Hellie73

A question for all those professional midwives and parents out there.
I am due to give birth in november and want to know about other peoples experiences with the kiwi system. I am torn between community care and independent midwife care. My daughter was born in uk and we had exceptional care with her, however was slightly complicated and had to have section. I saw an independant midwife a couple of weeks ago here in nz but alarm bells rang when she said they get a payment on the delivery of the child, doesn't really convince me that they have the best interest of the patients.
Any info/advice would be greatly appreciated.
I think I have already really made my mind up I guess I just want to know if anyone else went down the community route.
Thanks

JennyV

Hi, I had my son out here (Christchurch) 12 weeks ago and the care I got was fantastic. We moved here when I was 27 weeks pregnant so I found it quite difficult to find a midwife, but my doctor gave me a list of ones to ring and managed to find a great one. She came out to my house for all appointments (weekly towards the end), was always on the end of the phone, never rushed through anything, gave loads of advice - overall was excellent and 10 times better than the care i'd had in the uk with my previous 2 pregnancies. I had complications with my first two pregnancies, both times the shoulders got stuck, so pretty horrible (both babies fine though), but midwife was really supportive and when baby looked to be bigger than the last two arranged for me to see a consultant at the hospital where it was decided i needed a c-section (4 days later!) due to risk of baby getting stuck again. My midwife came out to see me later that day once she found out, then for c-section she met me at the hospital before and was there throughout the c-section and then for a while in recovery too. Even made a few visits when I was still in hospital. Basically couldn't fault my midwife here, and found NZ maternity care fantastic. Hope this helps, any more questions don't hesitate to ask!

P18PPS

2 of mine were born here, the other 2 in England. Had a nightmare finding a midwife out here as one baby was due in the christmas holiday season and nobody would take me on!! Anyway found a lovely "alternative holistic style" midwifery team, who I thought initially were a bit too "earth mother" for me to be honest.... however they were amazing sand I went straight to them when I found baby number 4 was on the way, I had some post delivery problems with the last one and they were just great.

Can email you details if you like - pm me if you do

hellsbells7070

Hello Hellie73,

I have done both options. I had not had kids in the UK before I left so can't compare the service but I can tell you about my experience here in NZ.

My son is now 2.5 years old. We went through the public sector and used a midwife suggested by my GP. We went to Auckland Womens Health at the hospital for all our appointments.

She was amazing and I have to put the survival of my son down to her 'gut feeling'. Basically, I was not feeling much movement and a routine appointment with her on Christmas eve lead to her suggesting a scan and from there we went strraight to Auckland Womens. My son was born on Xmas day by emergency C Section.

He was born just over 3lbs and 6 weeks early and spent a month in the NICU unit at the hospital. The staff there were totally amazing and I can not commend them enough.

Despite the great care we had with out first, we decided to go private 2nd time round (I am now 36 weeks pregnant) because if the prem problems we had with our first. It's costing us a fortune but I am very happy with the service.

Interestingly, whether we go private or public, the hospital is the same, the anaethesists the same and the staff the same. Had I not has previous complications (and I am now over 40), I would not hesitate to use the Public service.

Good luck and please feel free to message me if you like.

ohdearydear

I am currently 20 weeks with my second child (due early November). I had my first in England by emergency cs at 38 weeks due to pre-eclampsia in early 2011. I'm also classed as high risk due to diabetes so I was a little concerned about the care here when I arrived - I'd been with the same hospital for 20 years and pretty much knew it inside out!

When I found out I was pregnant I went to my GP to find out what to do - thankfully for me I didn't have to go through the process of finding a midwife. I called five before my appointment and all of them said that they were fully booked in November (I was only 5 weeks at the time so couldn't believe how quickly they get booked up). I'm based in Wellington and was told that they are in demand here. I'm sure it's different in Auckland though and, from what I hear online (!), there are more options for packages and hospitals.

Personally the care that I've received at the hospital has been alright. I've had scans at 6, 11 and 17 weeks and will be getting another at 24 weeks - in the UK I would have had 2 by this point. My only gripe is that I see a different obs every time I go - I've not even met a midwife yet!

Doing it this way feels very similar to the UK system!

lisamct

I am a midwife in NZ so I guess I can give you an opinion from the other side of the fence!

