wingfic

Hi all

I have been living in NZ for 16 months now, currently on a 30month work to residency visa and looking to apply for residency in september once I have two years continuous employment under my belt. Hubby and I found out on the weekend that we are pregnant which is very exciting, its our first baby and I just wanted to get some info on the NZ maternity system here. I have an appointment booked with GP to confirm pregnancy but thats not until the end of the week so thought i'd do some research here first... I know a few of you have worked or do work in midwifery and so any advice would be greatly appriciated.

Cheers all

JAJ

Congratulations on the pregnancy, assuming it's confirmed.

Something you need to be aware of is that if you're not a permanent resident when the child is born (and neither is your husband), the child will not be a New Zealand citizen by birth.

Child will have to be included on your permanent residence application, and can become a citizen later on if/when you do (or pursue citizenship independently at age 16).

This surprises many on temporary visas.

lisamct

Congratulations!
I'm an LMC midwife here in Auckland. What do you know about the system already as its a pretty different system from most other places?

You don't have to see a GP to confirm your pregnancy if you don't want to. You can go straight to finding a midwife and they can arrange all your first scans and blood test etc for you instead.

There's a couple of main decisions to be made at this point;
Where to have your baby, home, birth centre, hospital?
Who to look after you, midwife or obstetrician?
Do you want continuity of care or are you not fussed?
What kind of birth do you want to aim for?

Feel free to PM me if you have any specific questions.

wingfic

Assume me to no nothing about the system over here at the moment, going to GP as I know in UK that is the logical step. How do you go about finding a midwife - are there lists and local health board websites etc I should look into?

From your post I presume it is not the same as in the UK where you just turn up at your doctors for midwife appointments throughout pregnancy and then its pot luck who is your midwife depending on when you arrive at hospital? I know all that is a long way in the future for me, so at the moment I am looking at the starting points, what I should be doing right at the beginning.

Thanks

Tom1983

Congratulations

Well, from the experience the boss had the midwifes are fine over here. Get yourself one asap as they can often go very quickly.

Once booked, you'll get a box from plunket congratulating you on the news. It'll come with a lot of goodies from health charts to toddler advice. All very well to read up on.

You'll generally see your midwife every 4 weeks from announcement until the 30th week, then it'll be every 2 weeks before it goes to every week. The midwife will then be with you when its that time. Once your transfered to a ward (if you have a hospital birth), you'll get looked after by the midwife staff in the hospital as well as your general midwife popping in.

They'll remain with you until your wee one is 6 weeks old, then you'll get transfered to plunket or another childcare provider.

As your on a 30 month WTR visa, you'll get childcare provided. My main worry was we'd have to pay when the wife announced we were expecting. That is not the case for a 30 month one. It just means your young one won't be recognised as a kiwi. You can apply for a UK passport for him/her if you want or you can just remain on the island until citizenship and get a kiwi passport that way (like we're doing).

Even though you'll know what your status the young one is, you can send off for a free status check on any new arrival. It doesn't cost anything and can be done at a immigration branch. Waste of time if you ask me but some like to get checked out, in case the status is different.

lisamct

Toms pretty much covered most of it.
FYI in the UK you don't need to see a GP either to confirm your pregnancy you can go straight to a midwife. GP's continue with the myth that this is the case though as they get paid extra for confirmation of pregnancy so don't want to lose this money making part of their business.

Anyway, yeah its a bit different to the UK system as most women here will have a Lead Maternity Carer (LMC) who is a midwife. You can choose to have an obstetrician as an LMC but it would be private care and therefore cost you a considerable amount (@$4000 I believe)

Basically you choose your LMC, either through recommendations (I can give you some if you want) or you can go to the NZ Midwifery Council website http://www.midwiferycouncil.health.n...ind-a-midwife/
and choose from the midwives in your areas.
Its a good idea to 'interview' a few midwives to find one that suits you and your thoughts around pregnancy/birth, midwives are used to this happening so don't be worried about 'offending' them by doing this.
You will see your LMC midwife at each appt, she will be on call 24/7 around the time your due and will be there to catch your baby and will see you up to 6 weeks after the baby is born. Its a pretty intensive relationship which is why its good to pick the right midwife from the start (although you can change throughout the process if you want to)
LMC's often work in either a partnership or small group so they have back up just in case more than one woman labours at the same time so be sure to ask about this when you do your interviews.

