The team
- Who do you work with?
My immediate midwifery partner is Sam Rhodes, and we work alongside other midwives as needed. - Where are you based?
My clinic is at Leading Midwifery Care, 47A Fraser Street, Tauranga. There is parking and a waiting room on site. - Does anyone else work with you?
At times we will need to call in a locum to care for our clients while we are away and this is often at short notice if we or our children are sick. A locum is a midwife who will come in for a set period (usually 24 hours) and be on call for our clients during this time for if they are in labour or need urgent care. We recognise that this isn’t ideal for clients who are labouring, but is an unavoidable reality, and we have a pool of experienced, competent, kind midwives to call on when we need to.
We also sometimes have students working with us – please see the ‘students’ section below for more information.
More about me
- Do you have children?
I have two boys – My first child was born at home in 2012 and my second was born at Bethlehem Birthing Centre in 2016. - What education do you have?
My primary midwifery training was completed at AUT in Auckland and I graduated with a Bachelor of Health Sciences in Midwifery at the end of 2010. I was admitted to the NZ register of midwives upon completion of this.
In 2017 I completed a Postgraduate Diploma in Midwifery through Otago Polytechnic with specific interest papers: Maternal mental health, Diabetes in pregnancy, Nutrition in pregnancy, and Global midwifery and safe motherhood.
All midwives in New Zealand are required to engage with ongoing education. We revise and update maternity emergency situations and also complete special interest education days every year. - How experienced are you?
I have worked across the scope of midwifery practice in New Zealand. Straight after graduating I completed the Counties Manukau DHB new graduate midwifery programme in which I worked on rotation at Middlemore Hospital in the assessment, labour, and birthing unit (ALBU) and the high risk antenatal and postnatal ward, and at Botany Downs primary maternity unit. I continued working part time at Middlemore Hospital for 5 years. In 2016 I moved home to Tauranga and worked at Bethlehem Birthing Centre for a few months. In 2018 I started working with Womb and that’s where I’ve been ever since. - What is your midwifery philosophy?
I believe strongly that women and their families should be supported to know about their bodies and the choices they have in relation to pregnancy and childbirth. My goal is to provide you with clear and appropriate information and education so that you can make the decisions you need when the timing is right for you. - How many clients do you take on at a time?
I book about 5 clients each month, with scheduled time off every year over the summer school holidays (mid December to early February) where I don’t have clients booked. This is considered a full time caseload. - Do you have space to take me on as a client?
I have an availability calendar at Find Your Midwife which I do my best to keep up to date. To book with me, please make contact with me by text, email, phone call, or by filling in the booking forms on my website. I like to talk to new clients on the phone before confirming a booking. - What’s the best way to contact you?
For non-urgent questions, please text me. If it’s complex then you’re welcome to briefly explain what your question is and I’ll call you to discuss when I can. If your question is minor and can wait then please write it down (so you don’t forget) and ask it at our next appointment. For urgent things, please always call. When I am off call, my phone is forwarded to the midwife who is covering me, so when you call my phone it will always be answered by a midwife. - How much time do you have off call?
Sam and I share our on call duties 50:50. During the week Sam is on call for our clients on Mondays and Tuesdays, I am on call on Wednesdays and Thursdays, and we alternate weekends (Friday/Saturday/Sunday) – one of us will be on call the first weekend and the other the second, and so on. We occasionally have a few extra days off at various times during the year as needed, and this will be communicated with you at the time if it will affect you. - That seems like a lot?
Sam and I have found that this system is sustainable for us and works well with our families. We work closely together and work in a very similar way, so you will be well looked after no matter who is with you when you birth. I make sure you have the chance to meet Sam during your pregnancy so that you are comfortable with her if it is Sam who is with you at your birth.
Maternity care in New Zealand
- What do midwives do?
The NZ College of Midwives has a good breakdown of what to expect from midwifery care in New Zealand. - Who is eligible for free care?
All maternity care in New Zealand is free for NZ citizens, permanent residents of NZ and Australia, people holding a work visa that is for two years or longer, and people in a relationship with someone who fills any of these categories. - Are there any extra costs?
The only things you may need to pay for are part charges for some scans – see the section on what to expect in pregnancy below. There are some optional extras that you will need to pay for yourself – NIPT screening, gender scans, and 3D scans.
What to expect in pregnancy
- How often will I see you?
We usually meet for the first time in pregnancy around 10 weeks. after that, the standard schedule for antenatal visits is:
– every 4-6 weeks until 28 weeks
– every 2-3 weeks until 36 weeks
– every 1-2 weeks until your baby is born
At about 36 weeks we usually go through a birth preference list, where we consolidate the things you’ve learned in your antenatal classes and make note of specific things you do or don’t want for your labour and birth.
