What is an Independent Midwife?
Independent Midwives are fully trained, qualified and registered healthcare professionals who provide care, support and advice to women during pregnancy, birth and in the early weeks after birth and provide care to the newborn and infant. Independent midwives choose to be self-employed and practice in the community.
Independent Midwives support womens choice and will discuss all options using the best available evidence-based information to guide and support you in making informed choices about you and your baby’s care. Being private practitioners, Independent Midwives are not constrained by hospital policies, procedures and guidelines.
However, to ensure safety and to protect the public, Independent Midwives are registered with the Australian Health Practitioner Regulation Agency (AHPRA), who is their regulatory body and therefore, must comply with the midwifery practice codes.
The Australian College of Midwives has also produced a guideline for collaboration and referral to guide independent midwifery practice.
Why choose a Midwife?
While Australia is one of the safest countries to give birth, medical intervention rates have skyrocketed over the last 20 years and there is a trend away from normal vaginal births. The World Health Organisation recommends that the caesarean section rate should not be higher than 10 to 15 percent as birth by caesarean is associated with high maternal and neonatal complications. The current caesarean section rate in Australia is 32.3%, with substantially higher figures in private hospitals.
Pregnancy and birth are natural events in a woman’s life and the World Health Organisation (1996) states that the midwife is the most appropriate person to be assigned to normal birth. The Victorian Auditor-General’s report (October 2011) also recognises that women with an uncomplicated pregnancy do not need specialist supervision or intervention with the vision to give all Victorian women with normal pregnancies access to a midwife for provision of all pregnancy, labour, birth and postnatal care.
Traditionally, Independent Midwives provide this type of care to a woman and her family. One to one care or also called continuity of care is widely acknowledged to be the ‘Gold Standard’ of maternity care. This individual care gives women the opportunity of getting to know a midwife and to establish a trusting and supportive relationship.
Research has shown that women who receive midwifery care are…
… more likely to:
- Be satisfied with the maternity care you receive
- Feel in control of and have a more positive experience of labour and birth
- Experience spontaneous onset of labour and normal, vaginal birth
- Experience lower rate of (medical) intervention
- Initiate and successfully breastfeed your baby
- Cost the healthcare system less
- Have your birth attended by a midwife that you know
… less likely to:
- Need epidural or use other drugs during labour
- Have and instrument birth (forceps or vacuum)
- Have an episiotomy
- Have induction of labour
- Have a caesarean section.
And your baby is:
- More likely to be born at term
- Be born healthy
- Less likely to be admitted to a special or neonatal care unit
- Have a shorter stay in hospital.
What do our Midwives do?
Through regular appointments during your pregnancy we will get to know each other and have the opportunity to establish a partnership, which is an essential part of providing individual midwifery care. Openess, trust and honesty from both sides are a prerequisite for this partnership to be supportive and optimal.
Important goals of pregnancy care provision in my practice are promotion and maintenance of a healthy lifestyle and prevention or identification of potential health problems.
During every pregnancy appointment we will check the wellbeing of you and your unborn baby. For a routine physical pregnancy examination that includes the position and size of the baby, listening to your baby’s heartbeat, collecting urine or blood tests as required and checking your blood pressure and weight.
You and your partner will have the opportunity to ask your questions, discuss any concerns and express your personal wishes and ideas. We will also talk about routine investigations and screening tests that are recommended during pregnancy and provide you with independent, evidence-based information about individual tests to support you in making safe and informed choices for you and your baby.
The length of an antenatal appointment is approximately 60 to 90 minutes and during your pregnancy we will be 24/7 on call for you and are contactable at any time for over-the-phone advice.
If any medical concerns arise during your pregnancy that require further investigations and follow up I will refer you to your GP, our collaborating Obstetrician Dr Ravi Kashyap or to your local Maternity Hospital for an obstetric review.
There is no average length of labour and natural birth can take its time from start to finish, especially for first time mums.
Your known midwife will be 24/7 on call for your labour and birth and is always contactable. If required, we will visit you at home in early labour when the love and encouragement of your support team is called for. Otherwise, we will attend your labour once established. Your baby’s heart rate will be checked in regular intervals, your contractions monitored, vaginal examinations performed as necessary and your baby’s position will be checked.
If you are planning homebirth 2 Registered Midwives will be present during the birth of your baby. At least 1 Registered Midwife will stay for a minimum of 4 hours after birth to make sure you and your baby are doing well.
If you are planning to give birth to your baby in the hospital, your midwife will accompany you and your support team to the hospital when you feel it’s time to go or if birth is imminent, which is assessed by your midwife.
Midwives are trained to recognise abnormal situations, intervene early and establish if and when a transfer of care to hospital is required.
After Birth Care
The major focus of after birth care is to ensure your and your baby’s health and that you are confident in taking care of your newborn baby, equipped with all the information you need about breastfeeding, reproductive health, contraception and the imminent life adjustment.
Postnatal visits include:
- feeding support
- newborn examination, baby’s weight & measures
- assistance with parentcraft (bathing, sleeping, settling)
- Newborn Screening Test (NST) 48 to 72 hours after birth
- postnatal exercises & nutrition
- checking your recovery and health
The schedule of postnatal visits will be tailored to meet your individual needs and the amount of postnatal visits will depend on your personal situation. There is no limit on the amount of visits and during the 6 week postnatal period your midwife will always be personally contactable, 24/7. The average length of a postnatal appointment is 60 to 90 minutes.
If any medical concern arise for you or your baby that require follow up I will refer you to your GP, our collaborating Obstetrician Dr Ravi Kashyap, Maternity Hospital or Pediatrician.