What is a midwife?

A midwife is a registered healthcare professional who works in partnership with women before conception and during pregnancy, labour, birth and the first few weeks after birth.

Midwives support natural birth and are able to identify complications and provide emergency care for you and your baby if necessary. Midwives also work with other healthcare professionals and may refer you to medical care if needed.

Midwives make sure that you’re fully informed about the care you and your baby will receive. They are your advocate, and they can help you to have the birth experience you want.

An endorsed midwife is a midwife with an extra postgraduate qualification. They can prescribe some medicines and order certain tests relating to pregnancy, birth and the newborn period.

Midwives can work in many places, including:

• your home
• your community
• public and private hospitals
• birth centres
• clinics or health units, including Aboriginal Community Controlled Health Organisations (ACCHOs)

A midwife is not the same as a doula.

What is midwifery continuity of care?

Midwifery continuity of care is when a midwife (or a small group of midwives) supports you through your pregnancy and birth. This can be done in many ways.

Midwifery-continuity-of-care-models can be found in cities, regional and rural settings and some remote communities.

Research shows that this model of care can help you to have a healthy pregnancy and birth. It can also help you start good parenting practices.

Midwifery continuity of care is also sometimes called:

• continuity of carer
• caseload
• midwifery group practice

What are the benefits of midwife continuity of care?

Getting continuity of care from a midwife you know has many benefits. With this model, you are more likely to have the same carer throughout your pregnancy and birth.

Sometimes, you may have a small group of midwives looking after you. They may continue to care for you up until 6 weeks after birth.

Benefits of midwifery continuity of care include:

• having a more positive experience during labour and birth
• having less interventions during labour
• being more likely to have a vaginal birth
• being more likely to successfully breastfeed your baby

Midwifery continuity of care also helps reduce the chance of having a premature baby. There is strong evidence to show that nearly 1 in 4 women are less likely to have a preterm birth if they get midwifery continuity of care. For Aboriginal women, the improvement is even greater, with 1 in 2 women less likely to have a preterm birth with midwifery continuity of care.

How do I access continuity of care with a midwife?

Many hospitals are working towards midwife-led models of care. Below we explain what some of these models look like and how they work.

Caseload midwifery or midwifery group practice

With caseload midwifery or midwifery group practice, you have one midwife who you get to know well. They care for you during your pregnancy and are also on call for your birth.

Your midwife will have 1 or 2 other midwives to back them up if they are not available.

Your midwife will also work with the doctors in your local maternity service if needed. Sometimes midwifery group practice offers the option of a home birth.

Team midwifery

With team midwifery, you are cared for by a small team of midwives during your pregnancy.

You are less likely to see the same midwife at each antenatal visit. But each midwife in the team will be familiar with you and your pregnancy.

You will usually get to know all the midwives on the team. One of them will be available for your labour and birth care.

The midwives work with doctors in the maternity unit.

Private care with a midwife

Some midwives choose to work privately, rather than being employed by hospitals. They are called midwives in private practice (MIPP).

You may choose to employ a MIPP because you want to choose your care provider, or the service they offer is unique.

You may wish to employ a MIPP for continuity of care throughout pregnancy, labour and birth. The same midwife will support you through labour and birth, either at home or in hospital. They will also provide postnatal care (care after the birth of your baby).

Birthing on Country

The term ‘Birthing on Country’ is used to describe the best start in life for Aboriginal and/or Torres Strait Islander babies and their families. Birthing on Country uses a holistic and culturally appropriate model of care to support the change to motherhood and parenting.

Birthing on Country models describe maternity services that are designed for and with Aboriginal and/or Torres Strait Islander women. The models include some (or all) of the following features. They:

• are community-based and governed
• support traditional practices
• involve connections with land and country
• have a holistic definition of health
• value Aboriginal and/or Torres Strait Islander ways of knowing and learning
• include culturally competent service delivery

Birthing on Country Models can be used in anywhere.

Is there a cost to have continuity of care with a midwife?

Medicare can help you with the costs of midwife care during pregnancy and when you give birth.

If you have private health insurance, it may help you with some of your costs. Ask your insurer what your policy covers during pregnancy and birth. Keep in mind, most insurance policies have a 12-month waiting time before you can claim pregnancy and birth costs. Also, ask your midwife what out-of-pocket fees you can expect.

If you don’t have health insurance, you can pay for private care yourself.

If you plan to give birth at a birthing centre, you should ask about the costs when you make your booking.

How else can I get continuity of care, if a midwife is not available in my area?

There are other models of maternity care available. Your options will depend on where you live and whether you have any complications during pregnancy.

Shared care

Shared care is when your pregnancy care is shared between the hospital and a local doctor or midwife. Medicare usually covers the cost of doctor or midwife visits not held at a hospital.

Try using Pregnancy, Birth and Baby's service finder tool to find your nearest doctor, midwife, obstetrician and maternal child health nurse.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

When you contact your local maternity provider, you can ask them what kind of care they offer.

Having a doula, student midwife and supportive birth partner may also be helpful if you aren’t able to get continuity of care with a midwife.

Resources and support

For more information on midwifery continuity of care, you can speak to your doctor or midwife.

To learn more about midwifery, visit the Australian College of Midwives. To find a private midwife, visit Midwives Australia.

You can check a nurse’s or midwife’s registration by searching Australia’s Nursing and Midwifery Board’s national register.

The Royal Women’s Hospital website has fact sheets on labour and birth in different languages.