The life-changing experience of pregnancy and birth is magical, unique and, at times, incredibly confronting. It’s a journey that can see women at their most fragile and yet most powerful – all in the same moment.
Over the coming months (or let’s be honest, the next 18 years!) you’ll experience more weird and wonderful things than you ever thought possible, and will find your body (and your mind) is capable of more than you ever imagined.
Choosing the right care to support you on this journey to motherhood is essential. Whether it’s your first, second, or fifth baby, every birth is different and therefore the care required will be different too. You might be a seasoned mama looking for an alternative experience from the previous births, or you might be a new mama who isn’t sure what you want yet.
Today there is a huge range of different care options available to women. Most importantly, it’s about finding the right care for YOU.
ANTENATAL CARE MODELS
GP shared care
As one of the most common forms of antenatal care, shared care is where the pregnancy care is shared between the GP and the public hospital where you will give birth. You’ll see your GP for regular pregnancy check-ups, and you’ll also have hospital appointments at the hospital with the midwives and obstetrician on duty.
Many women prefer this model as they are already comfortable with their own GP, and if your GP bulk bills there are no costs involved (otherwise you will pay a gap on your GP visits). The downside is that you won’t know the midwife and obstetrician in the delivery room.
Public hospital care
Hospital care is another common form of care within the public system. Your antenatal care is all managed through the public hospital you are due to give birth in, with all check-ups with the midwives and obstetricians conducted at the hospital. They will also provide antenatal classes.
There are no financial costs involved in this form of care, and you get to know the hospital where you will give birth.
Because you will give birth with whichever midwife and obstetrician is on duty that day, you are unlikely to know who will be in the delivery room. However, some hospitals now offer group midwifery practice care through their antenatal clinic where you will be assigned to a small team of midwives who provide you antenatal care and midwifery birthing care.
Private midwife or group practice program in a public or private hospital
Providing guaranteed continuity of midwifery care, a private midwife is a care option that is increasing in popularity. With a private midwife, or care from a private midwife group practice, you have one point of contact for the duration of your pregnancy, birth and for six weeks beyond, providing breastfeeding support and home visits through those critical early weeks as a new mum. This midwife (or midwife team) will perform all your check ups and will be there for the birth. Being professionally trained, the midwives can provide all the medical advice, guidance and nurturing support you need. Private midwives will usually have agreements with local hospitals to provide this high level of continuous care, whether you choose to give birth in a hospital or at home.
There is a cost involved with a private midwife, so check with your private health insurance and find one that fits with your budget and birth plans. Also check which hospitals the midwives have agreements with to make sure they can attend in the hospital of your choice. Medicare rebates are available.
For those with private health insurance, private care with an obstetrician is a well-known care choice. With this model you choose your own obstetrician with whom you will have all your pregnancy check-ups. He/she will also deliver the baby at the private hospital. You can also add a private midwife to this model, to work in conjunction with your obstetrician. The midwife provides continuity of midwifery care both in the ante- and postnatal periods.
This continued care from both a selected obstetrician and a midwife can mean you build up a relationship of trust throughout the pregnancy and birth, providing you with all the benefits of continuity of midwifery care.
“It’s not well known that you can have a private midwife along with a private obstetrician,” explains Brigid Feely, qualified private midwife and lactation consultant on the Sunshine Coast. “We work in partnership with the obstetrician to provide continuity of care in the private sector, meaning no strangers walking into the birth space.” Private midwives such as Brigid also offer extensive postnatal care. “A nurturing postnatal environment extends the midwifery care into the home supporting mothers both mentally and physically,” Brigid explains.
These services do incur a fee, but are eligible for Medicare rebates. Every care provider is different so chat with several until you find one that fits with you and your expectations.
A large part of choosing a model of care is based around where you want to give birth. Though most women initially think that giving birth in a hospital is their only choice, having a homebirth is a perfectly viable option for women with low-risk pregnancies.
There are many reasons women might choose to birth at home, including: keeping the birth as low-key and normal as possible; labouring and birthing in the privacy of home; continued care from known midwives, and a reduced risk of intervention.
As a midwife qualified to perform homebirths, Alison Broderick, Midwife and Director at Coast Life Midwifery, explains that a homebirth is a viable option for single pregnancies where the baby’s head is down and there are no pregnancy complications. “Childbirth isn’t a medical emergency, in the most part it is well women having babies!”
For Alison, the relationship between mother and midwife is key to successful homebirthing. “We spend a lot of time with women on birth preparation; we’ll spend an hour each check-up just chatting with the couple about how they are feeling and what they want, and getting to know the women and their families,” she explains. “This really builds up a relationship throughout the pregnancy so the trust is there when the birth comes around, so if we do recommend they go to hospital at any point during the pregnancy or birth, she will take our advice.”
“When a baby is born,
a mother is born.”
BENEFITS OF CONTINUED CARE
Continuity of care is a model that many women now look for, and with good reason. A Cochrane review (www.cochrane.org) that investigated the effects of midwife-led continuity models of care, found that women who received continuous care from a midwife they know, rather than receiving medical-led or shared care, are:
- more likely to have a vaginal birth
- more likely to have a more positive experience of labour and birth
- more likely to successfully breastfeed
- less likely to have interventions during birth
- less likely to use pain relief
- less likely to have a caesarean birth
- less likely to have a pre-term baby
- less likely for her baby to be admitted to special care
- less likely to suffer postnatal depression.
As well as the benefits through pregnancy and birth, continued care with the same midwife once a new mother gets home is just as important.
“A key part of our care is home visits,” Alison explains. “We offer a full six weeks of postnatal care supporting new mums in the transition into parenthood, which is invaluable.” She continues, “It’s a huge time in their lives and we ensure women don’t feel alone at this time. We need strong mothers to raise strong children, and it’s essential women feel nurtured.”
