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Lead Maternity Carers (LMCs)

Pregnant women are required to choose a Lead Maternity Carer (LMC) who coordinates their maternity care. Lead Maternity Carers are contracted through the Ministry of Health to provide a complete maternity service to you.

Most women and their families (over 75%) choose a midwife as their LMC. These LMC midwives work with their midwife partners and the midwives who are employed to work in maternity units.

When you choose a midwife as your LMC, you can expect the following from her.

On booking:

• a copy of your clinical notes (updated at each visit)
• information regarding the role of the LMC and contact details including arrangements for ‘cover’ if unavailable
• information about the standards of care to be expected, possible interventions and possible outcomes
• information about the availability of Pregnancy and Parenting Education courses
• information about Paid Parental Leave
• a comprehensive pregnancy assessment including physical examination, assessment of general health, family and obstetric history and screening for infectious diseases
• development and documentation of a Care Plan to be used and updated throughout your pregnancy, birth and after birth. (Your LMC will keep a copy and will give you one.)

In the second trimester (12 to 28 weeks of pregnancy):

• monitoring of your progress including early detection and management of any problems
• updating your Care Plan
• one-to-one education regarding healthy pregnancy, childbirth and parenting preparation
• booking into a Maternity Facility or Birthing Unit unless you are planning a Homebirth

In the third trimester (28 weeks until labour begins):

• monitoring of your progress including early detection and management of any problems
• updating your Care Plan
• one-to-one education regarding healthy pregnancy, childbirth and parenting preparation
• specific education for labour and birth including role of your support people, coping with the pain of labour, options for the birth itself, care of the afterbirth, immediate care of the baby and breastfeeding
• instructions for making contact when labour begins
• arranging for you to meet any other maternity carers who may be involved with your care

Labour and birth:

• initial assessment at home (preferable) or at a Maternity Facility
• regular monitoring of you and your baby’s progress
• all your primary care during your labour and the birth of your baby
• all your primary care immediately following the birth including initial examination and identification of your baby, initiation of breastfeeding, care of the placenta, any suturing required and notifying your baby’s birth to the Registrar of Births

If you are having your baby at home:

• arranging for a second practitioner to be available to attend the birth
• maintaining the necessary equipment including neonatal resuscitation equipment
• providing the delivery pack and other supplies

If you are having your baby in a birthing unit:

• arranging for a second practitioner to be available to attend the birth
• ensuring a practitioner remains with you until you are discharged

After your baby is born (from the birth until your baby is 4-6 weeks old):

• detailed clinical examination of your baby within the first 24 hours
• if you are in hospital, a daily postnatal visit prior to your discharge (unless another arrangment is made with you and with the facility)
• one home visit within 24 hours of your discharge from hospital
• a further detailed clinical examination of your baby within 5 days of the birth
• a total of 5 – 10 midwifery home visits and more if clinically needed
• a minimum of seven postnatal visits in total
• assistance with and advice about breastfeeding and nutrition for mother and baby
• assessment for risk of postnatal depression and/or family violence with appropriate advice and referral
• provision of the Ministry of Health information on immunisation
• access to screening programmes for your baby as outlined in the Well Child Tamariki Ora National Schedule
• advice about contraception
• parenting advice and education
• a final detailed clinical examination of the baby prior to transfer to the Well Child Provider (Plunket or other service)
• a postnatal physical examination of you prior to discharge from the LMC service
• transfer of your baby’s care from the LMC to the Well Child provider at a date agreed with you between 4-6 weeks after the birth, and formal notification of this transfer to the Well Child provider
• notification to your General Practitioner of your discharge from LMC services

This article was reproduced with kind permission from the New Zealand College of Midwives.