Do obstetricians and midwives attract different clientele?

New research has suggested that women who see themselves as active participants in the birth of their first child, and prefer a collaborative role with their healthcare provider are more likely to opt for a planned home birth with a midwife. On the other hand, women who perceive their role in the birthing process more passively and are more fearful of birth are more likely to seek obstetric care for a hospital birth.

Women's answers indicated whether they perceived the Mother’s Role as active or passive, the Provider’s Role as dominant or collaborative, and the Delivery Experience as fearful and painful, or as a positive occurrence.

Women who perceived their role as active, the provider’s role as collaborative, and the delivery of the child as a positive experience, were more likely to prefer midwifery care, birth at home, a vaginal delivery and the avoidance of pain medication.

The more painful and fearful a woman expects her birth to be, the more likely she is to prefer a caesarean to a vaginal birth.

Melissa Maimann is an endorsed eligible midwife in private practice in Sydney.  One of the first eligible midwives in Australia, Melissa now offers a range of care options for women including private midwifery care and birth support.  Visit Melissa's website to learn more about her services.

6 essential tips for a natural birth

Choosing a natural birth can be the most empowering and transformational experience in a woman’s life. In our culture, childbirth is viewed as a medical event and an emergency waiting to happen. We only have to turn on the TV and we witness birth being portrayed as a major emergency, and thank goodness those doctors were there to save the mother and baby. As well as this, when we ask our mothers about their births, we're bound to hear more horror stories. Forceps, stirrups, the dreaded episiotomy. Shaves, enemas, being bound to bed, not allowed to get up, let alone even sit up. Nothing to eat or drink. Husbands were not present. Is it any wonder that we are so fearful of birth?

Fear guides many birth experiences and results in the overuse of interventions and medications. As a result many women feel out of control and disempowered by their birth experience. It doesn’t have to be that way.

The following suggestions will help you prepare to have the best birth experience possible:

1. Understand the process of birth If you understand what is happening with your body during labour, you will have more confidence in the birthing process. Knowing that everything is as it should be, is the key to “letting go” and allowing birth to happen normally and naturally.

2. Good nutrition Good nutrition is essential to good health. The food we put in our mouths today will build the cells of tomorrow. In pregnancy, the food we eat also builds our baby, so we have an added responsibility to ensure that nutrition is optimal.

3. Exercise Birth is a physical event. Staying fit can minimise pregnancy discomforts and ease the birth process. Walking or swimming and prenatal yoga are very beneficial to the health of you and your baby.

4. Relax Your body instinctively knows how to birth your baby and it releases hormones that help you through birthing.  Fear, tension and anxiety can interfere with the natural process by inhibiting labour hormones and increasing fight / flight hormones.  I recommend Calmbirth to all women who plan a natural birth.

5. Address fears and concerns We are constantly bombarded with negative images and stories of childbirth. Over time these messages can become ingrained in our way of thinking. It is important to recognise our attitudes and beliefs and understand how they shape our experiences. Any negative thoughts or beliefs about childbirth can be explored prior to giving birth.

6. Care provider

Your choice of care provider has a great impact on the sort of birth you will have, despite points 1 - 5 above. Having a supportive care provider throughout pregnancy and birth is critical in positively influencing the outcome of your experience.

Birth is natural and women have done it for centuries. But in today’s society, a birth without preparation may not be the one you envisioned. You have all the resources available to help you prepare for the birth experience you desire.

Melissa Maimann is an eligible midwife in private practice in Sydney.  One of the first eligible midwives in Australia, Melissa offers a range of care options for women.  Visit Melissa's website to learn more about her services.

Why is choosing a care provider one of the most important decisions you will make in your pregnancy?

A woman’s choice of care provider for pregnancy and birth is one of the most important decisions she will make. This decision has the most important influence on how her birth will go and how she will experience her care.

Some things to consider when deciding on a care provider are:

  • What sort of relationship would you like to have with your care provider? Are you merely looking for physical check ups in pregnancy and someone to turn up for the last few minutes of the birth? Are you wanting to be cared for by strangers who do not know you or your wishes for birth / would you like to feel nurtured? Would you like to know the person who will assist you in birth?
  • How much information do you expect to receive? Are you happy with “It’s normal” in response to your questions, or do you need more information and a better understanding of your situation and progress and health?
  • Do you wish to be actively involved in the decisions made about your care or are you happy to leave all decision-making up to others?

