Pregnancy and birth are a normal part of a woman’s life. In Aotearoa/New Zealand you can choose where to give birth to your baby, who will provide you with maternity care and who you want to be with you during your labour and birth.
In Aotearoa/New Zealand, you can choose where to have your baby and who will look after you.
The first health professional you see for pregnancy care and information is required to provide you with information regarding the options you have for maternity care providers and place of birth.
Who will be your maternity care provider?
You will be required to choose a Lead Maternity Carer(LMC) who is responsible for organising your maternity care and developing your Care Plan with you. You need to ask whether the LMC will provide all of your care during pregnancy, labour and birth, and postnatally, or whether they share any part of your care with another maternity provider (e.g. midwife or hospital team).
If you are not happy with your LMC or the services they provide you can change to another LMC at any time.
Your LMC will be one of the following:
Self-employed midwife
• Provides care for normal pregnancy and birth
• Can provide all your care during pregnancy, labour and birth, and after your baby is born
Family doctor (GP)
• Can provide care for normal pregnancy and birth and for some medical problems complicating pregnancy
• Can provide pregnancy care at their consulting rooms; attends for part of the labour and birth (but some labour and birth care will be provided by a midwife); shares postnatal care with a midwife who will visit you at home
Note: Most GPs only provide early pregnancy care and will recommend that you find a self-employed midwife or register with your health district’s Community Midwifery Team for LMC care.
Private obstetrician
• Specialises in complications during pregnancy and birth, and can also provide normal maternity care
• Attends for part of the labour and birth (but some labour and birth care will be provided by a midwife) and shares postnatal care with a midwife who will visit you at home
Note: All care provided by a private obstetrician involves a cost to the woman.
Community Midwifery Team
• Can provide all of your pregnancy and postnatal care
• Care during labour and birth is provided by a hospital midwife
• Can share your care with hospital employed doctors/specialists if you or your baby develops complications
All maternity care provided by midwives, GPs, Community Midwifery Teams and hospital specialists is free to New Zealand citizens, residents and other eligible women.
Where will you give birth?
Home attended by either:
• a self-employed midwife of your choice
• hospital based caseloading midwives*
Primary Birthing Unit/Birthing Centre attended by either:
• a self-employed midwife of your choice
• hospital based caseloading midwives*
Large maternity hospital attended by either:
• a self-employed midwife
• a self-employed midwife and private obstetrician
• a GP and hospital team midwives
• a private obstetrician and hospital team midwives
• Community Midwifery Team midwives
• hospital based caseloading midwives*
*Currently only a small number of hospitals have a caseloading midwifery team.
In some areas, not all of these options are available.
If you have chosen to give birth at home, in a birthing unit or a small maternity hospital and complications occur, you can be transferred to a large maternity hospital.
What does it cost?
Most maternity care (except care provided by a private obstetrician) is provided free of charge to New Zealand citizens, residents and long term work permit holders (and to women married to a New Zealand resident, citizen or a long term work permit holder). For more information about whether or not you are eligible for free maternity care head to https://www.tewhatuora.govt.nz/for-health-providers/publicly-funded-health-and-disability-services/pregnancy-services.
You may be required to pay for the following:
• A negative pregnancy urine test
• Some screening and diagnostic tests
• Part or full charge for some ultrasound scans
• Birth and parenting classes
• Care provided at a private maternity hospital (unless this facility has a contract with the local Health District of Te Whatu Ora)
• Private obstetricians charge for any maternity care they provide
Childbirth and parenting classes
Classes may be offered by:
• Private childbirth educators
• Marae-based or other Māori organisations
• Some self-employed midwives
• Publicly funded Community Health Services
• Organisations such as Parents Centres, home birth groups and Plunket
• Some Pasifika midwives and organisations
For more information about pregnancy services in Aotearoa, go to www.health.govt.nz/your-health/pregnancy-and-kids/services-and-support-during-pregnancy
Pregnancy
Care during pregnancy can be provided by:
• A self-employed midwife at their clinic or in special circumstances, in your home
• A GP at their clinic (only the first 1–2 visits unless the GP is registered as an LMC)
• A private obstetrician at their rooms
• Community Midwifery Team midwives at a hospital or in a community based clinic
Monitoring during your pregnancy visits usually includes urine testing, blood pressure checks, listening to your baby’s heart beat and checking your baby’s growth.
Care Plan
Throughout your pregnancy, your LMC is required to write up a Care Plan that records all the choices you make about:
• Your care during your pregnancy, including your choices about tests and monitoring procedures.
• Your labour and birth, including where you have chosen to give birth, any medical interventions you have consented to and how you want to be supported during your labour.
• Your care after your baby is born, including how often you will be visited, your choices about routinely offered newborn tests, what support will be provided to assist you with feeding your baby, and what your midwife will do to support you and your baby in making a healthy transition during the first 4 to 6 weeks after birth.
