Midwives are the specialists in normal childbirth. Ninety per cent of women are able to birth without intervention, therefore I find very little if any intervention is required at home.
I generally advise that you book into a hospital of your choice. Private midwives usually have a discussion (lots of discussions as you can see), about what each hospital in your area has to offer, and where you'd like to go (if needed). Should a transfer be required, the midwife should go with you and act as your advocate It is not compulsory to book into hospital, however if you are engaging a Medicare Eligible midwife, booking into hospital is required for you to claim a rebate.
Generally, independent midwives do not 'require' you to have any particular tests. We discuss what testing is available, pros and cons, and you decide which testing best suits your needs. These tests can be organized through the GP or if the midwife in Medicare eligible, she can write the referral. (It is generally recommended that you book into a hospital, so you can access and extra care needed).
Monitoring of baby's heartbeat during labour – The majority of midwives carry a doppler and a pinards stethoscope. Ideally , the midwife can monitor baby every 15 minutes in established labour and after each contraction in second stage. Baby's heart rate is one of our best indicators on how baby is going. Generally, at home, without stress or interruption to the process, baby's do very well. The midwife is also watching you, your contractions, and other 'vital signs' - looking at you on a more personal level, for example: what is your intuition telling you?
Once again, we discuss if this is something you would like to give baby. Current research is discussed and your decision is an informed one. If you would like baby to have Vitamin K, it is available by injection or orally and can be purchased from the chemist if you live in NSW.
Private midwives are unable to provide the actual test at home, but should have the numbers and contacts to give you, so that the test can be arranged at the local hospital within 2 weeks of birth, should you wish to have the test done. NOTHING is compulsory.
Mostly we find very few women have feeding issues when birthing at home, as the whole process in uninterrupted. Generally a private midwife would be visiting each day for the first week or so, to watch over you as you and baby get to know each other. Some midwives are lactation consultants themselves, and other should have access to several lactation consultants if you require one.
Most midwives will be on call 24/7 for you from the time you book until 6 weeks after baby is born. Visits are generally 1 hour long antenatally, and about the same postnatally, depending on your needs. The time spent with you at the birth will be from when you need the midwife, to approx 4 hours after the birth. Each midwife will have her own fee schedule. Some may work in pairs and some may work alone, some may even work in a collaborative arrangement with an obstetrician or hospital. Medicare offers a rebate for some services for eligible midwives, so it’s worth investigating if your midwife has eligibility. In Sydney, fee’s in 2013 range from $4000-6000 for a full episode of care from a midwife.