If your midwife is self-employed, they will attend your labour and birth. In the event that they are away or busy, they will have arranged a back-up midwife to be available instead. Make sure you know who the back-up is and how to contact them. If your midwife is a hospital-based community midwife, your labour and birth care will be provided by a hospital-based midwife. Please ensure you know the correct number to call for both your community midwife and the hospital birthing suite directly. Make sure you understand the signs of labour and when to call your midwife. Every labour and birth is different and not all go according to plan. Make sure you understand what can happen and be prepared to change your birth plan. Your midwife will talk to you about what may happen and also about what strategies you can use to manage labour pain. Some midwives provide care for women who have been given an epidural by an anaesthetist, have an oxytocin drip and abnormal fetal heart trace, others do not. Please check to see if the midwife you choose offers these services. Labour & birth information on the National Women's Health website. You may also find it useful to view the Labour & Birthing Suite Virtual Tour and read some of our leaflets. Things to bring to hospital Pain Relief Options in Childbirth Auckland City Hospital Map There is additional information on the National Women's Health website www.nwhealthinfo.co.nz

Because pregnancy care is so important for your health and the health of your baby, it is free for all NZ citizens, residents and many other visa holders. Your midwife will give you advice on keeping yourself healthy in pregnancy and you will be offered regular appointments so your midwife can monitor your progress. Your midwife will be looking out for any signs that you or your baby are becoming unwell. Some conditions in pregnancy may not be obvious to the untrained eye, so attending appointments is vital. Your midwife will order blood tests and ultrasound scans as required. Please make sure you undertake these tests promptly so that any problems can be detected early. If any problems are indentified you will be referred to a hospital specialist, who will make a plan of care with you and your midwife. Your midwife will talk to you about what you want for your pregnancy and will plan your care with you. You will be asked to think about the kind of labour and birth you would like and your preferences will be recorded. It is a good idea to attend a childbirth education course, especially if this is your first baby. Pregnancy Testing The National Women's Walk-in Centre can provide a pregnancy confirmation service as well as your own GP. Information about the Walk-in Centre can be found on the National Women's Health website https://nationalwomenshealth.adhb.govt.nz/our-services/maternity/pregnancy-care/walk-in-centre-and-community-clinic/ Pregnancy Check-ups and Tests First trimester (0 - 14 weeks): Check ups are once a month if all is well with your pregnancy. First trimester screening: Screening can provide some information about the chance of your baby having Down syndrome or another condition. This test requires a blood test and the 12 week ultrasound (see below) Ultrasound: At approximately 12 weeks you have the option of an ultrasound scan. There may be costs associated with this. Please consult your midwife. A blood test will usually be organised at or after your first appointment. Your midwife will discuss and advise you on this. Second trimester (15 - 28 weeks): Checks ups are once a month if all is well with your pregnancy. Ultrasound: At 18 to 22 weeks you have the option of an ultrasound scan; there may be costs associated with this. Please consult your midwife. Polycose Test: Between 24-28 weeks it is recommended that you do a polycose test. This blood test is to screen for gestational diabetes. This test is free and carried out at a Diagnostic Medlab. Other blood tests are also usually carried out during the second trimester at the same time as your polycose test. Your midwife will discuss and advise you on this. Third trimester (29 - 40 weeks): Weeks 29-35: Checkups are once every two weeks if you are in your first pregnancy and monthly with your second or subsequent pregnancy if all is well. Weeks 36-40: Checkups are once a week for your first pregnancy and fortnightly with your second or subsequent pregnancy. Additional tests during pregnancy: Consult your midwife if you wish to discuss these: Chorionic villus sampling (CVS) Amniocentesis Maternal Serum Screening Development of Your Care/Birth Plans The LMC is responsible for organising your maternity care. They may provide all your care or share the care with one other, or more, practitioners. They also provide information to assist with decision-making during pregnancy, preparation of the birth and for parenting. Topics will include nutrition, exercise, the risks of smoking and alcohol, labour and the birth process, pain relief, breastfeeding, baby care, immunisation, community services, contraception and many more. It is important that you have a 24 hour contact number for your LMC and that back-up arrangements have been discussed with you in case your LMC is unavailable at any stage. If you choose a community midwife at National Women's, she will only be available during the day but you will be given the delivery unit phone number to contact if you are in labour or concerned about anything regarding your pregnancy which cannot wait until your midwife returns the next day.

After the birth you will be tired and busy getting to know your new baby. Most women who have had a normal birth stay in the hospital or birth centre for 48 hours. If you have had a caesarean section, the usual hospital stay is 3-5 days. There may be an option to have your postnatal stay in a primary unit if you have given birth at hospital. Some women choose to go straight home after birth, this is called a planned early discharge. Talk to your midwife about your postnatal stay and make sure your family know what your plan is. Approximately 4-6 hours after the birth of your baby, if both mother and baby are well, you will be transferred to Birthcare Auckland. Please remember to bring a car seat for your car, to transport your baby safely. Your care will be continued at Birthcare, where you will be able to rest and become proficient with breastfeeding your baby. If you or your baby need further care or you have had a caesarean birth, you will be transferred to one of the maternity wards. At times the wards are very busy and the staff may request that if all is well with you both, you transfer to Birthcare Auckland for the remainder of your stay to free up the ward for those who need the beds more urgently.

Home visits provide an opportunity for you to discuss any concerns you have about your health or the health of your baby. Your midwife will assist you with breastfeeding and will monitor your baby's growth and development. Your midwife will visit you the day after you get home. You will then receive between 5 and 10 visits until your baby is around 4-6 weeks old. It is important to let your midwife know where you are, if you are planning to stay at another address after the birth. A midwife will visit you at home 5-10 times, until 4-6 weeks after baby has been born. This includes one home visit within 24 hours of being discharged from a maternity facility. You will usually receive approximately two visits in the first week, but more frequent visits if you have gone home straight away, after the birth to check on you and your baby's progress and to assist with any breastfeeding challenges. Discharge from the care of the midwife can be any time from 4 to 6 weeks postnatally and she will pass on your care to a Well Child provider of your choice. Your midwife will discuss this with you.

Your midwife will transfer the care of your baby to a Well Child / Tamariki Ora Service before your baby is 6 weeks old. Well Child / Tamariki Ora Health providers work with families to provide support, advice and care for all children under 5 years old. The most common Well Child / Tamariki Ora provider is Plunket but there are others in your region, ask your midwife for information about this service. All babies born in New Zealand are registered with the National Immunisation Register. To find out more about the NIR click here. It is important that you register with a local GP. If you do not have a GP or a GP for your baby, it is important to do this when you are pregnant. You can check for Well Child Providers on the following website http://www.wellchild.org.nz/ and in the Well Child Provider leaflet