Before you choose your LMC decide where you want to have your baby. You have the choice of birthing at home, in a primary birthing unit, Birthcare in Parnell would be your closest (where I work out of at present) or in the hospital. Be sure to tell your chosen LMC where you want to birth as some only birth babies in specific places so might not be able to meet your needs.

LMC's are the main responsible care givers and all going well you wont need to ever see a doctor thoughout your pregnancy or birth. LMC's here have full prescribing rights so can provide you with prescriptions for any pregnancy related meds you might need and can refer you for all your required blood tests/scans etc.
LMC's do work closely with obstetric colleagues though and will refer you to them if anything out of the normal comes up. Sometimes this just means a one off visit to the Obs who then discharges you back to your LMC or sometimes your care will be shared between them if you have an ongoing issue.

Hopefully I haven't bombarded you with too much info!

wingfic

WOW! Thanks both for all the info! Thats been great. I will look on the website and get some further info from the midwifery council. As you are a practising midwife, what kind of 'interview' questions do you regularly get asked? Appart from asking how many ladies the midwife would be looking after around my due date and whether she is happy with my choice of birthing location, are there any other specific questions worth asking or is more about how you both 'click' as you say it is going to prove to be a pretty intense relationship.

I am full of admiration for the profession, esp knowing that you guys go on call 24/7 near the end - very comforting to know!

lisamct

We're actually on call for you from the day you book with us for any 'emergency' issues or worries you have that cant wait until your next appt so not just on call for the birth

What I'd expect to get asked at a 'meet and greet' interview are things like;

- How many women do you take in a month and whats your back up plans if more than one person needs you at a time (most individual midwives will have around 5 women due each month)
- Will I get to meet your back up midwives at some point
- Do you support things such as HypnoBirthing, TENS machines, water birth, active birth, partner involvement (I have lots of dads catch their own babies), really anything you think you might want to do or try.
- Whats your policy about handing over to secondary care if I have to transfer to the hospital in labour (important if your planning on birthing in a birthing unit as you'll want to know if your midwife will stay with you or hand your care over to hospital staff if complications arise in labour)
- Do you do home visits or do I come into clinic every time
- When and where do you run clinics (some midwives have set clinic days that might not suit you)

Most other things can be covered as you go along but these are the kind of things I would look to cover in a meet and greet whether or not they were brought up by the woman or not.

Tom1983

There's also something else that I should point out for you which liamsct hasn't. It's mainly because of certain horror stories about NZ midwives which is utter rubbish of course, but the media do like to overhype a story

Midwives accept your decision when it comes to feeding!

You may have some midwives generally asking why if you decide to bottle feed over breast feed but they certainly won't raise concerns or treat you any differently to mothers that breast feed.

I believe NZ midwives were advised by government to try and advise mothers to breast milk instead of bottle fed but the stories in the media about midwives acting different towards bottle feeding mothers is untrue.

However, if you do decide to bottle feed, I must warn you that newborn formula is a rip off compared to toddler formula and so on. I think we pay $23.99 for Karicare formula new born, it's only $13.99 for toddlers aged 6months+. Thats when babies often move onto solids and away from baby milk

We found that the same with the hospital as well. My wife gave birth at Christchurch womens and none of the staff there treated her any differently when she said she was bottle feeding. They happily gave her the pill and accepted the decision she made. Some pen pusher might be angry, who cares what a pen pusher thinks anyway.

