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What is an Early Pregnancy Care Clinic?
An early pregnancy care clinic is a place you can go to get an early pregnancy check up, to find out what midwifery care is and what to expect. Wrap around support is available if needed. We can help you navigate systems. Midwife Tui can spend 1 hour with you for a full pregnancy checkup and plan. You will get your own set of pregnancy notes. Tui can order pregnancy blood and urine tests, ultrasound scan if needed. Tui can get your care started and help you find your own LMC Midwife for the rest of your pregnancy. Tui is easy to talk to, and will share information with you in whatever way suits best.
Where: Aronui Whare, 5 Onslow Street, Huntly or at another one of Raukura Hauora o Tainui’s medical clinics like Nga Miro in Ngaruawahia, Te Papanui Medical in Enderly, or Te Rengarenga Medical in Dinsdale.
See Raukura Hauora o Tainui website. Tui is part of the Taurima Te Pā Harakeke team supporting whānau from conception to age 5 years. You can receive specialist support, mirimiri and spa available.
Contact Tui - click here and we will be in touch soon.
All about your pregnancy care
A LMC (Lead maternity Carer) can be a GP, an Obstetrician or a Midwife in the community. A LMC Midwife is the most usual way people access maternity care in Aotearoa/New Zealand. Most LMC Midwives work in small group practices supporting each other to provide primary care for you. They can work collaboratively with other health professionals such as obstetricians if needed. Once you register with a LMC Midwife they will be your first point of care during your pregnancy, birth and first 6 weeks after pēpi/baby has arrived.
Regular visits in pregnancy and after pēpi/baby is born are important. You will be offered visits each month. Then every 2 weeks as you reach full term. Weekly until your birth, with regular check ups at home for 4-6 weeks.
Come to a small group Hapu Wananga to learn for pregnancy, birth and post birth group learning sessions. There are wahakura weaving wananga too.
After pēpi/baby is born your midwife will see you at the maternity unit, and then at your home once a week for up to 4-6 weeks. Your midwife will let your GP and Wellchild Services, including Tamariki Ora or Te Kaute Pasifika, or Plunket . Wrap around support is available if needed.
Need to change an appointment?
A midwife’s schedule can be unpredictable due to the difficulty of planning appointments around births! Occasionally your midwife may need to reschedule your appointment. To assist with this please ensure your midwife can always contact you by letting her know if you change your phone number or address. Always check your messages the day of your appointment, if your midwife was up all night with caring for a client in labour your midwife would send message to reschedule ideally in the same week, so that she may get some rest and sleep. Hence text messages are always on silent, remember if you need urgent care please call and the phone will still ring to wake her up.
If you are not able to keep your appointment please contact your midwife in advance and she will her best to arrange a new date and time. Please be aware that if you do not cancel and then miss an appointment you will have to wait until your next scheduled visit.
Research shows that non-attendance in pregnancy carries a substantially elevated risk of severe adverse outcomes which puts you and your baby at risk.
If appointments are frequently missed your midwife will ask you to make other arrangements for your on going care.
Your first appointment?
Your first appointment with your LMC Midwife (Lead Maternity Carer) will usually be at between 6 to 12 weeks of pregnancy and takes about one hour. The earlier you find a midwife the easier it will be. Waikato Hospital Whānau Mai Team Midwives also provide care where needed.
Your midwife will tell you how she practices and how to contact her. She will ask you questions about your health and complete a thorough assessment with you so she can provide recommendations about your pregnancy. This is called making a “care plan”. You might have already done this with Tui, she will send a copy of your pregnancy notes to you and your LMC Midwife.
Your midwife is there to guide and support you and your pēpi/baby.
What does my midwife need to know?
Your pregnancy and birthing history. Any medicine or foods that you are allergic to.
You and your immediate family’s medical history.
When your last period was to estimate when your baby is due.
Your midwife will ask about lifestyle including diet, exercise, smoking, drinking or drug use, and if you have any concerns about your safety so that she can care for you best.
If you have have religious, cultural, or spiritual beliefs we would like to know so that we may incorporate this in your care.
How does my midwife monitor our wellbeing?
Your midwife will measure your height and weight, take your blood pressure, check a urine sample, and she may ask to feel your pregnant tummy to estimate how far into the pregnancy, listen to your baby’s heart beat and ask you about your baby’s movements.
If it is not clear how far along you are or your period dates are uncertain she may ask you to have an ultrasound scan.
Your midwife will offer you blood tests relating to your pregnancy. These tests check for anaemia/low iron, blood type and Rhesus factor, Ruebella immunity, and also to screen for diseases like HIV, diabetes, syphilis, and hepatitis B which can usually be prevented from transmitting to your baby with early intervention.
Your midwife may prescribe medications for your pregnancy and will discuss vaccinations for your pregnancy.
