeks after the birth of your baby
  • Midwives will visit you in your own home or you may visit your midwife or her midwife partner at her clinic for your pregnancy care
  • Midwives will usually come to you at home in early labour and as your labour progresses you can choose to stay at home or the midwife will come with you to the local birthing unit or to the hospital if you need hospital care
  • Midwives visit you and your baby at home after the birth and will help you adjust to becoming a mother, caring for your baby and with successful breastfeeding
  • Midwives give you the time you need to ask questions and to plan around you and your family’s needs during pregnancy, birth and the weeks following
  • Midwives work with other midwives that you will meet so that you have access to 24 hour/seven day a week consistent care, even when your midwife is having a weekend off, is ill or is on holiday

We wish to acknowledge the support we have received from Citizens for Midwifery, USA, CFMIDWIFERY LINK who gave us permission to adapt some of the above information from their brochure ‘Midwives Model of Care’ for our New Zealand context.