Congratulations… yes indeed!
So you have started growing a baby. That may explain some of those symptoms you have noticed; sore breasts, fatigue, nausea, odd tastes, mood swings etc.
Regardless whether this pregnancy was planned or a surprise, you’ll probably be thinking “what do I have to do now/what comes next”, and particularly so if it’s your first.
You’ve peed on a stick which indicated you had a positive text, so you are now at your GP. The GP being your first port of call, goes through diet/nutrition/lifestyle/exercise, medical and social history, medications etc., then gives you a pathology referral for antenatal bloods, radiology referral for ultrasound and perhaps other investigations, and hopefully your GP has explained to you thoroughly, what and why they are offering you all these tests; and just to clarify, these tests are recommendations not an expectation, so there should be an opportunity to ask and explain the rationale for testing, and if there are other alternatives (but that’s another story). For those uninitiated, navigating the “system” may be confusing at first. Then there is the question that you may or may not have thought about… your GP asks what hospital do you wish to birth in?
Hang on… is that the only option available? Is there a choice of care provider and where and with whom to birth. Yep, you bet there is, and if your GP is switched on, may actually be able to provide and counsel you on all your options, without judgement or opinion, and then will be able to organise a referral to whichever care provider you request.
So what are these alternatives? I’m going to try to keep this as basic as possible, because in between the options there are many variables to your choices depending on what state and where you live as well as health complexities and/or cultural diversity. So assuming you have a smorgasbord of maternity care models to pick from, let’s have a look what may be on offer.
Firstly, do you want to go through the private or public health system? Do you want to have your baby in a hospital setting, a Birth Centre (hospital-based or free standing), or at home?
Private - Obstetrician or Midwife? Midwives in Private Practice not only offer homebirths, in some instances they have visitation rights in certain hospitals.
Public – Shared care with your GP, endorsed midwives, hospital care providers that include midwives who work with the obstetric team, team midwifery care or midwifery continuity of care/group practice models that may also offer publically funded homebirth options.
Aside from deciding on where and with whom you wish to share your birth experience, you may also decide that you and your birth support may want to have additional support in the way of a birth doula.
Wow! Who knew you could have that much choice. So secondly, you really need to work out what it is that you want. In this advanced technological age, finding information about local services and how care is “delivered” has never been easier. Do you want one-on-one care? Would you like to go home early from hospital, or would you like to avoid a hospital setting? Would you prefer an extended stay? Does cost play a part in your decision making? Do you feel like you may need additional support for birth that isn’t family? Does distance to services factor into your consideration? Does it matter to you, if you see different people at your appointments or for your birth? Is having a private room important to you? What is significant to you?
Phew… that’s a lot to think about. However this can also become a whole lot more complex when other issues need to be added into the mix. For example geographical location can also determine what maternity services are available. Living in provincial, rural or remote areas means that access to a homebirth midwife may not be available, or you may need to travel out of the area prior to birth. Your hospital may then only offer one model of care, or there may be only a GP obstetrician available for consultation. Personal health complexities may mean that your pregnancy care requires specialist care or a team of specialists, so care options are then narrowed down to accommodate yours or your baby’s specific needs. Additionally you may want a maternity care provider that is able to be culturally savvy to deliver safe and appropriate care.
Bottom Line: You’re growing a human. Unlike baby goods, you can’t re-do your pregnancy and birth, so making sure that your care and education you receive during this time is supportive, informative, empowering, and that starts with ensuring you get the care provider as well as the care options that works for you. Do your research, and guess what, if your first choice is not a right fit for you, then you are entitled, if you’re able to, change model/caregiver to one that respects and supports your pregnancy and birth goals.
Wishing you an empowered and positive pregnancy and birthing experience.
References:
Australian Institute of Health and Welfare - https://www.aihw.gov.au/getmedia/f3423e4e-4efd-4597-8a0c-a1b47e7078ff/17991-per62.pdf.aspx?inline=true
Australian Government: Department of Health - http://www.health.gov.au/internet/publications/publishing.nsf/Content/pacd-maternityservicesplan-toc~pacd-maternityservicesplan-chapter3#Models%20of%20care
Better Health Channel - https://www.betterhealth.vic.gov.au/health/servicesandsupport/pregnancy-and-birth-care-options
Cochrane Library : Database of Systematic Reviews - https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004667.pub3/epdf/full
Doula Directory Australia - https://www.douladirectory.com.au/
Endorsed Midwives in Australia - https://www.eligiblemidwives.com.au/
Human Rights in Childbirth - http://www.humanrightsinchildbirth.org/rights/
Maternity Consumer Network - https://www.maternityconsumernetwork.org.au/
Midwife Thinking: Testing, testing - https://midwifethinking.com/
Midwives Australia - http://www.midwivesaustralia.com.au/
Practical Parenting - https://www.practicalparenting.com.au/pregnancy-symptoms
Pregnancy, Birth, Baby - https://www.pregnancybirthbaby.org.au/public-vs-private-care-during-pregnancy
Raising Childrens Network: Birth Choices - https://birthchoices.raisingchildren.net.au/
RANZCOG – https://www.ranzcog.edu.au/Womens-Health/Locate-an-O-G-doctor
VACCHO (Victorian Aboriginal Community Controlled Health Inc) - https://www.vaccho.org.au/wd/koori-maternity-early-years/local-koori-maternity-services/
Victorian State Government: Department of Health - https://www2.health.vic.gov.au/hospitals-and-health-services/patient-care/perinatal-reproductive/maternity-newborn-services/maternity-newborn-care
https://www2.health.vic.gov.au/about/publications/policiesandguidelines/koori-maternity-services-guidelines-mar-2017
World Health Organisation - http://www.who.int/workforcealliance/media/news/2013/midwifecochrane/en/