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«Clutha Health First Midwifery and Maternity Services Clutha Health First 3-7 Charlotte Street, Balclutha, 9230 PO Box 46, Balclutha 9240 Telephone 03 ...»

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Clutha Health First

Midwifery and

Maternity Services

Clutha Health First

3-7 Charlotte Street, Balclutha, 9230

PO Box 46, Balclutha 9240

Telephone 03 419 0500 Fax 03 419 0501

www.cluthahealth.co.nz

June 2016

What is a Midwife?

Midwives are specialists in pregnancy, birth and early parenting. They complete a three year

degree known as the ‘Bachelor of Midwifery’ in order do gain the knowledge, skills and

experience they need to provide safe and professional midwifery care.

Midwives work in the community and hospitals. Maternity care is provided to all women in New Zealand and over 80% of women today have a midwife as their Lead Maternity Carer (LMC).

Midwife means ‘With Women’ Midwifery care is the provision of knowledge, advice, care and support in partnership with women and their families during pregnancy, labour and birth and the early weeks following birth.

The service Midwives provide includes:

 Providing Continuity of Care Midwives work with women and families throughout the entire childbirth experience, from conception to 6 weeks after the baby is born.

 Enabling Women to make Informed Decisions Midwives offer a range of information which enables women to make decisions that are right for her and her family.

 There to provide one to one Support and Care during Labour and Birth Midwives provide care that facilitates the natural process of birth wherever possible.

Midwives are the LMC for over 80% of New Zealand Women.

 Providing Safe Outcomes for Women and Babies The Midwife promotes and supports the normal childbirth process, identifies complications in mother and baby and accesses appropriate medical assistance as necessary.

Clutha Team Midwives Here at Clutha Health First we believe pregnancy and childbirth are significant life events, and are delighted to be able to provide your Midwifery Care (Lead Maternity Care). Clutha Health First Midwives have a philosophy that focuses on promoting safe and effective care throughout your pregnancy, birth and postnatal experience. Our approach is holistic and aims to meet the individual needs of you and your family.

Jen, Megan, Michelle and Christy will provide the majority of your care, from your first initial booking, until 6 weeks after your baby’s birth. One of these Midwives will be with you during your labour and birth. We offer care for women birthing at Clutha Health First at home or at Queen Mary in Dunedin (regardless whether it be for clinical reasons or by your own choice).

As your Midwives, we aim to establish a partnership with you and your family, where your unique values and beliefs are respected. We provide you with individualised advice and information so that you can make informed decisions during your pregnancy, labour and birth and postnatal period. We would encourage you to undertake your own research.

We look forward to sharing this child birth experience with you and your family. Please feel free to discuss any concerns or questions with us.

Our Team and how to Contact Us:

–  –  –

Midwife Visits after Birth:

 We will visit you at Clutha Health First Maternity daily when your baby is born, and then at home as determined by clinical individual need.

 We will visit you 1-2 times in the second week.

 We will visit you weekly from 1-6 weeks, at which time you will be discharged from Midwifery care. A referral to a Well Child Provider (i.e Plunket or GP) will be offered.

If you are Sick If you are sick and have an illness such as diarrhoea, vomiting, influenza we ask that you phone your LMC before your appointment.

We try our very best to be punctual to all our visits, however this is a job that requires flexibility and there are times when our clients require more time than we have expected. We appreciate your understanding and will endeavour to let you know if we are running behind.

Midwife Availability We are available at any time between the hours of 9.00 am – 5.00 pm Monday to Friday to discuss any issue relating to you and your baby. Should you have urgent concerns regarding you or your baby’s health, please don’t hesitate to call outside of these hours; keeping in mind it may not be your Midwife who is available at that time. Please note that pagers are for urgent situations that require immediate contact with your Midwife.

While continuity of care is our aim, holidays and sickness may interrupt this ideal. In these situations your care will be provided by a locum Midwife. From time to time we may have a Midwifery student working with us. Your consent will be sought to have a student involved in your care.

Referrals If your pregnancy becomes complicated for any reason you can be referred to a specialist. Private specialists may involve costs to you.

