I have private health insurance, isn’t having a Private Obstetrician better?
For normal healthy women, the WHO recommends care by a midwife. Continuity of midwifery care is being shown to reduce the risk of complications for both mum and baby.
Obstetricians are specialists in complications of birth, the approach to pregnancy, labour and birth is different. Midwives see pregnancy, labour and birth as a normal part of life and because we know normal so well we recognise abnormal and encourage you to seek appropriate specialist advice/care if required.
Midwives understand that healthy mum and healthy baby is everyone’s primary goal, but the path to that goal is also important and very much part of the process of becoming a family. Midwives work with women to give them confidence, in their abilities as a mum and becoming one.
Midwives provide current unbiased information and encourage women to take an active role in their health care. The choice is always yours. If you feel you are in charge of your health, even when things don’t go to plan, you are empowered, confident and more satisfied.
Continuity of care reduces the risk of complications and improves women’s satisfaction. Your midwife will see you at every appointment (generally 30 – 60 minutes each time), be with you through your whole labour and birth, stay with you for several hours after the baby is born and visit you at home for postnatal appointments for up to 6 weeks.
I don’t feel comfortable birthing at home?
You may consider using a midwife anyway. A midwife can still provide your antenatal care, and perhaps more importantly the information and education that goes with it because they can provide unbiased information that doesn’t have to fit in with specific policies. A midwife can support you at home when labour begins and then go with you to hospital when you are ready as a support person. In both the public and private system when you arrive in labour you will be allocated a midwife who is on duty, chances are you will not have met that midwife previously, let alone know them. In the private system your obstetrician will be kept informed of your progress but will generally only be present sporadically through labour and then for the birth. Having a midwife who knows you can reduce your risk of complications and ensure you are empowered throughout the process.
After baby is born you can feel comfortable going home when you are ready because your midwife will be available to support you. In the public system you can expect to stay in hospital for 6 – 48 hours after baby is born if everything is normal. In the private system, your length of stay can be dependent on your level of cover, but is probably 3 – 5 days on average. Breastfeeding will be established best in a supported home environment. Your midwife will ensure both you and baby are recovering well with regular postnatal visits and support you with breastfeeding and adjusting to your new role.
What about the Community Midwifery Program or the Family Birth Centre?
The Community Midwifery Program and the Family Birth Centre are midwifery led care models that are part of King Edward Memorial Hospital. For some people these can be good options, however they are bound by policies. Which can mean your care can sometimes feel like a constant bargaining ground. Decisions can be made to keep “the managers” happy instead of the woman. And the threat of no longer qualifying for the program can actually take away your choice.
These models use teams of midwives to provide continuity of care, which provides a better work life balance for midwives but not true continuity of care for women and their families.
At this time birth does not end up normal as often as it should. As a general rule policies, procedures and interventions have not improved maternal and infant mortality rates but increased our caesarean section rate. Hospital policies are not individualised, their aim is to do no harm, but that doesn’t mean that they will offer what is best for YOU. It can take a lot of energy and confidence to get the right information, to question the standard procedure, to be able to just say “no”.
A midwife can help you achieve an empowered birth by being your translator, advocate, sounding board, leaning post, educator, supporter . . . and whatever else you need her to be.