Choosing the right care for YOU
In today’s world of social connection and information at your fingertips, women are much more in tune with what they want and are not afraid to choose what they want.
“With social media and women talking to women, they are no longer just going along with the system,” says Alison. “Women are now an active participant in their care; it’s a partnership rather than a prescriptive process and everyone has a choice.”
Before choosing your care, Alison suggests really doing your research and being mindful of what you want.
“Speak to friends, keep looking around, sometimes you don’t know what you are looking for until you find it. Meet the people who are going to support you and get a feeling about who will support you the best.” She concludes, “If you aren’t happy with the care you are getting, change it. You don’t have to go along with it, so don’t be dictated to.”
Prioritise your emotional health
Throughout these life-changing times, it’s not just a mother’s physical care that matters but also her emotional wellbeing. Eliza Pike, accredited Mental Health Social Worker and the Director of Blackbird Counselling, believes we need to have an honest conversation about motherhood.
“There is physical support around for women in the prenatal stage however once the baby is born, the focus is on the baby’s health and the mother disappears into the shadows of her role,” Eliza says. “Just like birth plans, a postnatal recovery plan is essential for any woman having a baby.”
By creating individual postnatal recovery plans for all mothers and mothers-to-be, Eliza believes women are better supported through the adjustment to pregnancy, birth and the postnatal period.
“This support needs to be put in place prior to having the baby, to assist women in pregnancy, self-care, nutrition and to build a postnatal kit that provides a new mum with essential services such as lactation support, pelvic floor specialists, and a good GP.”
In today’s world, where new mums are often missing that vital family support that existed for previous generations, motherhood can be a very isolating experience. This is where Eliza believes we need to reach out to our local community. “I’m passionate about supporting women to build their own tribes, mothers helping mothers, so you are not alone during these challenging early days.”
If you feel you are showing signs of perinatal or postnatal depression there are several places you can go for help: Blackbird Counselling (www.blackbirdcounselling.com.au) PANDA (www.panda.org.au), beyondblue (www.beyondblue.org.au), or your local GP.
Do I need a birth plan?
Writing a birth plan can be a very useful process, as it forces you to sit down and think about what you want from your birth experience.
However, Dr Stephen Elgey from Sunnybank Obstetrics and Gynecology, recommends remaining open-minded and willing to adapt in times of need.
“I encourage my patients to have a loose birth plan in mind, but to also be prepared to go with the flow,” said Dr Elgey.
“It is understandable that patients will have certain ideas about how they would like their journey to progress, but I do not encourage a written manual because, chances are, things will not always happen exactly as planned.
“The baby does not read the birth plan and when parents try to control the experience to such a strict extent, it can often be a catalyst for things to unfold very differently.
“Patients can become so fixated on a birth plan that when the journey does not turn out as planned, they become stressed and overwhelmed. This can also be a trigger for instances of postnatal depression, because mothers immediately feel they have failed, which is not the case at all.”
Mother-of-four Tarryn Fryer says forgoing a birthing plan during her most recent pregnancy actually made her feel more in control. The Jimboomba mum says while she had followed a structured regime with previous pregnancies, taking a more flexible approach allowed her to meet unexpected challenges with a more open mind.
“Due to previous pregnancy complications and surgeries I had experienced, I was very scared and nervous going into my fourth pregnancy and had no idea how it would play out,” says Tarryn. “I already knew what worked for me and what hadn’t throughout my previous pregnancies, so I had a few preferences, however I remained a lot more flexible. Because I didn’t have a structured plan, when something unexpected occurred, I felt reassured in knowing I hadn’t failed – it simply meant I was able to discuss the best courses of action to alter the experience and meet some of my preferences, whilst ensuring a safe pregnancy and healthy baby.”
As well as the essential healthcare, here are some extra services available in the region to help you on your motherhood journey:
Andrea Bicket Acupuncture: Offering traditional acupuncture, naturopathic consultations and fertility management programs in a relaxed healing environment that nurtures people towards better health. www.abacupuncture.com.au
Babes + Picnics: The original pay it forward Mama initiative, B+P organise picnics and meet ups for mum across the region whilst raising funds for local charities. www.facebook.com/babesandpicnics
Blackbird counselling: Providing perinatal counselling, postnatal counselling, workshops and more, Blackbird counselling is all about supporting mothers to thrive. www.blackbirdcounselling.com.au
Bubba Sleep: Offering professional, supportive, non-judgemental help with sleep associations, routines, naps, night waking, early waking and more. Restoring sleep your household. www.bubbasleep.com.au
Can’t Stop Staring Photography: Story-teller and creative natural light photographer, Peta looks for the wonder in each and every day, and take immense pleasure in capturing, forever, those fleeting moments. www.cantstopstaring.com.au
Cottontail Nappy Service: Providing a cloth nappy laundry delivery service to homes and childcare centres from Brisbane to the Sunshine Coast. Also offering a gorgeous range of swim nappies. www.cottontailservice.com.au
Little Beach Bums: Making choosing cloth for your baby (and the environment) a breeze, delivering freshly laundered organic cotton nappies to your doorstep for an affordable weekly price. www.littlebeachbums.com.au
The Milk Pantry: An extensive range of lactation products for busy breastfeeding mums are designed to nourish the body, taste great and includes special ingredients that target breast milk production. www.themilkpantry.com.au
To the Shaw & Back Photography: Newborn, maternity and family photographer, based in beautiful Noosa, on the Sunshine Coast. www.totheshawandback.com.au
Zzleep my Baby: A sleep consultancy offering a specialised service to parents that want to recover their healthy sleep habits after having a child. Also offers lactation advice and infant massage courses. www.zzleepmybaby.com