Congratulations on the news of your pregnancy! It is a big year ahead and we are here to help guide you through it. Of course there are many people who you may meet on the way, but as a Lead Maternity Care provider, we are responsible for co ordinating your care and ensuring that you get appropriate referrals as needed.
Schedule of Visits We have a clinic at 154 Victoria Street where we usually meet you between 10-12 times during your pregnancy. Generally we see you 5 weekly up until 28 weeks, then 2-3 weekly up to 36 weeks, then every week up until you have your baby. Remember that we are always on call for you, so if something more urgent comes up and you need to check in with us, then you can. Postnatally we see you frequently at home for the first week to 10 days, then weekly until we discharge your care to the GP or Plunket.
In New Zealand, maternity care is free for women holding citizenship, residency or working permit greater than 2 years. If you are married to a citizen or a permanent residency holder, your care is usually covered. If not born in New Zealand, we will require you to provide more information to ensure you are covered. If you are not covered by our national health, then we will charge you at the same rate as what we are paid by the Ministry of Health, and that is usually paid in 3 installments.
LMC Role: An LMC can be a GP, a Midwife or an Obstetrician. In Wellington, most LMCs are midwives, although there are some Obstetricans who provide this care in the community.
Midwives provide primary care. That means that we look after women who are normal, with no risk factors in their pregnancy identified.
Secondary care means that essentially the women are having a normal pregnancy, but there has been a potential risk factor identified that requires input from the Obstetric team. This is usually done through Outpatients at Wellington hospital. The kind of issues that come up can be very diverse, but they mainly relate to a previous event such as a previous caesarean, or health condition; or they may be something to do with the current pregnancy such as rising BP or slow growth of the baby. Generally your case is reviewed and advice is given to the LMC regarding management of care. Wellington Hospital has an on call 24 hour/7 days a week obstetric, anesthetic and pediatric team, which means we have their expertise to call upon as required. We also have lactation consultants, social workers and physiotherapists to call on when required.
Tertiary care is where your care is transferred from your LMC to the hospital team. It is because you require 24 hour medical input, which is provided by the hospital doctors and midwives. An example of where this might happen would be a premature labour, antenatal bleeding or postpartum hemorrhage, or possibly severe BP problems. Once the issue has been resolved, your care is generally picked up by your LMC again.
So although you may have no contact with any other health professional over this time, we midwives are part of a larger team and are fortunate to have their assistance to call on when we require it.