Complications in pregnancy labour or birth

 

Things don't always go according to plan and some women have complications in their pregnancy, labour, birth or postnatally. Your midwife is able to identify when something is not right and can make referrals to the appropriate healthcare professionals. The New Zealand maternity system has in place guidelines (The Maternity Referral Guidelines) that identify situations and conditions which recommend referral to other healthcare professionals.


      What is my midwife's role?

The New Zealand midwifery scope of practice is in normal pregnancy labour and birth. That is to say midwives in New Zealand are primary healthcare workers. However, your midwife is able to identify deviations from normal and is  required to make recommendations to you for appropriate and timely referrals to other healthcare professionals.

If your midwife feels a referral is warranted, she will discuss and explain this to you. The final decision for referral is yours based on informed choice.

Your midwife will work with other healthcarers to ensure you and your baby receive safe and effective maternity care that meets your particular needs.

Your midwife may recommend a consultation with an obstetrician for various reasons. This may or may not require your care to be transferred to an obstetric team, however usually your midwife is able to continue to provide you with midwifery care regardless of whether the responsibility of your care has been transferred. You may resume maternity care (or postnatal care) with your midwife once obstetric care is no longer required.


     The process of referral

Your midwife may identify something regarding your pregnancy health that she feels requires a referral. She will discuss her findings with you and may make a recommendation for a referral. This information should include the reason for referral and to whom.

This may be to your GP or for an ultrasound, blood tests, a specialist eg a dietician, an endocrinologist or an obstetrician.

If you decide on a referral your midwife will make an appointment and you will be advised of the date and time.

In some cases this may be a one off consultation or you may have to have further appointments or consultations.

Occasionally the responsibility for your pregnancy care may have to be transferred to an obstetric team and this may mean you have to stay in hospital, but not always. If you do not have to stay in hospital your midwife may continue to provide midwifery care while working with the obstetric team who will continue to monitor you and your baby's wellbeing.

While your  midwife is able to continue to provide midwifery care, she may not continue to be responsible for your maternity care.

 

 The New Zealand Maternity Referral Guidelines state that conversations regarding your healthcare is a three way conversation between yourself, your midwife and specialist.