If you’re thinking you’d like a midwife...

This type of care can best be described as a partnership between the mum-to-be and her midwife, with the main focus on what the patient wants from her pregnancy and birth. "The aim is to create an environment where a woman can express herself and feel listened to," says Joanne Gray, director of Midwifery Studies at the University of Technology Sydney.

If there are complications, a midwife can also collaborate with obstetricians and hospital staff to achieve the best options for you.

There are several ways you can access midwife care through the public system. With team midwifery, your prenatal care and support during labour, birth and beyond is provided by a team of midwives. Unfortunately, there’s no continuity of care, so you may end up seeing a different midwife at each appointment. Then there’s midwifery group practice (MGP), or caseload midwifery, which is available in the birth centre, labour ward and sometimes in your own home, depending on your hospital. You’ll be seen by the same midwife for your pregnancy, labour and birth and the postpartum period. Or as your third option, you can hire a private midwife who can handle all your prenatal and postnatal care, help you labour at home and accompany you to hospital as an advisor and support person only – they won’t be able to perform any medical procedures. However, come July 2010, the introduction of health reforms should allow your chosen private midwife to offer you Medicare rebates, have visiting rights at your local hospital and remain your lead caregiver once you feel the need to transfer to hospital.

Unfortunately, some rural hospitals don’t yet offer midwifery-led care, but the National Maternity Action Plan (NMAP) is working to make the choice of having a midwife as your primary caregiver available to all women.

If you’re considering an obstetrician...

An obstetrician is a doctor who cares for healthy women and their babies, as well as those who face complications throughout pregnancy. They work closely with GPs, midwives, nurses, physiotherapists and other health professionals to provide comprehensive care for all aspects of your pregnancy and birth.

Dr Steven Tan, a Sydney-based private obstetrician, sees himself as an advocate, advisor and educator, and essentially a pregnant woman and her partner’s guide to having a baby. "Pregnancy and birth is a natural process that runs smoothly 99 per cent of the time, however, there’s always a one per cent risk of something going pear-shaped, so my job is to oversee the process and rectify problems," he says. Dr Tan offers "24/7" care to his patients. They have access to his mobile and email, and can book in to see him as often as they like, as he feels he is there to help alleviate anxiety. He also encourages patients to call him after they’ve had the baby if they’re having problems with breastfeeding or feeling anxious or teary, so he can "get the ball rolling" or call in other specialists to help.

If you’re giving birth in a public hospital, you’ll only see an obstetrician on a regular basis if you develop complications, such as high blood pressure or gestational diabetes. To find a private obstetrician, ask your hospital for a list of obstetricians who work there, or get recommendations from friends, relatives, your GP or online forums like bubhub.com.au or bellybelly.com.au.


To read the rest of this story and find out more about your care options, check out the Winter 2010 issue of Cosmopolitan Pregnancy, on sale now!