It may take some time and energy to find the right care provider for your pregnancy and birth. It is very helpful to interview several midwives and obstetricians before deciding on the one that is right for you.

What about place of birth?

There are three options for place of birth: home, birth centre and hospital. Midwifery care is available at all three locations. Obstetricians generally work only in hospitals, however a few will attend birth centre births. Knowing where you would like to birth your baby can help you in choosing a care provider.

What should I look out for when I am interviewing care providers?

One of the most important issues to consider really doesn’t need much consideration at all. How do you feel about your care provider at the end of the initial consultation? It’s a gut feel. You can trust your gut.

You will want to ask your care provider about his/her practices to ensure that their practices are consistent with what you’re wanting for your pregnancy and birth. If waterbirth is important to you, you need to find a place of birth and care provider who can provide this. It’s best to find this out at the initial consultation stage rather than at 38 weeks.

You will also want to explore your care provider’s philosophy on pregnancy and birth to ensure that there is a match with your own.

Are there any poor reasons for choosing a care provider?

Yes! And I hear them very often. It is not wise to choose a care provider because:

  • They are close to your home / office
  • Your mother used them
  • You feel you don’t have any other choices (there are always choices; it’s not a question of resources, it’s a question of resourcefulness)
  • They are female / they are male.
  • Your GP recommended them (unless you are sure of the basis for that recommendation and you agree that they are right for you)
  • They are cheap
  • They do an ultrasound at every visit
  • They delivered you
  • It would offend Aunt Bessie if you didn’t go to Dr X
  • Although you don’t like the person, you’re sure they’ll be fine on the day (your gut is always right)

Melissa Maimann is an eligible midwife in private practice in Sydney.  One of the first eligible midwives in Australia, Melissa offers a range of care options for women.  Visit Melissa's website to learn more about her services.

Holistic midwifery care

Holistic midwifery care is care that assesses and incorporates the needs of the pregnant woman, rather than merely focusing on her pregnancy.  A midwife who is working holistically will be interested in a woman’s family, her health and medical history, her previous births, her emotional well being, any fears that she may have around birth and parenting, her work life, and her relationships. A midwife who is working holistically will tend to see women for longer appointments, around an hour each, so that there is plenty of time to get to know each other and for the woman to feel safe and comfortable and supported.

A midwife who works holistically believes in the mind-body connection.  When we consider pregnancy and birth, a holistic midwife will understand that issues in life can impact a woman’s pregnancy, and s/he will recognise when fears, uncertainty and doubt are affecting a woman’s labour.  The midwife works with the woman through her pregnancy and birth holistically to help the woman to birth naturally, safely and calmly.

Melissa Maimann is an eligible midwife in private practice in Sydney.  One of the first eligible midwives in Australia, Melissa offers a range of care options for women.  Visit Melissa's website to learn more about her services.

Fetal heart rate monitors - reassurance?

During pregnancy, it is very normal for women to crave reassurance that their baby is healthy.  The purpose of regular antenatal care is to ensure the health and well being of the mother and baby, but for some women, it is this period between visits with their midwife or doctor that concern starts to build.  Is the baby ok?  How do they know? Some women purchase or hire fetal heart rate monitors (dopplers) to keep track of their baby’s heart rate.  They feel that if they can hear a heartbeat, all is well and they feel reassured.  Midwives and doctors general recommend against this practice.  But why, if it provides women with reassurance?

When a midwife or doctor listens into baby with a doppler (or pinards), they are interpreting several aspects of the baby’s heartbeat, and they are putting this piece of clinical information together with the other aspects of the antenatal visit to create a complete clinical picture of the health and well being of the mother and baby.  It is simply not as simple as listening to the baby’s heartbeat in isolation and without reference to the overall health and well being of the woman.

As well, the interpretation of the baby’s heart rate and rhythm requires a degree of clinical training.  The mere presence of a heartbeat is not necessarily reassuring, and by the same token, it is very common for there to be some difficulty in locating the heartbeat and in differentiating the heartbeat from the other sounds that emanate from the uterus.

So, if midwives and doctors recommend women do not use monitors to reassure themselves of their baby’s well being, how can a woman feel reassured?

The simplest and most effective way for a pregnant woman to monitor her baby is to monitor the baby’s movements after 28 weeks of pregnancy.  A healthy baby moves, and often quite a lot!  Monitoring the baby’s movements after 28 weeks, and reporting a reduction in movements to your midwife or obstetrician is by far the safest and most effective way to monitor the health of your baby between appointments.