Going back to midwives, you will be given a page number to call. There's always someone in the office who's handling the calls. They'll then forward the call onto the midwife on call at the time. When the wifes waters broke, the midwife called within 5 minutes (the ones we used always called within a maximum of 5 minutes) and that was the end of the waiting game.

Note you may probably get asked if you'd like a student midwife to also be involved throughout your pregnancy. Totally up to you on that. For our first, the wife said no but she wouldn't mind a student helping out on the next birth. Don't panic over the student midwife story in the herald last year, not all student midwifes are as bad as that. It is a joke that she's changed her name to get back on the LMC list. Jessica her name was, think shes at Whangarei now, was in Auckland I believe.

lisamct

Most midwives actually don't work this way, only a few still use the pager system. Almost all LMC's carry their own work mobile phone that women call directly to access them.

As for the feeding thing, well again that is midwife dependant.
Its true that all midwives (NZ and UK based) will, or should be advocating that breast as best, because it is, there's no question about that.
However, you shouldn't be treated differently if you make an informed decision to artificially feed your baby, its your baby after all so your decision. What some people do feel is that in trying to ensure you are making an informed decision, some midwives can go over the top in providing you with the positives about breast feeding and the negatives about formula and don't give a very unbiased picture.
Saying that, artificial feeding isn't all that common in NZ, certainly not compared to the UK so women who do decide from the outset to do it will find some element of surprise from some midwives.

Just had to also respond to this. Firstly she wasn't a student midwife, she was a newly qualified midwife. Also she didn't just change her name to get back on the LMC 'list'. She was never removed from the register so there was no getting back on to do, and if she had been removed you cant just get re-registered by changing your name. She also didn't change her name in any sneaky way, she got married and took her married name, as thousands of other women do every day.
The whole story surrounding this case was a hugely complicated one. This individual midwife is being held accountable not only for herself but also for the actions of her midwifery colleagues as well as obstetric, paediatric and anaesthetic staff who all made huge mistakes in this case but havent been drawn through the media in the same way as the easily scapegoated newly qualified midwife has been.
Ok, climbing down off my soapbox now....

wingfic

I supose I hold a pretty traditionalist view about childbirth and feeding, I want to have the baby in a hospital so that help is at hand should medical assistance be required and I would like to breastfeed as I do believe this is important, only wouldnt if for a medical / physical reason it wasnt possible.

It looks like hubs and I have a lot of reading and decision making to do. At the end of the day though the midwife is the professional and I shall be trusting their advice and recommendations

Purely out of interest - do you get many male midwives in NZ?

lisamct

Have a good read and a think about your choice for place of birth. Most midwives would advise and recommend you not to birth in a hospital if there's no medical need so if this is what you want you'll need to be sure that the midwife you choose supports this choice for normal births.

There are some male midwives around, not many but there are a few.

grantanddebs

We had a homebirth a few months ago and it was the best thing ever! Awesome midwifes and so relaxed. Highly recommend!!

(ps - our first child was a hospital birth)

maisiep

Congratulations! There's lots of info here to consider but I think the main one is to find a midwife you like and feel comfortable with and if that means meeting more than a couple before you make your decision then so be it. I found it all a bit daunting being pregnant and a long way from family and friends, but the care I had here was absolutely excellent (I had my boy at Christchurch Women's last year). My midwife was great as was the obstetrician and I felt really well looked after and listened to throughout my pregnancy. The stay I had in hospital (4 nights) was actually really good because it forced me to rest and just enjoy the first few days with my baby. My midwife also visited me at home after the birth, I think the day after I was discharged then once a week then once a fortnight until my boy was six weeks old. So my overall experience of the maternity system here was really positive. I hope yours is too! Good luck!

wingfic

Thanks all, I have found a midwife which is great and now just waiting and growing the bean until 9 week appointment. Fingers crossed all goes well and I have a healthy and happy 9 months and a posative pregnancy experience too!