In the event of complications, Midwives co-ordinate your care with obstetricians at Queen Mary Maternity Centre at Dunedin Hospital. A specialist also visits once a month in Balclutha. Ultrasound scans are usually held in Balclutha, but sometimes need to be performed in Dunedin.

Costs Maternity care by Midwives is free in New Zealand, but normal doctor’s visits, prescription charges and scan surcharges still apply.





Queen Mary Maternity Centre Queen Mary is our tertiary provider for specialist services. Parking is difficult – you are best to use one of the parking centres either on Frederick Street or Great King Street during working hours.

There are no facilities for your partner to stay overnight, so if you are from out of town it pays to plan ahead. There are a range of hotels/motels around the hospital. If you require a list please let your Midwife know.

Postnatal stays at Queen Mary vary from going home from delivery suite 2 hours after birth to 3-5 days if you have a problem or delivered by caesarean.

If delivering in Dunedin, Clutha Health First encourages you to return to us from Queen Mary as soon as possible to get the full benefit of our skilled postnatal care in our Maternity Ward.

When in Clutha Health First or Queen Mary you need to bring with you:

For You  Day clothes (for 1-5 days), open shoes or jandals.

 Night wear (for 1-5 days), dressing gown, slippers.

 Toilet gear, including 3 packets of sanitary pads.

 Breast pads and a well fitting bra (36 weeks is a good time to buy a bra).

 Your own pillow (for a better sleep), mug, treats, tissues and a pen.

 Something light to read or do.

 Coins for papers etc.

 Cellphones are restricted to areas without medical equipment (so please ask before using) or you can use our patient phone.

For your baby:

 Clothes to take your baby home in.

Have your baby’s car seat available.

 Woolen singlet’s – Hospitals can be cold for little babies.

  We recommend Almond oil for washing, using as a nappy barrier and massaging your baby with over the first 3 weeks, it causes the least reactions, or alternatively you could use olive oil.

Following Birth at Clutha Health First Following birth, providing that you are recovering from the birth of your baby and that feeding is going well, it will be expected that you can go home 24 – 48 hours after birth. If you have a caesarean section, the average stay is 3 - 4 days. The length of stay depends on how you and your baby are doing.

Self Care in Pregnancy  Continue with normal daily routines if and when possible.

 Rest and take a nap if you need to. Tiredness in early pregnancy is very normal as your baby is developing rapidly at this time.

 Exercise is important, however in early pregnancy women don’t often feel very energetic so save energy and only do what you are able.

 One hour moderate walking is beneficial so walk if you can.

 You may continue to do any exercise that you have been participating in prior to becoming pregnant, however don’t suddenly decide to start running marathons or go rock climbing as your body just will not be used to it.

Nutrition in Pregnancy  Most importantly – water, water, water! At least 8 glasses a day.

 In early pregnancy it is common for women to experience nausea and vomiting. However if you are unable to hold down food or fluids over an extended period of time then you should contact your Midwife immediately as you may require medical input.

 Our best advice to you in early pregnancy is that you eat little and often, to maintain a steady blood sugar level. If you become hungry your blood sugar level lowers, which then increases your nausea, which in turn makes you feel less like eating, which of course continues to make you more nauseated, and so it becomes a vicious circle. Therefore eat breakfast, morning tea, lunch, afternoon tea, dinner and supper.

 If a chocolate bar is all you desire and all you can keep down then eat it – it is food!

 A healthy well balanced diet is important during pregnancy and therefore you will be provided with information on food safety and healthy eating. Your Midwife will discuss healthy weight gain in pregnancy with you.

 We recommend that you increase your daily intake of iron enriched foods as iron is important for giving you energy, and baby will want to get as much of this from you as possible. We recommend that you try having a glass of orange juice or other form of vitamin c alongside any iron enriched foods as this helps your gut absorb it.

 No tea/coffee or Coke should be consumed within an hour either side of eating iron enriched foods, as this decreases its uptake by the gut.

