Midwives - what do they do?

Midwives are health professionals who are trained to support you during your pregnancy, labour and birth. They can also care for you after you give birth.

What training do midwives have?

In Australia, midwives can complete a 3-year university degree. They do not need to study nursing first. Registered nurses can also become midwives by completing postgraduate studies in midwifery.

Most midwives in Australia are females.

Some midwives have extra qualifications.

Endorsed midwives have a postgraduate qualification to give scheduled medicines. This means they can:

• prescribe certain medicines
• order tests
• refer you to other healthcare professionals, such as an obstetrician or paediatrician, as needed

Practising midwives must register with the Nursing and Midwifery Board of Australia (NMBA).

If you are pregnant, there are different ways that you can be cared for during your pregnancy. These are called models of care. Your model of care will outline:

• who will be your main carer during pregnancy
• how many antenatal appointments you will have
• where and how you choose to give birth
• who will care for you during labour and birth

Midwives can take part in your pregnancy care regardless of the model of care. Depending on your model of care, your midwife may have a different role.

At your first antenatal visit, your midwife or doctor can discuss care options with you. This will be based on your needs.

There are many different models of care, including:

• public maternity unit care — midwives will usually provide most of your care
• shared care — your care will be managed by a team of healthcare professionals that includes midwives
• midwifery group practice —you will be cared for by a midwife who is supported by a second midwife
• private midwifery care — where you employ your own midwife for a birth at home or in hospital
• private obstetrician care — where a midwife may support your care

Midwifery group practice has many benefits. A small group of midwives will get to know you well because they care for you throughout your pregnancy. This is called continuity of care.

Depending on your model of care, your midwife can provide care in:

• hospital maternity units
• birth centres
• midwifery group practices
• community health centres
• private homes
• obstetrician's consulting rooms

If you have a complicated pregnancy, your midwife or doctor may recommend that you receive special care from an obstetrician. They may recommend that your baby is carefully monitored throughout your pregnancy and labour. This might limit where you can receive your pregnancy care.

If you live in a rural or remote area, your choices might also be limited based on the service and health professionals available in your area. You might see a midwife (or doctor) at a local community health service. You may also need to travel to a hospital with a maternity unit to give birth.

During pregnancy, your midwife will usually:

• organise routine tests and checks
• check your baby's health, growth and position
• give you support and advice
• advise on hospital bookings
• help you prepare for labour and birth

Midwives will support you through labour and the birth of your baby. They can:

• give you information, encouragement and emotional support
• monitor your progress and suggest strategies to help your labour
• monitor your baby's heartbeat and other signs of wellbeing
• organise pain relief
• get extra medical help if needed

If you plan to have a home birth, your midwife will manage your labour and the birth. They will be supported by at least one other registered midwife. If there are complications, your midwife might need to call an ambulance if you need medical intervention.

Midwives can't give epidurals. These can only be given in a hospital by an anaesthetist.

Your midwife will care for both you and your baby immediately after the birth.

Your midwife or doctor will check if you have lost too much blood or need stitches.

Midwives offer postnatal care in hospital, including:

• helping you with breastfeeding and settling your baby
• showing you how to bath your baby and change nappies
• organising pain relief if needed
• carrying out routine health tests, such as newborn screening

After you give birth, a midwife will usually visit you at home.

After a home birth, your midwife will usually visit you the next day. They may continue to visit you regularly for a few weeks. Some midwives will also be available to give advice over the phone for the first few weeks.

Your midwife might do your 6-week check-up after giving birth.

Ask your midwife what postnatal services they offer.

You might want to ask your midwife:

• if they are registered with the Nursing and Midwifery Board of Australia (NMBA)
• what tests and checkups are recommended throughout your pregnancy and why
• what procedures are recommended and why
• where you can give birth
• what your pain-relief options are for labour

Your midwife can help answer any questions you may have. They can give you advice and explain your care options throughout your pregnancy.

It's important to ask questions, especially if you don't understand what your midwife is saying or need more information. In this way, you can make informed choices about your care. Together, you can make shared decisions about your pregnancy that are best for you and your baby.

Use the healthdirect Question Builder to help you form a list of questions to ask your midwife. You can print this off and take it with you.

Public midwifery care is usually covered by Medicare. If you have a Medicare card you will have no out-of-pocket costs.

If you choose to give birth at a birth centre, ask about costs when you make your booking.

If you chose midwifery care under a private obstetrician or midwife, you will need to pay a fee. It's a good idea to ask about costs before your first appointment. Some private midwives are registered as Medicare providers. In this case, you may get a rebate through Medicare.

If you have a home birth, Medicare will cover some care offered by a midwife with a Medicare provider number. Only care given during the pregnancy and postnatal care may be covered — not the actual birth.

If you have private health insurance, check how much they will cover for your pregnancy care.

You can find a midwife on the Australian Health Practitioner Regulation Agency (AHPRA) website.

You can also ask to your doctor to recommend a midwife.

Try using Pregnancy, Birth and Baby's service finder tool to find your nearest midwife.

You don't need a referral to see a private midwife.

However, you will need a referral from your doctor to see a midwife who is based in a public hospital, including those working in a maternity group practice.

To learn more about midwifery, visit Australian College of Midwives.

Read more about the health professionals involved in your pregnancy.