Frequently Asked Questions
- What is Caseload Midwifery?
- Who will listen to what I want?
- Will my spiritual and cultural ideas be listened to?
- Will my parenting ideas be listened to?
- How will caseload midwifery change my experience?
- How are my appointments scheduled?
- Can I do a tour of the maternity unit, even before I’m pregnant?
- What if I have a question?
- What if my midwife isn’t available?
- Does Ryde have ante-natal classes?
- What do I need to bring to hospital?
- Will I have help developing my birth plan?
- What happens if I develop complications during pregnancy?
- Will I ever see an obstetrician?
- What if I am overdue?
- Can I have a water birth?
- Can I have a Lotus birth?
- Who can I have at my birth?
- Can I bring a doula?
- Can I bring my children to my labour?
- What are my pain relief options?
- Do I have to have any drugs?
- What facilities are available during labour?
- What happens if I have complications during labour?
- Can I donate my placenta/cord blood?
- How long will I stay in hospital?
- Where do I go if I have problems with breastfeeding?
- What happens if there is a problem with the baby?
- What do I do in my first few days at home?
What is different about Ryde?
What is Caseload Midwifery?
Caseload midwifery is the phrase used to refer to one-to-one care provided by a midwife.At Ryde, you will be allocated a midwife who will care for you during your pregnancy, labour, birth and for the first few weeks at home. Your midwife will see you for all of your ante-natal appointments, and discuss the various stages of pregnancy with you, as well as checking on the progress of your baby. When you go into labour, you will telephone your midwife, who will discuss your situation, give you advice, and meet you at the hospital when labour has become established.
Who will listen to what I want?
One of the great benefits of caseload midwifery is that there is one person listening to what you want. Your midwife builds a relationship with you, and comes to understand the aspects of pregnancy and childbirth that are important to you. If you have any special concerns or requests, you can discuss these with your midwife, knowing that you will have the same person listening to you throughout your pregnancy and birth.
Will my spiritual and cultural ideas be listened to?
Ryde Midwifery Group Practice prides itself on listening to the varieties of spiritual and cultural approaches to childbirth which exist in our culturally and linguistically diverse community. The midwives welcome your views, and will help you to incorporate them into your birth experience.
Will my parenting ideas be listened to?
Your midwife will listen to your ideas, and, provided they are safe, help you to incorporate them into your birth plan. Your midwife may also make suggestions and recommendations, which you may choose to adopt.
How will caseload midwifery change my experience?
The usual practice in a large public hospital is to see whoever is on duty for your ante-natal appointments, which are conducted by midwives in the ante-natal clinic. Different midwives are on duty in the labour ward, and different midwives are on duty in the maternity ward.Another common practice in a large public hospital is to book in with the “team midwives”. These midwives work in a team, and the purpose is to ensure that you will meet each of the midwives in the team during your ante-natal visits, so that you will have someone you have met before to assist you with your labour and birth.
At Ryde, the caseload model enables you to build a relationship, understanding and trust with the one person. If you have a problem during pregnancy, you simply call your midwife who will help you out over the phone, or schedule another appointment with you. When your midwife offers advice to you, you will know that she has taken into account your views discussed throughout your pregnancy, and you are more likely to trust her.
How are my appointments scheduled?
Your appointments are scheduled between you and your midwife at a time convenient to both you and your midwife. Caseload midwifery is characterised by much shorter waiting times and longer, individualised appointments. Of course, your midwife may need to cancel from time to time if one of her other women has gone into labour. However, when it is your turn, you will be assured that you are her primary focus.
What will my care be like?
Can I do a tour of the maternity unit, even before I’m pregnant?
Of course. If you would like to do a tour, and discuss whether the Ryde philosophy of birth is for you, then by all means telephone the Maternity Unit on 9858 7549 to make arrangements with the midwives.
What if I have a question?
You are very likely to have lots of questions during your pregnancy. Many can be discussed at your ante-natal appointments. If your midwife does not know, she will find out for you and telephone you to give you the answer. However, if something happens during your pregnancy which is of medical concern to you, then you can simply telephone your midwife’s mobile phone and ask the question.
What if my midwife isn’t available?