Melissa Maimann is an eligible midwife in private practice in Sydney.  One of the first eligible midwives in Australia, Melissa offers a range of care options for women.  Visit Melissa's website to learn more about her services.

Knowing Your Midwife

For many women, pregnancy can be an emotional rollercoaster.  Many women experience excitement, joy and hope, but also fear, uncertainty and even disappointment and sadness. The relationship a woman develops with her midwife is important to a woman as she journeys through her pregnancy, birthing and in the early weeks with her baby.

It has been shown that women who are cared for by one dedicated midwife for the duration of their pregnancy, birth and early newborn period find this form of care to be highly satisfying.

It is about having one person who shares in your pregnancy, who listens as you share your fears and concerns, who shares information with you and who supports your decisions and choices.

When a woman knows and trusts her midwife, there is a shift of power towards the woman as she feels a greater sense of control over her entire experience.  She becomes aware of her choices and options, she feels confident to make her own decisions and she goes to her birth feeling confident, informed and supported.  She knows who will be caring for her on the day, and she knows that her midwife knows everything that is important to her for her birth.

There is no sense of being a number in a busy system.  There is no need to repeat yourself at every visit.  There are no lengthy waits for appointments.  Each appointment takes around an hour, so there is plenty of time to get to know one another.

Private midwifery care is an option that more and more women are asking for, although it is only accessed by a small number of women.  Yet research shows that this care model, in which a woman is cared for by one midwife from early pregnancy though to birth and post-birth care, offers numerous benefits to women and babies. These include a greater chance of a spontaneous birth without stitches, feeling in control during labour and exclusive breastfeeding with minimal chance of postnatal depression and baby blues.  Private midwifery care also means much less requirement for pain relief in labour, fewer inductions of labour and of course a much lower chance of needing a caesarean.

The care I am describing - where a woman knows and chooses her midwife – is available for both home and hospital births.  If private midwifery care is available in your area, you may decide that is what you would like.

Melissa Maimann is an eligible midwife in private practice in Sydney.  One of the first eligible midwives in Australia, Melissa offers a range of care options for women.  Visit Melissa's website to learn more about her services.

My pregnancy is high risk. Can I have a midwife?

Yes, midwifery care may well be an option for you.  Your public midwifery options may be limited as public hospitals will generally steer higher-risk women towards obstetric care.  However, private midwives can care for women of all levels of risk in consultation with an obstetrician for the issues that may need obstetric input.

Melissa Maimann is an eligible midwife in private practice in Sydney.  One of the first eligible midwives in Australia, Melissa offers a range of care options for women.  Visit Melissa's website to learn more about her services.

5 myths about homebirth

1. Home birth is unsafe

Numerous studies have shown that a home birth is at least as safe as hospital birth for healthy, low-risk women, who are attended by midwives, with back-up plans in place.

2. Home birth is messy.

Many homebirths occur in water, and the birth pool is simply drained after the birth and everything stays very clean!  However, if you are birthing out of the water, your midwife will provide you with a list of homebirth supplies that you will need, and this will include such things as towels, sheets and plastic to protect floors, lounges, beds, carpet and so on. Garbage bags are always available and midwives always leave the house as they found it after the birth.

3. What if something goes wrong? "I / my baby would have died if we had had a home birth!!!"

How many times do we hear hear this?  Provided the homebirth is "low risk"and there is a midwife in attendance, the chance of things going very wrong is very very small.  The important issue is to ensure that good care has been provided in pregnancy, that there are back-up plans in place and that the woman and her baby are healthy at the start of labour.  In this group of women, homebirth is at least as safe as hospital birth, for both mother and baby.

If things take a different path in the labour, the midwife is often able to manage issues with simple measures. If more complicated measures are needed, the midwife will take the woman into hospital.  Most studies show that this happens in less than 15% of home births.

Typically, midwives bring a range of safety equipment and supplies to a birth. These include: - Oxygen - Suction equipment - Suture material and local anaesthetic for tears - Medication to stop any excess bleeding after the baby is born - Vitamin K for the baby - A doppler to monitor the baby's heart beat - Blood pressure equipment - Urinalysis sticks - Scales to weigh the baby - Resuscitation equipment for the baby - An oxygen mask for the mother - A catheter in case the mother is unable to pass urine - General equipment such as gloves, a mirror, needles and syringes, sterile water and normal saline, gauze, cotton wool, tape, cord clamps (unless the family prefer to use a cord tie) and so on. It's quite a big kit when it's all put together!