Postnatally, we usually visit you 7-10 times after your baby is born, dependant on how you birth your baby (vaginal birth or caesarean) and whether you or your baby experience any difficulties during or after birth. Postnatal visits are most commonly on days 1, 2, 5, and 10, and then weekly after that until your baby is 4-5 weeks old. After this your Well Child provider takes over your baby’s care alongside your GP. - What blood tests are recommended?
Once your pregnancy is confirmed, you will be asked to complete some initial antenatal bloods. Blood tests in the Bay of Plenty are always done at Pathlab. The standard blood tests we do in pregnancy are:
Haemoglobin (your circulating iron)
Ferritin (your stored iron)
Platelets
Red blood cell antibodies
In your initial antenatal bloods we also check your blood group and we do some screening for infections. The infections we check for are all things that we can manage in pregnancy if you have them, and they are all things that can affect babies if they are not treated in pregnancy. These are:
HIV
Hepatitis B
Syphilis
Rubella
We also do a diabetes check at this initial antenatal screening (HbA1c).
Your blood group will be either positive or negative. If it is negative, this has implications for your pregnancy which you can read more about in this pamphlet from NZ Blood.
The next set of blood tests we ask you to do is around 24-28 weeks, and this includes another diabetes screen which you can read about on the Health NZ website.
The third set of bloods we ask you to do is at about 36 weeks, and is just the standard blood tests mentioned above.
If there are concerns with blood pressure, diabetes, bleeding, or something else in your pregnancy, we may ask you to do extra blood tests. We will discuss this with you at the time as needed.
- What scans are recommended?
There are two standard scans that we recommend everybody have in pregnancy. These are the nuchal scan, which is done at around 12 weeks and is part of Maternal Serum Screening, and the anatomy scan, which is done at about 20 weeks. If you are unsure of your due date then you may be advised to have a dating scan early in your pregnancy also, but these are not recommended to be done unless necessary.
Growth scans are recommended to have in your third trimester if there are any significant health concerns for you or your baby prior to or during pregnancy. It is quite common to be advised to have growth scans so don’t be concerned if this is something I discuss with you.
There four providers of pregnancy ultrasound scans in Tauranga:
Bay Radiology (Tauranga, Mount, Papamoa, and Pyes Pa)
Focus (11th Ave and Domain Road, Papamoa)
Medex (11th Ave)
Bethlehem Ultrasound (Bethlehem)
There are two options for private scans that you can have in pregnancy. The first is a gender scan which is offered by Bethlehem Ultrasound from 16 weeks. The cost for this is $50 and you self refer for it. The second is to have a 3D scan, which are offered at some of the places listed above. Please get in touch with them to find out more. - What about screening for chromosomal abnormalities?
The main screening we do for chromosomal abnormalities like Down Syndrome is the Maternal Serum Screening, which is offered at the end of the first trimester. About a week after you have completed the scan and blood test for this screening, your result will be returned to me. It will either have a ‘low chance’ or ‘high chance’ result. If it comes back as low chance then you carry on with your pregnancy and we don’t offer any further assessment except the anatomy scan. If you have a high chance result then you will be offered an amniocentesis which is done through the Maternal Fetal Medicine service in Auckland, usually around 15 weeks. This is a diagnostic test and will clearly say whether your baby has one of the chromosomal abnormalities they test for or not. If it is positive, they will offer you the option of continuing your pregnancy or terminating your pregnancy. If the amniocentesis comes back negative, you carry on with your pregnancy as normal.
Your other option for chromosomal screening is to do the NIPT test. This is a screen, just like the maternal serum screening, but is more specific and accurate in the estimation of whether you have a baby with chromosomal abnormalities or not. There is significant cost associated with this screen (about $700) and it can be done through Pathlab or Illumiscreen. - How long is pregnancy?
A normal pregnancy will last between 37 and 42 weeks. The day we call your ‘due date’ is the day you will be 40 weeks pregnant, but it is normal to labour any time from when you are term (37 weeks). Most people having their first baby will labour naturally some time between 40 and 41 weeks. At Tauranga Hospital, induction of labour is offered to women who have reached 41 weeks and not yet laboured. You can read more about induction of labour on the RANZCOG website. - What can’t I eat?
There are some bacteria like listeria that don’t make adults very sick when we are infected but which can severely impact your baby if you are infected when you are pregnant. for this reason, we recommend that you avoid certain foods while you are pregnant. There is a comprehensive list available on the MPI website, and more information on Health Navigator NZ. - When should I feel my baby move?
Most first time mums feel their baby move for the first time around 18-20 weeks. It is common to start feeling your baby’s movements settle into a pattern and you should start to familiarise yourself with this. In the early weeks of feeling movements there is still space for the baby to move down towards your pelvis or to turn backwards, and if that happens you may not feel your baby move as much for a while. From 28 weeks of pregnancy we consider your baby’s movements to be the best indicator of their wellbeing and we ask you to contact us if you are concerned that your baby’s movements have significantly reduced or stopped altogether. Read more here. - What vaccines should I get in pregnancy?
