Frequently asked
questions


FAQ


MIDWIVES

  • What do midwives do?
  • What training have midwives done and do they continue training after graduating?
  • Why is it so hard to find a midwife?
  • What does ‘continuity of care’ mean?
  • When will I see my midwife?
  • What happens at a booking visit?
  • Why don’t you do interviews?
  • Will I get a chance to meet the ‘back-up’ midwife?
  • Why can’t my midwife prescribe my normal medications?
  • How experienced are your midwives?
  • What if I need an obstetrician?
  • How much does it cost to have a midwife?
What do midwives do?

LMC midwives look after you from your first antenatal booking appointment through until your baby is 4-6 weeks old. We are responsible for the health and wellbeing of your baby and you during your pregnancy, labour and birth and postnatal period.

We do the relevant health checks, organise scans and blood tests, liaise with GP’s and Obstetricians if necessary. We access social services if required and make referrals where needed. Our midwives do an antenatal clinic once or twice a week where we see all our antenatal clients.

Sometimes, if a woman is in labour we do need to cancel our clinic but we will reschedule appointments at a mutually convenient time. The rest of the week midwives do postnatal visits at women’s homes and paperwork/administration. Midwives also attend study days from time to time and meetings at the hospital.

What training have midwives done and do they continue training after graduating?

Midwives have a Degree in Health Science (Midwifery) or a Bachelor of Midwifery depending on which University they attended. They will have completed the equivalent of a four year degree.

Midwives in their first year of practice, after completing the degree, will have delivered at least 40 babies by themselves under supervision. They are mentored as part of the Midwifery First Year of Practice programme by an experienced midwife.

All Midwives are required to attend annual mandatory emergency study days and an extra 8 hours of elective education annually as well as participating in professional activities such as taking students, mentoring, attending NZCOM or PMMRC meetings. These requirements must be met in order to obtain an annual practicing certificate.

Every three years a full Midwifery Standards Review is undertaken by every midwife, part of the Standards Review is looking at her individual statistics, feedback from the women the midwife has cared for, feedback from colleagues who work in the hospital and a reflection on her overall practice for the past three years.

Why is it so hard to find a midwife?

Currently there is a chronic midwife shortage of both Core (hospital) and LMC Midwives.

Midwives are underpaid and LMC midwives are currently in negotiation with the government for better pay and conditions. We work long and unsociable hours with a lot of responsibility and we do a lot of work that we are currently not paid for. We get no additional payment for being on call or working weekends or public holidays. Although midwives are contracted (and paid) by the Government, we are classed as self-employed. to make matters worse, our work expenses equate to approximately half of our income. Midwives often miss their own family occasions because babies do not follow a schedule. Because of these reasons (and many others), numerous LMC midwives have left the profession.

With the extra demands placed on midwives from both our clients and the government, many midwives have been forced to cut down the number of clients they take per month. It is very hard for any midwife to turn women away, but we have to look after our own wellbeing and families too.

What does ‘continuity of care’ mean?

Continuity-of-care means you get to know your caregiver and will see them throughout your antenatal, labour and birth and postnatal care.  However, continuity-of-care means that if your midwife is on her scheduled time off, or is unable to attend to you, one of our practice partners will look after you. The care is still continuity-of-care as all the midwives at The Cottage Midwives share the same philosophy. If you are under secondary care, we will look after you but if we have been up for more than 18 hours we may hand over to the core staff.

When will I see my midwife?

Your midwife will arrange to see you in our clinic generally between 7 and 10 weeks for an initial booking visit.

After that generally, you will be seen every 4-5 weeks, up until 28 weeks and then every 2-3 weeks up until 36 weeks. After 36 weeks you will be seen every week until the baby is born. Sometimes extra visits may be required. Your partner and children are welcome to attend visits with you.

In general, our clinic appointments are from 9am-5pm. You are entitled to 10 hours of unpaid leave to attend these visits.

Once your baby is born, your midwife will visit you in hospital and then at home until the baby is 4-6 weeks old. This is when Plunket will take over.

What happens at a booking visit?

During a booking visit we start to get to know each other. Your midwife will ask you lots of questions about your health and lifestyle. We will tell you about any screening or testing that you may have at that time. We will discuss diet, exercise and lifestyle. We will organise any testing that is needed and give you the forms. We will talk to you about antenatal education and answer any questions that you may have.

The booking visit is usually 40 minutes to 1 hour long and any subsequent visits usually take about half an hour.

Why don’t you do interviews?

Many women are now wanting to interview midwives. Unfortunately, we are not paid for ‘booking visits’ by the government/DHB. And, like many midwives, we will not conduct an ‘interview’ at the clinic. We will, however,  talk to you on the phone where you can ask us any questions. You can find The Cottage Midwives individual profiles on this website. They have been written to be informative and to demonstrate how we follow our philosophy of midwifery in practice.

