Your midwife will support and care for you during your labour and will help deliver your baby / pēpi. Pain Management There are no two pregnancies or labours exactly alike. Every woman's experience is unique and individual to her. Labour and birth are normal physiological processes and there are 3 stages to labour. The first stage occurs from the time regular contractions are established until your cervix is completely open and the baby can pass out of the uterus and through the cervix. The second stage is when the woman has a strong, natural urge to bear down with the contractions and push her baby out. Your baby is born! The third stage is the delivery of your placenta. Your placenta detaches from the uterine wall and is expelled through the vagina. Labour is painful but it is important to keep this experience as positive as possible. Pain is a very personal and subjective experience. Regardless of your tolerance for pain, you can learn constructive ways of coping. The pain of labour is definable - it comes with a contraction and then goes away. It is important for you to discuss your options of pain relief with your midwife before you go into labour. Please share any concerns you may have about the possible effects on you, or your baby. Keep an open mind and know your options ahead of time so that you can make an informed choice in managing your labour. Possible Medical Intervention During Labour This is discussed in antenatal classes and may also be covered by your midwife or LMC around 36 weeks when your birth plan will be talked about. The reasons why you may require any medical intervention would be in consultation with you and would usually only occur if you or your baby were considered to be needing assistance.

Your midwife will provide pregnancy care including regular checkups, organising any tests as required and planning your labour plan. Pregnancy care is free for New Zealand citizens and permanent residents. For more information view the New Zealand Government website. Pregnancy Check-ups and Tests First Trimester (0 - 14 weeks) Antenatal visits are usually once a month but may need to be more frequent, a care plan will be formulated for your needs; Ultrasound scan: pre-natal testing will be discussed with you at your booking visit. Booking visits usually take 1 hour. This includes an explanation of how the clinic runs. During your visit your medical and obstetric history is recorded. Your height, weight and blood pressure is measured and you will do a urine test. We will answer any questions or queries you may have. Second Trimester (15 - 28 weeks): Antenatal visits usually occur monthly but may need to be more frequent. At each antenatal check-up your midwife will check your blood pressure, test your urine, listen to the baby's heartbeat (12 weeks onwards) and palpate your abdomen. Ultrasound: An anatomy scan will be discussed and offered at around 18 weeks. Some women may need increased surveillance (i.e. twin pregnancies) Polycose Testing: Between 26- 28 weeks, it may be recommended earlier if diabetes is suspected. This test is free and is carried out at Labtest. Third Trimester (29 - 40 weeks): Weeks 29-35: Check ups are usually once every two weeks, but may be more frequent. Weeks 36-40: Check ups are usually once a week, but may be more frequent. Additional Tests During Pregnancy: Consult your midwife if you wish to discuss these: Chorionic villus sampling (CVS) Amniocentesis Maternal serum Sampling Development of Your Care/Birth Plans Your LMC is responsible for organising your maternity care. They may provide all your care or share the care with one other, or more, practitioners. They also provide information to assist with decision-making during pregnancy, preparation of the birth and for parenting. Topics will include a wide range of matters such as nutrition, exercise, the risks of smoking and alcohol, labour and the birth process, pain relief, breastfeeding, baby care, immunisation, community services, contraception and many more. It is important that you have a 24 hour contact number for your LMC and that back-up arrangements have been discussed with you in case your LMC is unavailable at any stage. The Maternal Fetal Medicine Clinics (High Risk) are a tertiary service. We offer a consultation service and in some cases, because of the complexities of the women and babies we care for, become their LMC.

Your stay at a birthing centre or hospital after giving birth will usually be up to 2 days, or 2-5 days if you have had a caesarean. During this time you will have regular visits from your midwife and be supported to care and feed your baby. Following the birth of your baby you will most likely stay on our postnatal Ward 96/98 (sometimes this may include Tamaki Ward). The length of postnatal stay will vary between women. The length of your stay will be influenced by factors including the reason for your pregnancy being considered high risk, the type of birth experienced and/or any other concerns. Midwives on the wards will assist you in caring for yourself and your baby, preparing you for the transition to going home.

Your midwife will provide weekly home visits from after you give birth to when your baby / pēpi is 4-6 weeks old. Your midwife will provide support, assist with breastfeeding and monitor your baby’s growth and development. Once discharged from hospital your midwife that you met antenatally, will visit you at home 5-6 times (visits are tailored to meet your needs). If your midwife is on annual leave or sick, then one of her team colleagues will visit you. Your midwife will liaise with you to determine a mutually convenient time to visit you and your baby. It is important that you ensure your midwife has the correct address of where you will be with your baby and your telephone details.

Your midwife will help connect you with a Well Child/Tamariki Ora service once your baby / pēpi is 6 weeks old. Well Child/Tamariki Ora services provide free health checks for your tamariki from 6 weeks old to 5 years. It is also important to register your baby with a local GP for ongoing medical care and to organise immunisations. All babies born in New Zealand are registered with the National Immunisation Register.