4. Only hippies have home births.

This couldn't be further from the truth! The general profile of a homebirthing family goes something like this:

- tertiary educated - in their 30s - already has one child or has been researching birth for many years - works in professional or managerial industries And many are from a health background.

5. It's expensive to have a homebirth.

Costs range from $3000 to $6000 which is very little when you consider what it covers, and the fact that it is spread over about 9 months of care.  After Medicare benefits have been claimed, the out-of-pocket cost is much lower than this. 

Care includes things such as:

  • antenatal (pregnancy) care
  • postnatal care for 6 weeks
  • labour and birth care at home or in hospital
  • your own midwife being on-call 24/7 from the time you book in until 6 weeks after your baby is born
  • access to a library of books and DVDs

Melissa Maimann is an eligible midwife in private practice in Sydney.  One of the first eligible midwives in Australia, Melissa offers a range of care options for women.  Visit Melissa's website to learn more about her services.

Tips for Choosing a Midwife

When you're pregnant and choosing care for you and your baby, you want a midwife who you can trust and build a solid relationship with.  There are a few simple steps and issues to think about when you’re choosing the best midwife for your family.

  1. Employed or private practice? In Australia, most midwives work in an employed capacity.  They may either work in a private hospital or a public hospital.  Midwives may also work in private practice.  “What is the difference?” I hear you ask.  Well, the difference is that if your midwife is employed by a hospital, you will not generally be able to interview and choose your midwife; rather, you'll be cared for by whichever midwife is rostered on when you birth your baby.  However, interviewing and choosing your midwife is very much a feature of your engaging a private midwife.  The benefits of choosing to have a private midwife include: you can choose your birth setting (most private midwives attend births at home and in hospitals), an eligible midwife meets an additional registration standard, so if you choose to have care with an eligible midwife, you are assured that your midwife has been assessed and educated to a higher standard; and your midwife will provide all of your care including ordering your tests and scans and also writing any prescriptions you may need.
  2. Finding a midwife: There are various ways of finding a midwife.  A new Directory has been established that lists eligible midwives to assist you to locate an eligible midwife in your area.  You may also choose a midwife because of referral or recommendation; or because of the options of care that the midwife is also to offer you.  if you are choosing a midwife based on recommendation, it’s important to interview your midwife and maintain an open mind: there is no guarantee that another's recommendations will be suitable for you.  If you are considering midwifery for your care, it’s really important to think about finding a midwife early in your pregnancy, as many midwifery options and private midwives book out early on.  Some women prefer to interview their midwife before they become pregnant.
  3. Skills and experience:  each midwife will bring different skills and experience, however every registered midwife meets the same standards of education in order to qualify as a midwife.  Eligible midwives meet an additional standard, and this can be checked on the AHPRA website: you can search for your midwife and see that they have a “notation” to indicate that they are an eligible midwife.
  4. Convenience Of all things, this is one of the least important considerations.  You may find that you are traveling to receive the care you need, and on reflection, women who do this say that it was worthwhile to travel, rather than settle for care that was close to home, but not necessarily meeting the woman’s needs.
  5. Choice of place of birth: If your pregnancy is normal and you are healthy, you might like the option of birthing at home.  Hence, you may like to choose a midwife who offers homebirth.  However, it is also important to seek out a midwife who can attend your care in the hospital, in the role of the midwife.
  6. Method of practice:  midwives working in employed continuity models (that is, employed by a hospital but working in a model such as caseload or midwifery group practice) will book their own clients and see those women primarily.  However, they share the care of the women with the other members of the group practice.  This means that the midwife who you book-in with may not be the same midwife who provides all of your care. There are also some private group practices where you are cared for by two or more midwives throughout your care.  The other option is to see a private midwife who undertakes to attend all of your care: these will usually be midwives working in sole practice, and these midwives have a smaller caseload to ensure that they are readily available to their clients.  It is worthwhile understanding what arrangements your midwife has in place for times when they are not available, and also to ask what percentage of their booked clients’ births they actually attend.
  7. Your gut feel: It is important that you feel a sense of confidence in your midwife, and that you feel a sense of trust and comfort with her.  You should feel comfortable asking questions, and letting her know what is important to you.  In my experience, your gut feel is your best indicator.

