Who can be a Lead Maternity Carer?

A midwife, doctor (GP) obstetrician or a hospital-based team can be an LMC.

A midwife

specializes in providing maternity care for women experiencing uncomplicated pregnancies, labour and births and provides care for mothers and babies during the first 4- 6 weeks after the baby’s birth.
can provide all your care during pregnancy, labour and birth and after you baby is born.
should have a back-up midwife who can provide care if she is busy with another woman in labour or is on her rostered time off.
can sometimes provide care for women who have complications during pregnancy and/or labour with either a private obstetrician or a hospital based specialist.
can be a self-employed midwife who contracts to the Ministry of Health and works in her community (also known as an independent midwife) or a midwife who is employed by the local District Health Board Hospital and works either from the hospital antenatal clinic or a clinic in the community.

All maternity care provided by a midwife is free

A family Doctor (General Practitioner)

can provide maternity care for women experiencing uncomplicated pregnancies and for those experiencing some medical problems that can complicate pregnancy.
shares care during labour and birth with a hospital midwife
shares care of you and your baby after you’ve given birth with either a visiting midwife from the hospital or an independent midwife.

NB – An increasing number of doctors who do not provide LMC care are now charging for maternity consults during the first 12 weeks of pregnancy.

* Note: Very few family doctors in Auckland or NZ/Aotearoa provide full LMC services. Most doctors only provide early pregnancy care – and you may be charged for this. In areas where there is a shortage of midwives some GPs provide care up until the last month of pregnancy and this care is generally provided free of charge.

A private Obstetrician

specializes in providing care for women who are experiencing complications during their pregnancies, labours and births.
can also provide care for women who expect to have an uncomplicated pregnancy and birth.
shares care during labour and birth with either a hospital midwife or an independent midwife.
shares care of you and your baby after you’ve given birth with either a visiting midwife from the hospital or an independent midwife.

You will usually be required to pay for maternity care provided by a private obstetrician.

Hospital Teams

All your care during pregnancy, labour and birth and after you’ve given birth can be provided by a hospital team based at a birthing centre, maternity unit or hospital.

1. A midwifery team

can provide care for women experiencing uncomplicated pregnancies, labour and births and provides care for mothers and babies in the first month after the birth.

Sometimes these teams are just 2 – 3 midwives who

take it turns to provide your pregnancy care so you get to meet all the members of the team.
take it turns at being on call to attend labour and birth, so, whoever is rostered on when you go into labour will provide your labour and birth care.
provide care for mothers and babies after the birth for one week out of every 2 – 3 weeks, so, you are likely to see all the midwives on the team during the 4- 6 weeks after you’ve given birth.

These midwifery teams are often called KYM (Know your Midwife), DOMINO or Continuity of Care teams.

Some team midwives only provide pregnancy care and care at home after your baby is born. These midwives are often called “Community Midwives”. During your labour and birth you will be cared for by a midwife on duty in the labour and birthing unit.

If your LMC is a hospital based midwifery team, you will have your pregnancy check-ups at the hospital or in a clinic in a suburb close to where you live.

All care provided by a hospital based midwifery team is free

2. A team of doctors and midwives

provides care for women who develop complications during their pregnancies or labours. (If your original LMC was an independent midwife, your care may be handed back to her once the complication you have been referred for has been resolved or the danger period has passed.)
provides care for women who have medical conditions that could affect the outcome of their pregnancies, e.g. diabetes, heart conditions, blood clotting disorders, recurrent miscarriage etc

If your LMC is a hospital team, all your pregnancy care appointments will probably be at the hospital. You may have a nominated midwife within the team but you are likely to see different team members at different check-ups.

During labour you will be cared for by members of the Specialist team on duty with physician back-up if required.

After your baby is born your and your baby will receive care from hospital team members while you are in hospital then a visiting midwife at your home until your baby is 4- 6 weeks old.

All care provided by a hospital team is free