When you are pregnant you have a lower immune system so are more likely to be affected by things like the flu, and more likely to catch them. To keep you and your baby safe, this vaccine is funded for pregnant women. It is only offered between about March and August, but we advise you to see your GP or local pharmacy to have this when you can.
We recommend that anyone who will spend time around newborn babies be vaccinated against whooping cough, and in pregnancy we recommend that you have the vaccine yourself so you can pass your antibodies on to your growing baby. This vaccine is also fully funded for pregnant women and is recommended to be given between 16 and 38 weeks but earlier is better. The whooping cough vaccine costs about $60 for family members wanting to update their booster, which is recommended to have every ten years. Contact your GP to book. - What resources do you recommend for my mental wellbeing?
It is really common to experience changes in your ability to cope with things when you are pregnant, and antenatal depression and anxiety are commonly felt. There are significant changes happening in your body, your relationships, your work, and your future outlook, so expect there to be some periods of adjustment as you go through this process. There are also lots of new and changing hormones rushing around your body and causing havoc so give yourself some grace and make sure your support people are aware of how you’re feeling.
Unfortunately, mental health services in New Zealand are chronically underfunded and significantly understaffed, so there can be difficulty accessing funded mental health support except in times of crisis. There are some good websites with helpful information available though:
PADA (Perinatal Mental Health NZ)
Mothers Matter
Depression NZ
Mothers Helpers
and GPs have some ability to refer you for funded counselling if you need. The birthing centre in Bethlehem often have free counselling available with third year counselling students through BTI as well. The other option that a lot of new mums find helpful is to access community support groups, either in person through things like antenatal classes or Plunket, or in online communities like Facebook. A good place to start can be by joining the Tauranga Mummy Matters Facebook page and finding more specific groups from there. - Do you recommend antenatal classes?
One hundred percent yes! These classes often cover a lot of things that you didn’t think to ask about and it can be very helpful to learn in a group environment. People often make friends in these classes too. There are a few different options for antenatal classes in the Tauranga area:
Free classes with a practical focus:
Parents Centre
Bethlehem Birthing Centre
Hapai Mama
Hei Tiki Pumau Antenatal
Pirirakau Hauora
Paid classes with a practical focus:
Hatched Antenatal
Paid classes with a holistic focus:
Mothers Circle
Hypnobirthing
Empowered Birthing
Routachment
We recommend that you book in to antenatal classes that finish when you are about 36 weeks if you can. That way they’re close enough to birth that you will remember most of what you learn, but not too close that you’ll miss some of the classes. Antenatal classes vary in length and you can choose one that best suits your schedule.
Students
- What kind of students do you have?
We regularly have midwifery students who work with us for a period of time – sometimes only a couple of weeks, sometimes for a few months. Occasionally in the hospital there will be medical students on a birth rotation as well. We encourage student involvement – usually having students is good for you, good for us, and good for them. - Is there anything a student can’t do?
It depends on the student. First year students are learning the basics of midwifery and will not undertake any invasive procedures or be responsible for any decision making. Third year students who are about to graduate will be given greater responsibility so they can practice using their midwife brains. Ultimately the responsibility for your care always remains with the midwife who is looking after you, so we will always be supervising any student who is working with us. - What if I change my mind?
It is always up to you whether you have a student involved in your care at all, and also how hands on they are with this. If you change your mind at any time, just let me know.
Feedback
- Where can I provide feedback on the care that I have received from you?
The best place to do this is through the NZ College of Midwives. This feedback method is anonymous and confidential. I get to see the things you write after it has been reviewed by someone at the college but no identifying information is passed on. At the end of our time together I am required to send you a link to provide feedback through the college, as above, so will do this at the end of your postnatal care. NZCOM are the body who regularly review our practice, and receiving consumer feedback is part of this process. I also love receiving cards from families I work with, and the best feedback I get is when people come back to have another baby with me. - How can I give feedback about care that I have received at the hospital or birthing centre?
Feedback is always helpful for us to know what we are doing well and where we can improve. The hospital and birthing centre always encourage feedback:
Tauranga Hospital
Bethlehem Birthing Centre - How can I complain to the Health and Disability Commissioner?
You can make a HDC complaint by going to their website and following their process. This is for serious complaints and is often traumatic for all involved, but can be a good way to resolution for if your rights have been ignored.
Your rights
In New Zealand, by law, you have rights to:
- professional care from skilled staff
- be treated with respect, including respect for your culture, values, beliefs, customs, privacy and confidentiality
- know how your information is stored and used, and who it will be shared with
- view any information held about you and to correct it if necessary
- know about the services that your midwife or specialist doctor provides
- have everything you need to know carefully explained, and be able to ask any questions you need so that you can make informed decisions about all the care for you and your baby
- refuse any care offered to you (and to change your mind at any time)
- have someone with you for support
- complain about the treatment you receive.
If you have any questions or concerns about your health care, the information you are asked for or your privacy, you should talk to your midwife or specialist doctor.
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