 Increasing your dietary uptake of calcium and protein is also recommended as calcium builds bones and protein is good for babies brain development.

 Folic acid is always recommended in early pregnancy as it significantly reduces the occurrence of neural tube defects such as sipina bifida.

 Iodine supplements are recommended throughout pregnancy and while breastfeeding as it is good for baby’s brain development.

Smoking Smoking is not recommended in pregnancy and if you wish, your Midwife is able to prescribe nicotine replacement therapy (i.e patches, gum, lozenges) for use during pregnancy, please discuss what support is available with your Midwife.

Alcohol No alcohol at all is recommended during pregnancy as consumption can lead to Fetal Alcohol Syndrome which has life long effects on your baby.

Birth Plan Your Midwife will discuss with you a birth plan and give you information about this. Your Midwife will also prompt you with some of the decisions you will have to make in the months ahead.

Time will be set aside to discuss this with you prior to the birth of your baby.

Common Pregnancy Complaints and Suggestions for Relief Nausea and Vomiting  Try and keep a good range of easily prepared, nutritious foods available so that you always have something to tempt yourself with.

 Preparing food often includes nausea, so ask family and friends to prepare occasional meals for you or invite you to a meal.

 Most women find that resting (preferably lying down) provides huge relief.

 Try acupuncture or seasickness pressure bands.

 Increasing the amount of carbohydrates and decreasing the amount of fat may be helpful. Dry crackers, unbuttered toast and non diet ginger ale is suggested. It is important to have these small snacks first thing in the morning before rising.

Consult your doctor if vomiting is severe or it continues beyond the 14 th week of pregnancy.

Constipation

Prevention and treatment could include:

 Eat plenty of fruit.

 Drink several glasses of water daily.

 Try hot prune juice or lemon juice in hot water half an hour before breakfast.

Haemorrhoids  Avoid constipation by increasing your intake of raw fruit and vegetables.

 Sit in a warm bath up to the hips for 10-15 minutes at least twice a day. If there is minor bleeding after stool and considerable pain, Epsom salts may be added to the water.

Insomnia  Some woman find that sleeping on their side is more comfortable with the upper knee drawn up and supported by a pillow.

 Try a warm bath before bed.

 A drink at bedtime can have a soothing effect: try warm milk or chamomile tea.

 Tart cherry syrup from the Pharmacy/Health shop could be beneficial.

Backache  Massage.

 Consult a maternity physiotherapist at your local hospital.

 Rest and put a cushion in the small of your back when sitting.

 Join a pregnancy exercise class.

 Try to maintain a good posture with your bottom tucked in and shoulders back.

 Rocking the pelvis whilst on hands and knees ore resting leaning over a bean bag will ease the ache.

Lower Abdomen and Groin Pain  Draw your knees up to protect the ligaments before turning in bed.

 Bend forward from the hip before coughing, sneezing or laughing.

 Avoid sudden jerky movements.

Oedema (Swelling)  Continue moderate exercise such as swimming or yoga.

 Do not reduce intake of fluids.

 Elevate your legs and feet whenever you sit.

High Blood Pressure  If the blood pressure is only mildly elevated rest can help.

 Avoid tea, coffee and alcohol.

 Rest lying on your left side.

 Take moderate exercise such as walking and swimming.

Persistently elevated blood pressure combined with protein in the urine and fluid retention are symptoms of pre-eclampsia, a condition which reduces the efficiency of the placenta. This condition needs to be treated to ensure the ongoing wellbeing of your baby and yourself.

Cramp  Ensure a good level of calcium absorption by exercising regularly.

 Try hot foot baths with a little lavender oil or marjoram oil added.

 Increase intake of calcium rich foods.

 Avoid coffee, tea, chocolate, rhubarb, silver beet and brewers yeast, all of which interfere with the absorption of calcium.

 Crampeze spray from the Pharmacy may be beneficial.

Heartburn  Eat frequent small meals.

 Decrease intake of yeast continuing foods (e.g bread)  Before going to bed, slowly sip a glass of warm milk or a small amount of natural unsweetened yoghurt.



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