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 Confirmation Your pregnancy may be confirmed with a urine pregnancy test. You can purchase home pregnancy tests from supermarkets, chemists or free of charge from a self employed midwife, Primary Birthing Unit or the drop in clinic at 124 Dawson Road, Otara. You can also visit your GP who may do a urine or a blood test. You may be charged for this visit. What to expect at your antenatal visits WEEK 9 -12 A welcome and introduction to Counties Manukau Health Maternity services. Your options of care will be discussed - who can care for you during your pregnancy, birth and postnatal period. The midwife will support you in finding a self employed midwife if you choose this model of care and you are anticipating a normal pregnancy and birth. Information will be given about birth preparation classes as you need to book early. A written history of your medical and past pregnancies history is recorded. The midwife will: discuss antenatal screening/1st antenatal bloods/vaginal swabs/urine sample. For more information on antenatal screening visit the National Screening Unit website www.nsu.govt.nz share information about food safety and foods to avoid due to risk of food poisoning during pregnancy share information about maintaining a healthy weight range/weight gain during pregnancy share information about warning signs in pregnancy and who to report those to The midwife will record your blood pressure, baby’s heartbeat, record your weight and dipstick test your urine at every visit. 15 The midwife will: discuss results of 1st antenatal bloods/vaginal swabs and urine* discuss and give a request form for baby’s anatomy scan at 19-20 weeks discuss results from antenatal screening test (if taken). 20 The midwife will review the ultrasound scan. 24 The midwife will: arrange 2nd antenatal blood tests including a screen for diabetes (Polycose or GTT) monitor baby’s growth by measuring the size of your womb/uterus with a tape measure at every visit now ask you about your baby’s movement patterns and discuss when to report any concerns discuss Parental Leave entitlement. 28 Review 2nd antenatal blood results*. The midwife will share information about infant feeding and support you in making a choice. 31 The midwife will share information about preparing for baby: car seat information/education Well Child provider e.g. Plunket, South Seas, Mokopuna Ora, Tamariki Ora-Papakura Marae Immunisation Programme/National Immunisation Register. 34 The midwife will: start writing your birth plan with you and discussing information to enable you to make choices about what you want during your labour/birth (birth planning) arrange 3rd antenatal blood tests (at 35-36 weeks) postnatal stay/discharge planning/contraception choices. 36 The midwife will review 3rd antenatal blood results. Birth planning. 38 You may be seen at 37 & 39 weeks if you and the midwife decide it is needed. 40 The midwife will start to discuss a plan if you go 8-14 days after your due date. 41 The midwife may request liquor volume & growth scan to assess baby’s wellbeing and offer an internal examination to stimulate labour to start. 41 +3 You may be seen by a specialist at Manukau SuperClinic to discuss your pregnancy and induction of labour. Your midwife would have advised you and you would receive a letter. * Test results may be telephoned to you or a letter sent informing you of the results. This occurs in situations where you may need treatment or a further test.

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. 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.

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. After discharge home from hospital or birthing unit Your midwife will visit you at home or the address you have given the day after you arrive home from hospital. If baby has to remain in hospital then your midwife will contact you to organise a visit at a place which suits you. Your midwife will ask how you are feeling and questions about your physical health and sleep/rest patterns. The midwife will advise you about abnormal vaginal blood loss and what to do if it is very heavy or flooding. The midwife will offer you support and advice about baby care such as care of the umbilical cord, bathing baby and infant feeding. The midwife will explain and undertake with your consent any blood tests the baby may require such as the Newborn Screening blood test usually taken at or after 48 hours old. The midwife will share information about the importance of a smoke free environment for baby and sleeping baby on their back in a safe space. You will be asked to provide the baby’s Well Child Book so a record is made of baby’s progress at the visit. At each visit your midwife will advise you when she will be visiting again. If you will not be home when she is due to visit please let her know or contact the Community Midwives office on (09) 276 0049 so an alternative arrangement can be made. Keep in touch! You will be given a contact cell phone number for your midwife and the Community Midwives office (daily 8.00 - 16.30hrs) and a 24 hours contact number in case of any out of hour’s queries. South Seas Well Child Team The South Seas Well Child Team is a diverse multi-skilled and qualified team providing Well Child assistance and services for the Counties Manukau area, specialising in Pacific languages - in particular Samoan, Tongan, Cook Island and Niuean. The team consist of: Well Child Nurses Well Child Community Health Workers Well Child Social Worker Well Child Coordinator. South Seas is also proud to provide the following additional services by Pacific staff mainly for Pacific communities but others too: Primary Care Clinical Services (Clinic) Chronic Care Management School Based Services at Otahuhu College Outreach Immunisation Services Kids in Action (Obese Children) Adults in Action (Adults Health and Wellbeing) Family Violence (Prevention and Intervention) Smoking Cessation. South Seas Well Child Team contact information Office Hours: Monday to Friday 8.00am - 6.00pm 31 East Tamaki Rd, Papatoetoe, Phone: (09) 273 9017

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. Well Child providers are health professionals that support you during the first 5 years of your baby’s life. Their service is free and will follow the growth and development of your child as well as provide a variety of other services to you and your whanau. There are 4 providers of Well Child services in the Counties Manukau region. After the birth of your baby you will be asked which Well Child provider you would like to be your service provider. The Well Child provider should make contact with you prior to discharge by the midwife or doctor who is your Lead Maternity Carer (LMC). The following is a brief outline of Well Child providers. Plunket is New Zealand’s largest provider of support services for the development, health and wellbeing of children under the age of 5. Counties Manukau offer a Well Child service through clinics, home visiting and mobile clinic services. Additional support includes: The Family Centre Parenting Education Car Seat Hire The Volunteer run Playgroups Coffee Groups Toy Library etc. Royal New Zealand Plunket Society Inc - Counties Manukau contact details 59 - 63 Druces Road, Wiri PO Box 97 353, Manukau 2241 Office Hours: Monday to Friday 8.30am - 4pm Ph (09) 260 4111 or Fax (09) 262 0854 PlunketLine: 0800 933 922 www.plunket.org.nz Mokopuna Ora team consists of nurses and support workers who provide comprehensive care and support for tamariki and whaanau in the South Auckland area. Services Mokopuna Ora provide include: home visits and Well Child checks to tamariki 0 - 5 years of age advocacy, support and linkage with other health and social services transport (criteria apply). Information advice and assistance with: dental education benefits, housing family nutrition health concerns child safety Auahi Kore / Smokefree support Manurewa Trust Health Care contact details New Hook Lane off 7 Hill Road Office Hours: Monday to Friday 8.30am - 5pm Phone: (09) 268 1242 or Fax: (09) 267 7854 Tamariki Ora - Papakura Marae offer information & advice on: Well Child Checks In your home At Papakura Marae Te Kohanga Reo At Day Care At your Workplace Health Promotion / Education Breastfeeding & Infant Nutrition Immunisation Prevention of Child Illness Child Development Oral Health Child Safety / Injury Prevention Whaanau Health Education Health Services Networks Family Doctor Hospital Clinics Hearing and Speech Clinics Vision Clinics Smoking Cessation Tamariki Ora contact details 29 Hunua Road, Papakura Office Hours: Monday to Friday 8.00am - 4.30pm Phone: (09) 299 8663 or 0800 TAMARIKI