Melissa Maimann is an eligible midwife in private practice in Sydney.  One of the first eligible midwives in Australia, Melissa offers a range of care options for women.  Visit Melissa's website to learn more about her services.

Dating scans

Your midwife or obstetrician may suggest a dating scan early in your pregnancy for a few reasons.  Dating scans are often performed between 7 and 12 weeks of pregnancy and there are a few good reasons for having a dating scan:

  1. You may see your baby's heartbeat, and this can be very reassuring to see and hear
  2. The scan can determine if the pregnancy is in your uterus, or in your fallopian tubes
  3. You can see that the placenta is starting to form
  4. You can tell if you are carrying twins (!)
  5. Also, a scan early in your pregnancy can more accurately date your pregnancy than using your period date alone.

Research has shown that when we use a due date that has been assessed from an early scan, women are much less likely to need to be induced for going beyond 42 weeks.  It also helps with more accurately timing other tests and of course telling the age of a baby who may be born prematurely.  As with all tests and scans in pregnancy, a dating scan is your choice.

Melissa Maimann is an eligible midwife in private practice in Sydney.  One of the first eligible midwives in Australia, Melissa offers a range of care options for women.  Visit Melissa's website to learn more about her services.

Fish in pregnancy

Fish is a really healthy food to eat. It is rich in protein, healthy fat and minerals. It contains the sort of fat that can help to lower bad cholesterol, and increase good cholesterol.

It also contains omega-3 fatty acids which are important for the development of the baby's central nervous system.  Some women have commented that they don't like fish, and have asked if a fish oil supplement is a reasonable alternative.  I think that if it's a supplement or nothing, then a supplement is good, but there's no substitute for the real thing, so where possible, eat fish and avoid the supplements.

Although fish is a great food source, you need to be careful about which fish you choose. Bigger fish, such as shark, eat smaller fish.  They also live longer than smaller fish.  Therefore, over their lifetime, they accumulate more mercury than what a smaller fish would accumulate, and this can be harmful for the developing baby when we eat bigger fish.

Small amounts of salmon or sardines every day is very beneficial to your developing baby.  It does not need to be a large serve; the important thing is to have a steady stream of nutrients and fatty acids to your baby.

Melissa Maimann is an endorsed eligible midwife in private practice in Sydney.  One of the first eligible midwives in Australia, Melissa now offers a range of care options for women including private midwifery care, antenatal shared care and birth support.  Visit Melissa's website to learn more about her services.

Independent childbirth education classes: a midwife's perspective

Women who book with me for care will know that I am a firm advocate of independent childbirth education classes.  Why do I feel that these classes are so important?  It’s not that I believe that women need to be taught how to give birth, because I know that women's bodies are designed to birth babies, and for the most part, women birth their babies without any help from anyone else.  Yet I still believe these classes are important ... vital, even. This is because all pregnancies and births involve choice.

And to exercise our choices responsibly, we need to have knowledge.

It is that simple.

If we do not know what choices we have, we do not have any.

If we are aware of our choices but lack any information about the implications of each path, we may not make responsible choices that lead us to a healthy birth and baby.

We have choices around care providers, place of birth, testing in pregnancy, interventions in birth, type of birth, methods of feeding a baby, postnatal care issues and early parenting choices.

Labour and birth and early parenting are not the times to be learning new information for the very first time: these are times in our lives when we are not in a state to take in new information and assimilate it.  This learning is best done in pregnancy, so that the time we get to labour, birth and baby, we are already aware of our options and our preferred choice.

Independent childbirth education classes cover more than basic hospital classes, in my opinion.  They will teach you everything from late in pregnancy to labour, birth and caring for your new baby.  They will provide all of the content of hospital-based classes and much more: more time, more resources and more attention.

The couples I have worked with over the years have been delighted with the classes they have attended, coming away feeling relaxed and calm, confident and knowledgeable.  They have helped enormously with birth planning and preparing for birth and baby, and with choices and decision-making.

Melissa Maimann is an endorsed eligible midwife in private practice in Sydney.  One of the first eligible midwives in Australia, Melissa now offers a range of care options for women including private midwifery care, antenatal shared care and birth support.  Visit Melissa's website to learn more about her services.

