What Does a Midwife Do?/What Is a Midwife?
“Midwife” means “with woman”. New Zealand midwives are degree trained health professionals who work with and support a woman through pregnancy, childbirth and the postnatal period, for 6 weeks.
The origins of midwifery go back hundreds, if not thousands of years. Women have always supported other women through childbirth and continue to do so today in various forms around the world.
The French words for midwife are ‘la sage femme’ which translates to ‘the wise woman’, which is still how midwives are perceived in many cultures around the world.
In New Zealand midwives have been independent practitioners since 1990, enabling them to work as Lead Maternity Carers (LMCs) and take a proactive, woman-centred role in normal pregnancy and childbirth.
How are midwives educated/qualified?
Midwives are educated through tertiary institutions in Auckland, Hamilton, Christchurch and Dunedin. They undertake a 3 year degree which incorporates academic study with clinical placements in both the hospital and community setting. Some midwives are also nurses and may have completed shortened courses in midwifery while some midwives in New Zealand may have trained overseas, but must satisfy the stringent requirements of certification here in New Zealand.
All qualifications and Annual Practising Certificates (APC’s) are monitored by the Midwifery Council of New Zealand.
In order to maintain an APC, a midwife must attend compulsory annual and triennial updates and continuing education, as well as carrying out professional activities, such as teaching and mentoring.
Is it true that midwifery care is free?
Midwifery care is free to all women who are residents of New Zealand. LMCs are paid per module of care that they provide for women: pregnancy is divided into 3 modules; there is also a birth module and a post natal module. The majority of women have midwives as LMCs but some do choose an obstetrician or GP, if this available to them.
When should I see a midwife?
As soon as you are pregnant, book your midwife as they are very busy in some areas of New Zealand.
You can confirm your pregnancy with a urine test, either at a Midwifery Resource Centre, purchase one from a chemist or visit your GP. A blood test is not needed to confirm pregnancy unless you are only a few days pregnant.
What different types of midwives are there?
Midwives can work in different ways and in different settings in New Zealand:
As community based / self employed midwives working as LMCs and can be called independent midwives
As hospital midwives, employed by District Health boards (DHBs) and can be called core midwives
As childbirth educators
As midwifery managers in institutions
As midwifery educators/ lecturers in educational institutions or DHBs
How do I find a midwife?
It's common for women to find a midwife by talking to friends, whanau and acquaintances. After all, midwives usually work in a relatively small geographic area, so other mums who live close by, should be able to give you some good advice.
If you don't have anyone who can give you a recommendation, look around to see if you have a midwife clinic in your area which will be able to provide you with a list of local midwives.
Another really good place to start is with the Find Your Midwife website.
What will my midwife do?
A midwife can provide all of your maternity care if your pregnancy, childbirth and post natal period are normal. Midwives are health professionals and experts in pregnancy and childbirth.
In pregnancy your midwife will see you regularly to monitor your health and the baby’s well-being. Often this will be done at a midwife’s clinic or rooms but occasionally she may visit you in your home. She will support and advise you throughout the pregnancy, ensuring that you and your baby remain in optimal health. With her training as a health professional combined with her experience, your midwife is a great source of information and this will be supported by childbirth education classes as well as information from other health professionals and family/ whanau.
If your LMC is a midwife she will usually care for you during childbirth. You may also receive care from hospital/DHB midwives who provide a supportive role for LMCs and families in the birthing rooms or suites.
Midwives provide postnatal care for up to 6 weeks following the birth of your baby. Initially this will be in a hospital or birth centre, unless you have had your baby at home, and then the midwife will visit you at home as often as you both feel is necessary.
If the midwife is concerned for the well-being of you or your baby at any time, she will refer you to an obstetrician for advice or medical care. There are national guidelines regarding conditions that require referral to obstetricians, for example:
During pregnancy - multiple births, previous caesarean section, preeclampsia, breech position.
During birth - fetal distress, abnormally slow progress in labour.
After the birth - abnormal blood loss, postnatal depression, abnormality with baby.
If your condition warrants your care being transferred from your LMC midwife to an obstetrician, a three way agreement should be made between yourself, the midwife and the obstetrician. The LMC midwife can continue to support you, but decisions regarding your maternity care will become the responsibility of the obstetrician (this is called secondary care), until such a time as the care was transferred back to the midwife - through joint agreement once again.
Sometimes the LMC midwife or GP may refer you to an obstetrician for advice, without transferring your care to secondary care; for example if your baby seemed large or small for the number of weeks pregnant. You would not pay for this consultation, as it was requested by your LMC, not yourself, and you would continue to receive care from your LMC.
What should I ask a midwife, before choosing her?
Ask your chosen midwife about her qualifications and experience - particularly if you have any risk factors (such as high blood pressure or previous complicated births).
If you have chosen a home birth, then ask your midwife about her experience at home births, her systems for dealing with complications at home, equipment she carries and her back up system for obtaining help in the community.
Access information about pregnancy and birth from various sources - childbirth education classes, midwife appointments, books, the Internet and friends and family.
Ask about your midwife’s arrangements to cover time off and holidays (you may wish to meet her locum or back-up midwife too).