You will be offered screening tests for chromosomal abnormalities such as Down’s Syndrome at approximately 12 weeks.
Between 18-22 weeks your midwife will offer to refer your for an ultrasound scan to check your baby’s anatomy and location of the placenta. She may recommend growth scans if this is indicated.
As your pregnancy progresses your midwife will continue to offer you tests as required and answer any questions or concerns since your last visit. Your midwife will also guide you in the direction of Hapu Wānanga labour and birthing classes to help you create your birth plan at around 36 weeks, you can self contact them directly to register for classes, we would recomend you start this process to register at around 28 weeks https://www.waikatodhb.health.nz/your-health/wellbeing-in-the-waikato/hapu-wananga/. Raukura Hauora o Tainui and the team at Taurima te Paa Harakeke also have Well-being Wananga you may be interested in, just ask Midwife Tui or one of our kaimahi about them.
What happens at birth?
You will have prepared yourself during your pregnancy to know the signs of labour, what to be concerned about, ways to cope in labour and when to contact your midwife or her backup team.
Your midwife will be guided by your birth plan and what happens at each stage of your labour.
Labour is different for every women, yours will be unique. Your midwife will guide you through the process. You will be able to contact her 24/7 on the phone if you have concerns or need urgent care. She will be with you in active labour to support you through your birth. This will include monitoring your wellbeing by checking your blood pressure, temperature and pulse, assessing your baby’s position and heart beat. With your consent, your midwife will check your labour progress by vaginal exam if needed.
After your baby is born you midwife will assist to delivery your placenta, check your perineum for any tears, help you to breastfeed and complete a top to toe newborn check.
After a few hours when the midwife knows you and your baby are safe and well she will make a custom care plan with you and the staff midwife for your postnatal stay at the maternity unit.
What happens if my pregnancy or birth becomes complicated?
Midwives specialise in providing “primary” maternity care within our scope of practice and follow MOH Referral Guidelines. A vital part of your midwifes role is to recognise when your pregnancy, labour, birth or postnatal care may have deviated from normal. If this occurs, in consultation with you, the midwife will arrange a referral to the medical / obstetric team at the hospital.
If you require ongoing “secondary” care your midwife will discuss this with you and the hospital team and it will be agreed who is best to now provide your maternity care. For minor concerns your midwife is likely to remain your main carer, working together with yourself and the hospital team. If your needs are more complex, responsibility for your care may need be transferred to the hospital team. Your midwife will then take on the role of providing support and advocacy working closely with the hospital team and / or remaining in regular contact with yourself and hospital team so she can maintain your continuity of care, in some cases all or part of your care may need to be transferred to the Obstetric & Community Midwife Teams- this would be in discussion with you.
All midwives are trained to provide emergency care if this become necessary.
How do I contact my midwife?
URGENT CONTACTS: You are concerned about you or your baby’s well-being or you are in labour please always call your midwife’s mobile phone number.
Examples: bleeding during pregnancy, excessive vomiting from morning sickness, you think your waters have broken, strong abdominal pain, reduced fetal movements or other illnesses/concerns relating directly to your pregnancy.
If your call is answered by voicemail please leave a message. If you do not receive a reply within 10 – 15 minutes (which can happen if they are on another call, busy with another client or visiting clients in areas with poor mobile phone coverage) you can always call Waikato Hospital if you have an urgent concern and can’t contact your midwife 07 839 8800 to speak with a midwife who will direct you what to do next.
Do not text for urgent queries because there can be long delays in text messages being received, texts can not be diverted to a back up midwife so may go unanswered or unseen, and urgent medical advice can’t be given via text due to the risk of misunderstandings.
If your midwife is “Off Call” your phone call will be automatically redirected to a backup midwife.
NON-URGENT CONTACTS for general questions or requests: these are usually questions you want answered or further information, these can usually wait.
Examples: you have lost or need repeat scan, blood test form, prescription, WINZ certificate, or if have a general question about pregnancy that could wait until your next visit- write it down so you remember to ask your questions. Your midwife provides you with links to lots of reliable information sources and you will see these links in your care plan, in the following info sheets the appear in pink lettering for you to click the link to take you to information pages, they are also listed on the information page at the beginning of your login page to your clinical notes. If you have forgotten when your next appointment is- you will be able to access your own clinical notes and your next visit will be written at the bottom of your last visit, and you would also have been given a card to put on fridge as a reminder. Midwives are here to help, but must also care for their own health and well being.
Before contacting us please consider if your question or request could wait until your next appointment? If not please remember that we also have families and personal lives outside of midwifery and restrict all non-urgent calls / texts to within business hours e.g. Monday to Friday 9 AM to 5 PM.
If you have a lingering problem please contact us during normal office hours and don’t wait until 10pm on a Saturday night to tell your midwife of a problem which has been bothering you for several days.