I admit I'm probably biased but I'd go with an independant LMC over community/hospital midwifery care if it were me.

Dont worry about the payment issue. Thats just how the Ministry of Health pays midwives. LMC's are paid in 3 parts, 1st at the end of your ante natal period, 2nd after the baby is born and 3rd when they discharge you at the end of your post natal care. Its done this way as some midwives choose to only provide certain aspects of care, usually post natal, so they can be appropriately paid for the care 'package' they provide.
We're paid regardless of whether your baby is caught by us or by a surgeon at section so its completely irrelevant to the type/quality of care we provide. I actually find it a bit insulting that someone would think they method in which we gets paid has any relation to our quality of care but I'm hoping you didn't quite mean it that way (and I'm a bit twitchy as midwives have been getting a very bad press recently)

Personally I think the ability for women to have an LMC midwife here, with continuity of care and carer, is an opportunity that shouldn't be passed over (the same level of care an independant midwife would provide in the UK except you'd pay £3-4000 for the priviledge!)
I'm in no way saying that community/hospital based midwives are any less qualified or skilled than LMC's but they do have to work within the constraints of hospital policies and procedures which aren't always in the best interests of women and babies.

Saying that, at this point you will have a problem finding an LMC midwife who is able to take you for November. Pretty much everyone I know, me included, is fully book till at least the end of Dec and many till the end of January

Hellie73

I had no intention to insult anyone, but the LMC I spoke to who was available in nov, was genuinely disappointed that she may not deliver my baby and that she may have to hand me over to hospital care and it was this reaction and the way that she said that they got payment at delivery that lead me to believe that care could be compromised if it where only down to a question of money.
Maybe it was me being twitchy although there is some information on the web about LMCs, two GPs I spoke to regarding the issue said it was up to me. Such a huge decision to make when I am neither qualified or knowledgable about nz health system.

ohdearydear

You are not the first mum-to-be that has been told this. I am part of a facebook group for mums due in November and nearly all 2nd time mums were told the same as you.

It's useful to have it cleared up by an actual midwife.

lisamct

Fair enough, as I said I'm a bit twitchy about midwifery at the moment due to all the adverse publicity recently.

Maybe you need to try and find a different LMC that wouldn't have to hand you over to hospital care if you needed more specialist input. Some LMC's only provide primary care so would pass you care over to hospital midwives if it became 'out of the norm' (sounds like this is what your midwife does) but lots of us provide secondary care too. This means that even if you need the input of the obstetric team they still provide your care in hospital as part of the 'team' with the medical staffs support.
Even if this means you need a c-section lots of LMC's will still come along as a support person and provide your immediate pre and post op care (this means they still receive the fees from MoH for your 'birth care' as they were still in attendance if not directly involved)

AndyR

We've got a 4 month old daughter born in NZ. We arrived in Auckland about 3 years ago with no family or friends so we went through the whole pregnancy with just the two of us and our LMC.

We did the whole interviewing LMCs thing, felt kinda weird but when we got to the third we both knew she was the one so we went with her. She was absolutely great!! She was with us the whole way through and when my wife had a few complications towards the end, she was even more attentive and looked after her really well. The day we had little Megan our LMC came round at 7am for the first check and then we went to hospital at lunchtime. She was already waiting for us and she stayed with us until 2am, and for this I will be forever in her debt. Having no friends or family around was immensly hard, and for me, having that one person there who knew what she was doing was a huge relief.

After the birth she visited us every day for the next 7 days in hospital, and came round for the first 3 days when we got home. We also then saw her once or twice a week for the first six weeks that Megan was home. Cannot fault her in anyway way at all. And all of this totally free us to, mind blown!

After the LMC had finished we have been handed over to Plunket who have been/are being great. We've had 2 checkups now and also had 2 home visits plus several "how are you" calls which is nice. And a big bonus was a few weeks ago when my parents came over to visit, little Megan was having a screaming fit as she is teething. We rang Plunket on a Sunday evening and they spent 30mins on the phone talking through things we could try. My folks couldn't believe they were so helpful as back in the UK she said NHS direct is closing!!

Overall, the whole having a child in NZ has been amazing!