Top tips for a healthy pregnancy

Folate Folate is a B vitamin that is found in food.  Folate helps to produce and maintain new cells - especially important during early pregnancy when the baby is developing.  Folate is found in green, leafy vegetables, citrus fruit, beans and peas.  As well as dietary sources of folate, it is recommended that women take an additional supplement of folate in the form of folic acid.  500 mcg daily is recommended for women from 3 months prior to pregnancy, until three months into the pregnancy.

Alcohol and smoking

Both are best avoided in pregnancy,  Alcohol crosses the placenta and directly affects the baby.  Alcohol can cause miscarriage, premature birth, stillbirth, a small baby and fetal alcohol syndrome.  Smoking reduces the amount of oxygen that is available to your baby, and can cause low birth weight.  As well as this, there are many chemicals present in cigarette smoke that can be harmful to a growing and developing baby.  Smoking can increase the chance of a miscarriage and preterm birth.

Sleep

Rest and sleep are really important in pregnancy.  Early pregnancy, especially, is often a time of tiredness and fatigue, and in general, the first trimester is easier when you are well-rested.  Some women will need an afternoon nap or sleep-ins on the weekend to get through the first trimester.  Likewise, the third trimester is also a time when some extra ZZZZZs are need.

Exercise

Exercise is great during pregnancy!  Any exercise that you have been doing consistently prior to pregnancy is safe during pregnancy, but it is a good idea to run this past your care provider.  Contact sports, high impact exercise and vigorous sports may need to be avoided.  The best exercises are walking and swimming, and some women also like to do pregnancy yoga and pregnancy pilates.  These are both very gentle.

Exercise has numerous benefits to you and to your baby:

  • Maintenance of a healthy weight
  • Reduction in the risk of gestational diabetes and high blood pressure
  • Promotes more restful sleep
  • Stress management
  • Improved sleep
  • More energy to get through your day
  • A shorter labour, perhaps with fewer interventions

Healthy diet

A healthy diet is the foundation of a healthy pregnancy.  A healthy diet can help to prevent gestational diabetes, high blood pressure and obesity.  Every mouthful of food helps to grow a healthy baby.  You want to give your body the best nutrients, frequently throughout the day (ie, several small meals throughout the day), to allow your baby to develop healthily.

Melissa Maimann is an endorsed eligible midwife in private practice in Sydney.  One of the first eligible midwives in Australia, Melissa now offers a range of care options for women including private midwifery care, antenatal shared care and birth support.  Visit Melissa's website to learn more about her services.

I'm pregnant and I have private health insurance. What are my options?

Great question! There are a few options available to you as a private patient, as well as all of the options that are available to public patients. The private options are either a private midwife, or a private obstetrician. Private midwife To receive care from a private midwife and obtain Medicare benefits, your midwife will need to be an "eligible midwife" (meet an additional registration standard) and work with an obstetrician or a doctor who provides obstetric services.  All private midwives can provide pregnancy and postnatal care.  Hospital options may include private or public hospitals; it’s best to ask your midwife which hospitals she attends births at. Eligible midwives provide complete continuity of care: the midwife you book with will be the same midwife who provides all of your pregnancy, birth and postnatal care.

Private obstetrician Private obstetricians provide pregnancy, birth and postnatal care, although birth care would also be provided by hospital midwives who may be unknown to you until birth. Private obstetricians deliver babies at public and private hospitals. Continuity is provided during the pregnancy, but birth care is mostly provided by hospital midwives. Postnatal care is almost always provided by hospital midwives, with your obstetrician visiting you each day in hospital and at 6 weeks.

Visit my website to learn more about my services.

Private midwifery

As a mum-to-be, you are embarking on an amazing and sometimes daunting journey.  Private midwifery care supports women through their pregnancy, birth and early days with their new baby.  It's about care with a midwife you know and trust.  Sadly, most Australian women will not see the same midwife twice.  I believe that having the same dependable, knowledgeable and caring midwife by your side is what makes all the difference.

There is now a wealth of evidence - including fresh new research - that shows that women and babies can expect safer, healthier outcomes in the short- and longer-term when they choose a midwife for their care.

  • More likely to have a normal birth            
  • Less likely to be admitted to hospital during pregnancy
  •  More likely to have a positive and satisfying birth experience            
  • Less likely to have an assisted birth (ventouse / forceps)                                
  • Less likely to have a caesarean
  • Less likely to give birth to a low birth weight or pre-term baby                                
  • More likely to successfully breastfeed            
  • Less likely to request an epidural for labour pain relief

Visit my website to learn more about private midwifery care.