If you change your mind about anything, this is added to or changed on your Care Plan.
Tests during pregnancy
There are a number of diagnostic and screening tests offered during pregnancy:
• Blood tests
• Genetic screening and testing
• Diabetes and gestational diabetes screening (routinely offered at time of booking and at 28 weeks)
• Ultrasound scans (two scans are routinely offered during pregnancy: at 12 weeks as part of genetic screening; at 18 weeks to check for normal growth and development of your baby and placenta)
For more information, click here to read/order ‘Screening and Testing During Pregnancy – Your Choice’.
Making informed choices
It is important to ask your LMC to fully explain any tests and procedures that are available to you during your pregnancy, labour and birth, including what they involve and the pros and cons of having them.
Before agreeing to any test or procedure, you need to decide if the results or outcomes they provide will improve your health and wellbeing, or that of your baby.
The final choice is yours.
Labour and birth
Care during labour and birth will be provided by your chosen LMC or her/his back-up. With your permission, midwives and doctors who are part of the hospital team may also be involved.
• You may have your husband or partner with you
• You may also like to have extra support from other members of your family/whānau or friends
• You may choose to have your other children present
Procedures during labour
If you consent to medical interventions/procedures during labour, you may receive care from hospital based midwives, doctors or nurses as well as your chosen LMC. You should be provided with information about who else is likely to become involved in your care as part of your informed decision-making.
Procedures that will include additional maternity care providers include:
• Induction of labour (using medical procedures to start labour)
• Epidural anaesthesia for pain relief or a caesarean section
• Forceps or ventouse assisted birth
• Caesarean section
Your LMC may also consult with another medical care provider for a second opinion or to transfer your care to the medical team if s/he is no longer able to provide the level of care you require.
After your baby is born
You are entitled to midwifery visits in your home after you have given birth. Your LMC midwife, a self-employed postnatal midwife or Community Midwifery Team midwives will provide you with 5–10 home visits during the first 4–6 weeks after you have given birth. These visits are for monitoring your health and wellbeing, monitoring your baby’s health, growth and development, and to ensure that you have sufficient information/support to (breast)feed your baby. If you give birth in a Primary Birthing Unit/Birthing Centre or a hospital, you are entitled to a minimum of 2 nights care in a postnatal ward. If you or your baby needs additional medical or nursing assistance (e.g. you have had c-section surgery, or your baby is unwell or not feeding well), you are entitled to stay until you are both well enough to go home.
If you and your baby are well, you can choose (with the agreement of your LMC) to go home a few hours after you have given birth.
Women who give birth at home generally receive all their postnatal care at home. However, if you give birth at home, you can make an arrangement to transfer to a Primary Birthing Unit/Birthing Centre or a hospital for 48 hours after you have given birth. If mother or baby need any medical care following a home birth you will be transferred to a hospital postnatal ward.
Other postnatal support options include:
• Well Child services. Your LMC is required to transfer your baby’s care to a Well Child provider and/or GP when s/he discharges you. You can choose who your Well Child provider will be (e.g. Plunket). Ask your LMC to provide you with information about your options.
• Plunket Family Centres. These are located in many communities and are staffed by Plunket nurses, Karitane nurses and Plunket Kaiawhina. Plunket provides free practical support and information for parenting including breastfeeding, infant nutrition, infant massage, growth and development, and more.
• Lactation Consultants. For mothers and babies who need additional support with breastfeeding, public (fully funded) and private (user-pays) options are available. Ask your LMC for information and a referral if needed.
If possible, it is helpful to arrange support from your partner/spouse, family and friends for the first few weeks after your baby is born. Other services such as home help, childcare and nappy services may be available in your area. You will usually have to pay for these services. You may also want to organise help with (online) shopping, meal preparation/delivery, laundry and housework, additional childcare for your other children, and more.
Your rights during pregnancy and birth
You have the right:
• To be treated with dignity, cultural sensitivity and respect at all times
• To choose where to give birth
• To choose your maternity care provider, and to change your maternity care provider at any time
• To choose who will be present during your labour and birth at home, in a primary birthing unit or in a hospital, and to ask anyone you don’t want present to leave
• To be given information about any side effects or risks associated with any procedure, drug/medication or test being offered or recommended
• To accept or refuse any medication or medical procedure
• To choose how you will give birth and to feel free to follow your feelings and instincts during birth
• To have your informed choices about feeding your baby fully respected and supported
• To have your baby with you from the time of birth until you are discharged from any birthing facility
• To make informed choices to accept or refuse any medical treatments or tests offered or recommended for your baby
• To make a complaint and to receive satisfactory explanations from your maternity care provider/s
and others involved with your care
• To read or have a copy of your medical records and your baby’s medical records
• To have a trained interpreter if English is not your first language
• To refuse to take part in any research project or to withdraw from a research project at any time
• To consent or refuse to allow student health professionals to provide care for you or your baby
Updated March 2023
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