New Zealand Midwifery

Finally, have a moment in-between patients to post. We still don't have internet at our house, which is really, really challenging. It is contributing to our homesickness!
The 3-4 births per month, has actually become 4-12 births per month. There is a part-time Kiwi midwife to work with me, but we have no CMA or other assistant for AP and PP visits. Thus, my brilliant idea to invite an American midwife student to come to NZ for an international opportunity. Clearly the passion is there, because after one email, I have received several inquiries from some extraordinary candidates. That could solve our personnel worries.
Midwives are the primary providers of maternity care here, and it shows. We are caring for women with a variety of needs: healthy, low-risk all the way to insulin-dependent diabetics, morbid-obesity and others. The higher-risk women need to see a specialist and we will attend their births in Invercargill. If all goes well, the physician won't come for the birth.
Tuaptapere Maternity is much like a birth center in the US. It is such a great place! Women can come here, have their babies and stay for up to 6 days postpartum. While they are here, we
do daily rounds. There is a nurse or nurse-aide who provide the home-cooked meals, breastfeeding support, etc. Because I order all the supplies, sign time-cards, make up the gravida list, be first call every day except my 8 days off, I am utterly swamped.
We are caring for women in 4 different clinical settings. They can birth at Tuatapere Maternity home, or at Southland Hospital in Invercargill an hour a way. If they are higher risk, they have to birth at Southland, but we still do all their care and they consult with an Ob-GYN who won't be at the birth, unless called. We also have some homebirths planned.
AP visit are at the Tuatapere office or in Patient's homes. All postpartum visits once they are discharge from the hospital or home are at the patient's home. Daily visits until discharge, which could be 3-6 days, the next visit at home in 24 hours, then weekly for 5 more weeks. On average each woman gets 9 postpartum visits!!! I feel like all my previous work as a dould, a midwife attending homebirths, a postpartum home nurse for Methodist and a CNM at HealthEast has prepared me for this position. I spent a month attending births with Rondi Anderson, CNM in Lancaster Co., Pennyslvania--so when I am driving around to farm houses, getting my shoes all muddy and once (so far) getting my car stuck in the mud requiring a tow-truck--reminds me of my time with her.
The people are lovely and I will continue this post later...