All of our midwives are experienced and comfortable with homebirth, waterbirth, VBAC and hospital birth. If you book with a particular midwife and down the track feel that you aren’t ‘connecting’ or are not happy with your care, then you can always change your LMC.

Will I get a chance to meet the ‘back-up’ midwife?

If you want to meet the ‘backup’ midwife, your LMC will book you into her partner’s clinic for one of your visits.

However, due to various circumstances (e.g. sheduled breaks, sickness, unplanned homebirths etc.), sometimes the person looking after you or attending your homebirth as a second midwife, may not be your midwife’s usual back-up. In these rare cases, another midwife from the practice will attend.

You will often see the other midwives working at the clinic when you come in for your appointments.

Why can’t my midwife prescribe my normal medications?

Midwives are able to prescribe drugs for antenatal conditions (eg folic acid, antibiotics, iodine, iron), labour and postnatal.

It is against the law for us to prescribe drugs outside of our scope of practice so please understand that any drugs you have been prescribed for medical conditions (e.g. asthma, thyroid, anti-depressants, etc.) will need to be prescribed by your GP.

Therefore, your GP will continue to monitor your on-going medical conditions and we will look after your pregnancy.

How experienced are your midwives?

We have a mix of experience in our team of both midwives, who have been practicing for many years, along with newer midwives. We have a collabrotive team and we support all of our new-graduate midwives with their practice.

Between us we have over 90 years of experience in midwifery!

What if I need an obstetrician?

If, for any reason, we believe you need an obstetric opinion or plan, we will advise you of this and the reason why. And, if you consent, refer you to the Obstetric team at North Shore hospital.

There they will give their input and your midwife will continue to provide care according to the plan made between the obstetrician, midwife and yourself. There is no charge for these obstetric visits.

How much does it cost to have a midwife?

If you are eligible for free healthcare in New Zealand, then there is no charge… our services are paid by the Government. However, you will still have to pay for scans and prescriptions – we have no control over that unfortunately.

Pregnancy Examination

CONTACTING YOUR MIDWIFE

  • How do I contact my midwife?
  • Are midwives ‘on call’ 24 hours per day, 7 days per week?
  • What do I do in an emergency?
  • When is it not appropriate to contact my midwife?
  • Will you attend my elective caesarean?
  • I want an epidural – will you stop me?
How do I contact my midwife?

We prefer to be contacted by phone call.

Text is alright if you are just wanting to change an appointment or organise something non-urgent. If it isn’t an urgent matter, but you can’t wait until your next appointment, you can text your midwife and ask her to call you.

If the matter has some urgency, we expect you to call us.

Are midwives ‘on call’ 24 hours per day, 7 days per week?

Midwives are ‘on-call’ 24 hours per day, 7 days per week but only for births and emergencies.

We have ‘off-call’ time when we are sick, on our scheduled weekend off (which is once per fortnight), on mandatory study days or on annual leave. We have a ‘back-up’ midwife who is on call for us when we are anavailable.

If we are contacted by text after hours or on weekends, it will not be answered until the next business day.

What do I do in an emergency?

In the first instance, phone your midwife. Do not text.

She will instruct you what to do next. If you can’t get hold of your midwife, or you need immediate medical assistance, you can go straight to the emergency department or call an ambulance.

When is it not appropriate to contact my midwife?

Most questions can wait until your midwife appointment.

We suggest you write any questions down as they occur to you between appointments and we will answer them during our visit.

Our weekday hours are 7am until 6pm and we have scheduled weekends off. We ask that you call us during our business hours during the week (unless you are in labour or you have an emergency).

Please do not text your midwife on the weekends for advice.

Will you attend my elective caesarean?

We do not always attend elective caesarean’s but often if we can make it to the hospital on the day we will attend. There is always a hospital midwife looking after you during your caesarean and, if we can’t attend, we will see you the next day.

I want an epidural – will you stop me?

We believe in you making informed decisions. We discuss pain relief options with you at our visits.

We will not stop you from having an epidural but we will explain the pros and cons of epidurals with you honestly and, should you require an epidural (which is secondary care), we will continue to look after you.


FEEDBACK ABOUT YOUR MIDWIFE

  • How do I provide feedback on my midwife?
  • What if I am not happy with my care?
How do I provide feedback on my midwife?
What if I am not happy with my care?

In the first instance, although it may be hard, we suggest you talk directly to your midwife. If you want to change midwife it is also helpful for us to know why you were unhappy with our care.

If you are concerned about your hospital care you can complain to the hospital directly.

You can contact the College of Midwives or the Midwifery Council who can give you guidance.

