The most common type of pregnancy and birth care is provided by clinical midwives within the public system. This type of care is midwifery-led but it is not the gold standard continuity of carer. This means that most of your care would be provided by the midwives who work in the antenatal clinic and you may see several different midwives throughout pregnancy. Most pregnancies are considered healthy and do not required medical care, but if concerns are raised then an appointment would be made to see a doctor.
Even though this system doesn’t provide continuity of carer, some women may still find this model of care to be practical. For example, it may be necessary to have an appointment with an obstetrician, which can be booked consecutively with your midwife appointment. Or if you require additional testing or screening, these may be offered at the hospital around the same time as your appointments.
For labour and birth, you will likely be in the hospital’s labour ward. Your care will be provided by the midwives who are on shift at the time you arrive in labour and they are often an unfamiliar face. The doctors who are on shift will introduce themselves to you, so you know who they are in case you require their medical assistance. All pharmacological pain relief for labour and birth is available to you.
After the birth of your baby and routine checks have been done, the midwives will help you get ready to move to the postnatal ward, where different midwives will take over your care. Your length of stay in hospital after birth will depend your health and your baby’s health. If everyone is healthy you may be discharged the same day, or the next. If there is a health concern your stay maybe longer. If you already know that you don’t want to stay in the postnatal ward, make sure to tell your care providers during pregnancy, that they can support you in leaving early. Once home again, visits at home are generally carried out by the postnatal/home-visiting midwives for up to four to six weeks. At six weeks it is recommended that you see your GP for a check-up.
By design, this model unfortunately does not provide continuity of care, Hospitals are aware of this and some try to provide some continuity by scheduling antenatal appointments with the same midwife. For some women, hiring a doula or having a student midwife can be a great way to provide the continuity-of-care support which is missing from this model. You can read more on birth support people here.