"Midwives provide safe, women-focused services that families can trust"

Midwives are specialists in pregnancy and childbirth. They complete a three-year degree known as the 'Bachelor of Midwifery' in order to gain the knowledge, skills and experience they have to provide safe and professional midwifery care. Midwives practice in different settings. They work in the community and provide birth care at home, in birthing units and in hospitals. Midwives provide free maternity care to all eligible women in New Zealand and over 75% of women today have a midwife as their Lead Maternity carer (LMC).

Midwives in New Zealand work in a partnership model of care with women. In this model each woman and her midwife are partners, working together to ensure that the woman has care that best meets her individual needs. The woman and the midwife get to know each other well over the whole maternity experience, building a relationship of trust with each other, sharing information and decision-making and recognising the active role that both play in the woman's maternity care.

Services provided by midwives include some or all of the following:

• Preconceptual advice
• Free pregnancy testing
• Antenatal care and assessments throughout your pregnancy with visits at home or at the midwife's clinic. This includes arranging any necessary blood tests or investigative procedures.
• Consultation with an obstetrician or other specialist if complications arise at any time during pregnancy, labour and birth or the weeks following.
• Information and education on a one-on-one basis and for groups
• Time for questions and planning to meet you and your family's needs
• Support and professional care throughout labour and birth in the place of your choice
• Labour and birth pool hire
• Support, advice and professional care after your baby is born and for 4 – 6 weeks afterwards
• Early discharge home if you birth in hospital
• Support, advice and assistance with breastfeeding and caring for your baby
• Contraceptive advice
• Discharge from midwifery care when you are ready at about 4 – 6 weeks and referral on to the Plunket nurse, iwi provider, other well child provider or general practitioner. These practitioners can provide support and assist with ongoing care such as immunisation and well child checks.

To practise as a midwife in New Zealand, the midwife must have an annual practising certificate issued by the Midwifery Council of New Zealand.

The New Zealand College of Midwives (NZCOM) sets and actively promotes high standards for midwifery practice. The NZCOM assists midwives to meet these through involvement in midwifery education and the Midwifery Standards Review process.

What To Look For In A Midwife?

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.

Respectful Treatment

• 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

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Personal Attention

• 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.

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Plenty Of Information

• 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

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Professional 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.

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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.

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Coping With The Pain Of Labour

• 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.

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Continuity Of Care Throughout The Whole Experience

• 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

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