What to expect when you visit Midwives Out West

Our three Midwives work closely together as a group so that if your Midwife (Lead Maternity Carer) is unavailable due to sickness, another delivery or scheduled time off then the continuity of your care continues as normal. You will have an opportunity to meet all three Midwives during your pregnancy.

Antenatal Care

During your antenatal period we ask that you visit us at our West Auckland clinic. We see you for an average of 10-12 antenatal appointments, depending on which stage of pregnancy you are at your booking visit. Usually 6 weekly till the 28th week gestation and then more frequently until delivery of your baby.  We will work with you in planning what is best for you and your pregnancy. Your care will include antenatal checks, diagnostic tests and screening. Your first appointment may last for one hour as we discuss your needs and how the care is organised. Follow up antenatal appointments are between 15 to 30 minutes.

Tests and Investigations

Blood Tests

Your first antenatal blood test should be done early in your pregnancy. This tests for Blood Group, Full Blood Count, Antibodies, Hep B status, Rubella status, Syphilis and HIV. Any additional bloods tests will be discussed on an individual basis and need.

Having blood tests early on in your pregnancy can help protect you and those close to you. These tests are free. It is best to have the tests as soon as you know you are pregnant. They are offered to all pregnant women including those who decide not to continue with the pregnancy.

Blood Group and Rhesus Factor: Your blood type falls into one of 4 groups A, B. AB or O. You will also be Rhesus negative or positive. It is important to know this information in case you require a blood transfusion which is uncommon If you have a rhesus negative blood type you may require an injection of anti-D following abdominal trauma or bleeding in pregnancy, miscarriage, termination or birth. This will prevent severe anaemia in any subsequent babies.

Full Blood Count: When you are pregnant your body needs extra iron for the baby and if you are not able to get sufficient iron from your diet you may suffer from anaemia (low iron levels). Anaemia can make you feel tired and less able to cope with blood loss at the birth and caring for your new baby. Your LMC will give you information about increasing iron rich foods in your diet. If necessary your doctor or midwife may recommend a supplement.

Rubella (German Measles): This test checks if you are immune to (protected against) rubella. If you are not immune, and you catch rubella in the early part of your pregnancy it can cause severe problems, such as deafness for your baby. If you are not immune you can receive a vaccination after you have given birth or are no longer pregnant.

Syphilis: Syphilis is a rare infection in New Zealand, but if untreated it can cause very serious health problems. It can be transmitted sexually or from mother to child at birth. Most pregnant women with syphilis do not know that they have it as they have no symptoms and feel well. If you test positive for syphilis you can be treated with antibiotics which can prevent serious health problems for you, your baby and any future pregnancies.

Hepatitis B:

You need to know if you have Hepatitis B virus so that you can avoid passing it onto others, such as your baby, sexual partner or whanau. Hepatitis B is a virus that can cause inflammation and long term damage to the liver. Most infected people do not know that they have it as they have no symptoms and feel well. However they may pass the infection to other people by blood and body fluids such as sperm and vaginal secretions. If you have Hepatitis B those close to you can be given a vaccination to protect them from catching the virus from you. Your baby will receive hepatitis immunoglobulin and a course of vaccinations will commence within 24 hours of birth. These vaccinations will protect your baby from being infected by the virus. Babies of Hepatitis B positive mothers are who are not vaccinated have a 90% chance of becoming carriers and a 30-50% chance of developing liver disease in later life. For more information about Hepatitis B contact:

The Hepatitis Foundation Ph 0800 332 010 or www.hepfoundation.org.nz

The health professional who organized your blood tests will let you know how you will get your results. This is usually at your next routine visit . Very occasionally (1:1000), you blood test results will be uncertain i.e. neither positive nor negative. If this happens, you may need more blood tests  

HIV:

HIV is the virus that can cause AIDS. It is possible to have HIV for years and not know it. If you have HIV it is possible to pass the virus to other people through blood and body fluids (such as vaginal secretions and sperm). You can also pass the virus on to your baby during pregnancy, childbirth or through breastfeeding. HIV is currently uncommon in New Zealand women. However numbers are increasing and it is therefore recommended that all pregnant women are offered an HIV test. If you have HIV infection the chance of the baby becoming infected can be reduced from a 25% chance to a 1% chance by a combination of treatments. Currently this would include medication for mother and baby, in some cases caesarean section and a recommendation not to breastfeed. If your HIV test is positive expert advice, help and support will be given to help you look after yourself, your baby, your sexual partner and your whanau. Your LMC will be your first point of contact, but you will also be referred for specialist consultant care. Further information and assistance is available from:

Positive women Inc (A peer support service for women and families who are living with HIV)

Ph (09) 309 1858 or www.positivewomen.org.nz New Zealand AIDS Foundation (Information, confidential counselling and research on HIV & AIDS) Ph. 0800 802437 (24 Hour toll free hotline) or www.nzaf.org.nz

Waitemata DHB Antenatal HIV screening coordinator. Ph. 021 223 8400

Further information and assistance is available from:The Hepatitis Foundation 0800 332 010  or www.hepfoundation.org.nz 

Positive women Inc (A peer support service for women and families who are living with HIV)Ph (09) 309 1858 

Maternal Serum Screening:

This is a combined scan and blood test that is done between 11 and a half weeks and 13 and a half weeks to identify the risk of having a baby with a chromosomal disorder such as Down Syndrome.  Click on following link http://www.nsu.govt.nz/current-nsu-programmes/antenatal-screening.aspx 

 

Subsequent Antenatal blood tests:

These are done at 28 weeks and 36 weeks and include iron studies. A Glucose test is also done at 28 weeks to test for Gestational Diabetes.

Scans:

Two scans are recommended, one at 12 weeks which tests for chromosomal abnormalities (there may be a small charge for this scan) and one at 20 weeks to check baby's anatomy. Other scans are recommended if there is a clinical indication. All scans are funded if required for clinical reasons.

 

 

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