Choosing between an obstetrician or midwife as the lead maternity carer (LMC) for your baby’s birth can be an easy choice for pregnant women with a well-established preference, but for others it can be a confusing process.
Whichever option you choose, it is your choice and you should always do what you feel comfortable with, rather than worrying what other people will think. The first appointment is often held between 8-11 weeks and so you need to book an LMC early in your pregnancy.
Whatever your decision, they will become your Lead Maternity Caregiver (LMC). It’s a good idea to start thinking about an LMC as soon as you find out you’re pregnant because they book up fast in some areas.
In New Zealand most maternity care is free to all women who are New Zealand citizens, have permanent residency or have a permit to stay here for two or more years. You may need to pay for antenatal classes and a surcharge for ultrasound scans. To find out whether you are eligible for NZ maternity care, visit the Ministry of Health’s website.
Choosing between a specialist doctor (obstetrician) and a midwife
When choosing an LMC, you may like to ask these questions:
- What is your childbirth philosophy?
- What is your previous experience?
- How often will you see me during my pregnancy?
- Will you be available to me after hours?
- Will you be with me throughout my labour?
- Where will you deliver my baby? (ie at home or at hospital)
- What backup care will you organise if you are unable to attend the birth?
Using a midwife for your pre and post natal care is (mostly) free.
In New Zealand, midwives have been able to act as LMC’s since 1990. NZ trained midwives undertake a 3 year degree which incorporates academic study with clinical placements. Some midwives are also nurses who have completed a shortened midwifery course while others may have trained overseas. All must meet strict certification requirements and have an Annual Practicing Certificate. Note that if complications arise, your midwife or GP may refer you to a hospital obstetrician, which is also free.
A specialist doctor or obstetrician has trained for many years and specialises in caring for pregnant and new mums. Many split their time between private practise and public hospital work. Many obstetricians work as LMC’s under the public funding system however there is usually an additional charge of up to $4000. Some obstetricians work together to ensure they are able to guarantee one is present at your birth.
Your LMC and you
Whomever you choose as your LMC, it is their job to look after you throughout your pregnancy until six weeks after the birth. He or she will check your health and your baby’s progress regularly, usually monthly for the first few months, increasing to weekly towards the end. They should inform you of your options, organise antenatal tests and scans as required, and be responsible for overseeing your labour and delivery. After the birth they should check your baby’s health and progress, help you establish feeding and show you how to take care of your baby before referring you to Plunket and your GP for ongoing care. You may find that a private obstetrician uses a midwife to complete some of the care in the period after you have given birth.