What is Maternity/Obstetrics?
Maternity/Obstetrics is the area of health concerned with the care of women during pregnancy (antenatal), labour and birth, and the 6 weeks after childbirth (postnatal).
Once pregnancy is confirmed, regular antenatal checks should be performed by a midwife, GP or obstetrician (doctor who is specialised in obstetrics). In the first 28 weeks, these checks are every 4 to 6 weeks but will increase as the pregnancy progresses.
Maternity Services Provided by Counties Manukau District Health Board (CMDHB)
Counties Manukau DHB maternity services are located at Middlemore Hospital, Botany Downs Primary Birthing Unit, Papakura Primary Birthing Unit, and Pukekohe Primary Birthing Unit.
CMDHB Lead Maternity Carer (LMC) Team
These midwives provide continuity of care throughout your pregnancy, labour and postnatal period. A team midwife is available 24 hours per day, 7 days per week. The midwives have easy access to consultation with obstetricians and may continue care if your pregnancy becomes high risk.
Shared Care
Some family doctors (GPs) contract with our maternity services to provide some of the care during your pregnancy. You will visit your GP antenatally plus 3 scheduled appointments with a CMDHB midwife. You will birth at the unit of your choice and be visited at home after the baby is born, by the same midwife you saw during your pregnancy.
Primary Maternity Services
Outpatient antenatal and postnatal care for women. Primary maternity services are offered in the community at clinics and the three primary birthing units in Pukekohe, Papakura and Botany Downs. Birthing for low risk women is encouraged at one of these primary birthing units, but for some women this is Middlemore Hospital as it is closer to where they live.
Young Mums Pregnancy Service
This service is provided for pregnant adolescent women who are under 18 years at the time of booking in their pregnancy. The service works alongside Te Kaha Rangatahi Trust and provides continuity of midwifery care during the antenatal and postnatal period together with social and peer support services provided by the Trust. There are dedicated social workers and community health workers.
Primary Birthing Units
Full primary maternity services (for women with low risk pregnancies) are offered at Botany, Papakura and Pukekohe Primary Birthing Units. These are midwife-led units that offer labour pools or water birth as an option during childbirth.
Labour/birth care is provided by experienced midwifery staff in the unit. You may also transfer to one of the units following birth for your post natal stay if you were not able/chose not to birth there. All units have BFHI accreditation recertified in 2011.
Self employed practitioners (LMC midwives) also use the Units as a facility for birthing.
Secondary/Tertiary Maternity Services
For women with higher risk pregnancies where obstetrician reviews are needed. Weekly obstetrician clinics are offered at Manukau and Botany SuperClinics™ as well as Pukekohe and Papakura Maternity Units.
Birthing for women who require secondary care will usually be at Middlemore Hospital.
Obstetrician Review (or Obstetric Consultant)
Specialist doctors who provide care for women with complications during pregnancy, childbirth and the postnatal period. If you require this level of care during antenatal, labour or postnatal periods, your LMC will discuss referral with you. You may see the obstetrician once or multiple times depending on the circumstances.
Obstetric Medical Clinic
This is a service for women with very complex medical problems before or during pregnancy. Women are seen by a specialist team and, if required, monitored closely during their pregnancy and postnatally. Continuity of care is provided either with the LMC or by an obstetrician and a High Risk Midwife.
This antenatal clinic is at Manukau SuperClinic™ on Thursday afternoons.
Diabetes in Pregnancy Service
This team provides close monitoring of your pregnancy if you have pre-existing diabetes or if diabetes occurs during pregnancy. The team consists of a midwife, obstetricians, diabetologists, and dietitians. Continuity of care may still be provided along with your LMC.
Services Provided by Middlemore Hospital
- Primary, secondary and tertiary inpatient and outpatient services
- Antenatal appointments in community clinics
- Assessment, Labour and Birthing Unit (ALBU) - a 24-hour unit for emergency antenatal/postnatal assessments, labour and birthing for women with high risk pregnancies, and low risk women living in the Mangere, Otahuhu, Papatoetoe areas. Referrals are necessary and early discharge (4 hours) following birth or transfer to a primary birthing unit are options
- Maternity Ward - antenatal and postnatal inpatient services for those who have risk factors or a baby requiring hospital care. The emphasis is on families, education and self care.
- Neonatal Unit - intensive or special care for babies requiring additional services after birth
- Gynaecology Care Unit and Early Pregnancy and Assessment Clinic (EPAC) - provides assessment and care for women up to 21 weeks pregnant with GP or LMC referral
- Postnatal home visits service up to 6 weeks.
Assessment, Labour and Birthing Unit (ALBU)
Located on the 2nd floor of the Galbraith Building (adjacent to the main road next to the Emergency Department). The entrance for labouring women/urgent antenatal problems is from the main road (labelled Birthing Unit) opposite the train station, straight ahead to the lifts and up to 2nd floor reception. For all other women coming to the Unit and visitors, please drive to car parking behind the building and follow directions from the main hospital entrance.
The facilities at Middlemore Hospital were relocated in October 2007 and offer up-to-date technology within modern rooms.
Facilities in ALBU are:
- 17 birthing rooms, all with adjoining ensuites, 4 have baths
- 5 assessment rooms, with either beds or lazy boy chairs
- 4 multi-purpose flexi-rooms, used for assessment, induction, birthing or other procedures.
Maternity Ward
Located on the 4th Floor of the Galbraith Building (see directions above). A 45-bed ward for high risk antenatal/postnatal women that require inpatient admission, as well as low risk postnatal inpatient services for women who live locally to Middlemore Hospital. Advice with breastfeeding from a lactation consultant is also available and BFHI accreditation was achieved in 2011.