Please remember it is your responsibility to ensure you are always able to contact your midwife. Please don’t text asking them to phone you back, they might miss the text.
TEXT MESSAGE POLICY
Text messaging okay during business hours Monday to Friday 9AM - 5PM to confirm, cancel or request an appointment change. Texts outside business hours will not be seen. If you have not received a reply within 24 hours of requesting an appointment change please call your midwife. This is because texts can be delayed, misunderstood and won’t wake a midwife up the way a phone call will.
STRICTLY NO TEXT MESSAGING FOR EMERGENCIES! TEXTING DURING AN EMERGENCY IS DANGEROUS FOR THE WELLBEING OF YOU AND YOUR BABY AND YOUR MIDWIFE SHOULD NOT BE HELD RESPONSIBLE FOR NOT SEEING YOUR MESSAGE OR MISINTERPRETING WHAT YOU HAVE SAID IN AN URGENT SITUATION.
Remember: If it’s an emergency CALL. If it’s about appointments: TEXT during business hours. If you have a non-urgent question please wait to discuss this at your next visit.
What happens if my midwife is “Off Call” or busy with another woman in labour?
Midwives maintain their own caseloads, with the benefit of working closely with other midwives so we can support each other when required. Like all health care professionals at times situations may change and births and emergencies can not be predicted and we don’t always have a guarantee that there will be another midwife available in the community, in this case we would seek assistance from our local birthing unit or the hospital if needed, remember that if this was ever to occur it is not through lack of trying but from a limited and stretched midwifery workforce especially in rural areas.
When your midwife is busy or has time “Off Call” a back-up midwife and / or the other midwives in the group practice / local birth centre or hospital would assist where possible to provide all care that is required including labour and birth care in rare situations, this does not happen often but your midwife can not control things which are beyond their ability and control. From time to time we may also have locum midwives working with us to ensure we can always offer you the safest possible care.
To provide optimal continuity of care our midwives share a maternity IT system which allows us all to access client records whenever required. Midwives also meet regularly to keep in contact and update each other about the clients their care. Most clients will meet their backup midwife at some time during the pregnancy. Please let you midwife know if you would like the opportunity to meet the other midwives in our group.
What does “Off Call” mean?
Midwives often work long unpredictable hours so it’s essential that they have regular time off to rest and recuperate. This is important not just for their own health and wellbeing, but also to ensure that they do not become too fatigued to care for you safely.
Some of your midwifes time “Off Call” is planned in advance, such as alternate weekends off (typically from Friday 5pm to Monday 9am), annual leave or attending meetings / study days for their required continuing education to which ensure their clinical and professional skills are always up to date. At other times they might need to go “Off Call” unexpectedly, if for example they are fatigued after a long birth, are unwell, or have a family commitment or emergency, they would always do our best to ensure care is still available for you.
Midwives understand that it can be disappointing when your own midwife is “Off Call”. They ask that you please respect their own self-care and understand that they have lives and families outside of work, just like you do. “Off Call” time means that they can do our best for you and your baby when they are on call.
What are the best websites to learn more about my pregnancy?
Smart Start
Provides step-by-step support to help you access the right services for you and your website.Maternity Consumer Council
A consumer organisation that promotes the rights of women throughout the birthing cycle. Their resource series called Your Choice and The Facts is based on evidence. You can also read real women’s birth experiences.The New Zealand College of Midwives
The College is the professional body of midwives in New Zealand. Its purpose is to promote and enhance the profession of midwifery in order to ensure excellence in midwifery services to women and babies.The Midwifery Council of New Zealand
The Midwifery Council protects the health and safety of women and babies during pregnancy, childbirth and during the first six weeks after baby is born.Nga Maia
The kaupapa of Nga Maia focuses on Mama, Pepi, Whanau and promoting Matauranga Maori in pregnancy and childbirth.La Leche League
Support and resources for breastfeeding mothers.
Privacy & Confidentiality
You are entitled to Privacy and Confidentiality, and your midwife will only ever discuss you or your case with another health care professional if it is relative to your care. You need to be aware that like any other healthcare professional, if a midwife has a serious concern about you or your baby’s well-being or safety they are obligated by law to discuss this with the appropriate people. As part of the agreement with the ministry of health, they do keep statistical information, however your personal name is removed and they use your NHI for your privacy.
Midwife Safety
Intimidation, threatening or abusive behaviour in any form from clients or their support people will not be tolerated under any circumstances and midwives reserve the right to withdraw from your care immediately.
You must ensure that your home is a safe environment for the midwife when they visit you. Any dogs on the property must be securely put away or tied up when they visit.
Disclaimer
The information expressed in the links above are not necessarily the opinions of Aroha Midwives and inclusion does not indicate endorsement or recommendation because we are not responsible for the information or maintenance of those websites. Links are intended for education and informational purposes only in order to provide a variety of information to assist you.