If you feel your rights have been breached, you can make a complaint to the Health and Disability Commissioner https://www.hdc.org.nz/your-rights/the-code-and-your-rights/


APPOINTMENTS

  • My midwife cancelled my appointment at short notice
  • Can my partner attend my appointment?
  • Can I bring my children with me?
  • What happens at an antenatal appointment?
  • What happens at a postnatal appointment?
  • What tests will you do?
  • They couldn’t see the gender of my baby on my scan – will you refer me to have another look?
My midwife cancelled my appointment at short notice

Midwives are looking after many women all at different stages of their pregnancy. Unfortunately babies don’t know which days are our clinic and postnatal days.

If someone is in labour we may have to postpone your appointment. Sometimes we have to deal with acute problems and therefore will need to cancel our clinic.In these rare cases, one of the other midwives from the practice may see you instead of your midwife.

We ask for you understanding in this and know that when it is your turn to have your baby, we will be there for you too.

Can my partner attend my appointment?

Your partner and whanau are very welcome to attend any or all of your appointments.

Can I bring my children with me?

Your children are welcome to attend your appointments. We have a little play area and toys available

What happens at an antenatal appointment?

We will have a chat to you about how you are feeling and answer any questions. We will discuss what you can expect and give you forms for any testing or scans. We will check your urine, weight and blood pressure as well as having a listen to the baby.

What happens at a postnatal appointment?

We will come and see you and baby at home. We will check you and your recovery and give you breastfeeding support and advice. We will weigh the baby and do full baby checks at one and four weeks. We will refer you to Plunket who will come in at six weeks.

We will see you for between four and six weeks postnatally.

What tests will you do?

At booking blood tests to check your blood group and antibodies, screen for syphilis, rubella immunity, hepatitis B and HIV status. We also do a full blood count, check your iron and your sugar levels and get you to do a mid stream urine test.  If you are sure of your last period dates then we do not need to do a dating scan but if you are unsure then we may do a dating scan around 6 or 7 weeks.

You will be offered the Maternal Serum Screen to do between 11 and 13 weeks. This is done by doing a scan and a blood test. You can opt to do the NIPT test instead which is private and has a charge attached to it.

At 20 weeks we do an anatomy scan. If everything is normal and healthy, this is the last scan that we routinely do.

Between 24 and 26 weeks we do another blood test, including the polycose screen to check for pregnancy diabetes.

At 36 weeks we do some more blood tests and a urine test

They couldn’t see the gender of my baby on my scan – will you refer me to have another look?

Ultrasound scans are expensive and, as they are subsidised by the government, we are accountable to the Ministry of Health for the scans we do.

The gender of the baby is of no clinical significance, therefore, we cannot give you a scan referral to check the gender or just to ‘look’ at your baby.

Also, the effects of ultrasound on a baby are unknown so we try to keep them to a minimum.


CONTACTING YOUR MIDWIFE

  • How do I contact my midwife?
  • Are midwives ‘on call’ 24 hours per day, 7 days per week?
  • What do I do in an emergency?
  • When is it not appropriate to contact my midwife?
  • Will you attend my elective caesarean?
  • I want an epidural – will you stop me?
How do I contact my midwife?

We prefer to be contacted by phone call.

Text is alright if you are just wanting to change an appointment or organise something non-urgent. If it isn’t an urgent matter, but you can’t wait until your next appointment, you can text your midwife and ask her to call you.

If the matter has some urgency, we expect you to call us.

Are midwives ‘on call’ 24 hours per day, 7 days per week?

Midwives are ‘on-call’ 24 hours per day, 7 days per week but only for births and emergencies.

We have ‘off-call’ time when we are sick, on our scheduled weekend off (which is once per fortnight), on mandatory study days or on annual leave. We have a ‘back-up’ midwife who is on call for us when we are anavailable.

If we are contacted by text after hours or on weekends, it will not be answered until the next business day.

What do I do in an emergency?

In the first instance, phone your midwife. Do not text.

She will instruct you what to do next. If you can’t get hold of your midwife, or you need immediate medical assistance, you can go straight to the emergency department or call an ambulance.

When is it not appropriate to contact my midwife?

Most questions can wait until your midwife appointment.

We suggest you write any questions down as they occur to you between appointments and we will answer them during our visit.

Our weekday hours are 7am until 6pm and we have scheduled weekends off. We ask that you call us during our business hours during the week (unless you are in labour or you have an emergency).

Please do not text your midwife on the weekends for advice.

Will you attend my elective caesarean?

We do not always attend elective caesarean’s but often if we can make it to the hospital on the day we will attend. There is always a hospital midwife looking after you during your caesarean and, if we can’t attend, we will see you the next day.

I want an epidural – will you stop me?

We believe in you making informed decisions. We discuss pain relief options with you at our visits.

We will not stop you from having an epidural but we will explain the pros and cons of epidurals with you honestly and, should you require an epidural (which is secondary care), we will continue to look after you.

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