Private Health insurance and birth

Over the past week, I have spoken to a few newly-pregnant women who have expressed some confusion with what exactly private health insurance covers.  So I thought I'd run through it here. Private Health insurance is available in two forms: hospital cover and extras cover.

Hospital cover covers the cost of your treatment while you are actually in hospital.  It does not cover the cost of your out-of-hospital care such as your appointments, scans, tests and so on.  These are claimed through Medicare.

You need to also check the level and type of hospital cover that you have.  Some cover you to be a private patient in a public hospital; others cover you to be a private patient in a private hospital, and others do not cover pregnancy at all.

The other thing to consider is your extras cover.  Extras cover may cover some services provided by private midwives that are not claimed through Medicare such as childbirth education and homebirth.  There is generally only a two month waiting period for extras cover, whereas there is usually a 12 month waiting period for hospital cover, with the exception of one or two funds who require 24 months of cover for pregnancy.

To re-cap, your appointments in pregnancy and after baby is born are claimed through Medicare as these are out-of-hospital services.  When you have your baby in hospital, your health fund covers the cost for your hospital accommodation and treatment in hospital.

Learn more about private midwifery care and antenatal shared care

Measuring a baby's growth in pregnancy

I am often asked by women how I am able to tell a baby's growth during pregnancy without doing an ultrasound. Sometimes an ultrasound can be helpful if a doctor or midwife has concerns about a baby's growth, but in most cases, a midwife or doctor is experienced in feeling and measuring the baby to gauge growth.

Midwives and doctors measure the growth of a baby using a tape measure.  They measure from the top of your uterus to the top of your pubic bone, and this measurement should be within 2cm of the number of weeks pregnant that you are.

I'm pregnant! What are my next steps?

If you have just found out you are pregnant, congratulations! You might be feeling a range of emotions: excited, fearful, overwhelmed, happy, anxious ... this is all very normal! Many women who contact me feel unsure about what to do next and are anxious to know all their options before making a choice, so I have put together a few tips to make you feel a little more confident. Although many women see their GP as their first port of call when they are pregnant, it’s handy to know that women may also see an eligible midwife who can order all the necessary pregnancy tests and any scans that are needed. An eligible midwife can also talk with you about the available options for your pregnancy and birth care, in a relaxed and unhurried setting. An eligible midwife can help you determine your due date and arrange any referrals that you may need. She can book you into a hospital, refer you to an obstetrician if needed, and also provide full pregnancy, birth and postnatal care.

Really, the first task of early pregnancy is to choose your care provider, and from that step, all else will follow as your care provider will arrange your ongoing care.  Many private care options will be fully booked by 6 weeks of pregnancy, while public options remain open to all women who reside in the hospital's catchment area.

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Pregnancy Symptoms

I am often asked by women what they might expect to experience in early pregnancy. Here's a guide below: The symptoms below are some of the more common symptoms that women experience. Eligible midwives are able to order all of the necessary tests and scans in early pregnancy.

Late period This is a common sign of pregnancy, and it is the one that it most often found first.

Morning sickness Some women experience this, while other women do not. Some experience it as a later sign of pregnancy.

Sore, tingly breasts This can also be one of the earlier signs of pregnancy and it can feel similar to premenstrual breast tenderness.

Tiredness Tiredness is a common pregnancy symptom in early pregnancy.

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5 thuths about private midwifery care

1. Your chance of caesarean is about as low as it can get

  • Approximately 5%, with almost all studies pointing to rates less than 10%, and some as low as 3%

2. The most likely outcome for you and your baby will be:

  • Your labour will start on its own
  • Well prepared, confident and supported, your labour will not need any form of medication to stimulate it once it has started
  • You will require no medical forms of pain relief
  • You will reflect positively on your birth
  • You will birth normally, and without the need for stitches
  • You will exclusively breastfeed your baby with minimal problems
  • You and your baby will experience optimal health and recovery from birth

3. It is an excellent investment in your health and that of your baby

4. While many women will change from one model of care to private midwifery care, few women change from private midwifery care to another model.

5. Private midwifery care means complete continuity of care.  Your midwife is not restrained by a shift duration, she will not be on annual leave with you give birth and she will personally attend you at the times that you need her.

Learn more about private midwifery care and antenatal shared care