Midwives are people too, which is what makes them so great at their jobs. However, they do need holidays and weekends away from time to time. Your midwife will tell you if she is going away. While she is away, her mobile phone will be diverted to another midwife, so you don’t need to remember any other phone numbers.Ryde Maternity runs a “Meet the Midwives” evening each month so that you can meet the other midwives in the unit. Occasionally a midwife is unable to attend the birth for a woman in her care, in which case one of the others in the group practice will be there. By coming to a Meet the Midwives evening, you can meet all the others and ensure that you have a familiar face at your labour. You can also be assured that the Ryde midwives have a shared philosophy of midwifery practise, and that the others are just as caring as the midwife you have grown to love.
Does Ryde have ante-natal classes?
Ryde runs ante-natal classes called “Prep for Parenthood”. You can attend a 4 week evening course or a full day Saturday class. Each class covers changes in pregnancy, signs of labour, coping with labour, options for pain relief, the support person’s role, medical support if needed, breastfeeding and the care of your baby in the first few days. A tour of the maternity unit is also included.The “Meet the Midwives” night run by the Ryde Midwives has a limited education component for those unable to attend ante-natal classes.
“WOW”, short for Women on Wednesdays, is a group for mums and mums-to-be to drop in and have a chat. This is an opportunity to meet other women who have recently given birth through Ryde, or who will shortly give birth to their babies. You can share ideas and explore relevant issues. One of the midwives is always there to facilitate informal discussion and help answer any questions that arise. It is a great place to touch base with others going through the same life experience and make some friends. It is held every Wednesday at 10am at Ryde Hospital. Please feel free to come along. If you would like more education, additional courses are run through Royal North Shore Hospital, Ryde’s “big brother” hospital. RNSH offers Early Pregnancy classes which provide information relevant to your first trimester, and Parentcraft Classes which focus on the early weeks at home with your new baby.
What do I need to bring to hospital?
Labour The birthing rooms have, in addition to a bed and other medical facilities, a mattress for the floor, a beanbag, several chairs and stools, a birthing stool, a fit ball and a CD player. You should bring your own CDs, and anything else which will make you feel relaxed. Talk to your midwife if you are unsure about whether a particular item is permitted in the birthing room. Pets are not allowed.You should bring clothes which are comfortable to labour in, if you are not wearing them already. Your support person should bring an extra change of clothes as they often get wet while assisting you in the shower or bath. You may want a headband or hair band to keep your hair off your face.
It can be helpful to have some food and drink, if not for yourself, for your support person. Foods such as fruit, muesli bars and of course, chocolate, can give you the energy you need.
After the birthYou will need a change of clothes for yourself and your baby. You should also bring your usual toiletries to help you freshen up, and a good supply of maternity pads.
Don’t forget your camera, to take those all important first photos.
You need to make sure your car seat is installed in the car so you can take your baby home from the hospital.
Will I have help developing my birth plan?
The midwives at Ryde have attended many births, and have seen many variations on what women and their families want for their birth. Your midwife will be able to discuss your ideas with you, offer suggestions, and advise you whether your birth plan is realistic in your particular circumstances.
What happens if I develop complications during pregnancy?
Ryde is designed for low-risk pregnancies. This means that the risk of complications is lower to start with. However, complications do arise even when there are no indicators prior to pregnancy and/or labour.The National Midwifery Guidelines for Consultation and Referral 2008 is the document which midwives consult in the event of a complication.These guidelines specify when obstetric consultation is required, and when a woman should be transferred from the midwife as primary carer to an obstetrician. The Ryde midwives are supported by a team of obstetricians at Royal North Shore Hospital. The obstetricians can discuss the circumstances with your midwife, and assist in deciding whether to provide limited or short term support, or primary care.
The Ryde midwives also discuss pregnancy variations with one another, and are able to draw on the experience of each other to provide you with the best possible care. Because your midwife knows you and your circumstances, she is in a good position to advise the best course of action for you.
Will I ever see an obstetrician?
If your pregnancy progresses normally and you experience a spontaneous onset of labour within 42 weeks, you may have no need to see an obstetrician.If you are overdue, your midwife will consult with the staff at Royal North Shore Hospital to arrange an optimal time when the birth of your baby may be induced.
If complications arise during your pregnancy, you may be referred to obstetric care at Royal North Shore for consultation and ongoing care.
What if I am overdue?
After your due date has come and gone, your midwife will discuss your options with you. Your options will depend upon your health and the health of your baby, and of course your own preferences as much as safely possible. If you are to be induced, the induction will take place at Royal North Shore Hospital. However, your Ryde midwife will be there with you, attending your labour.
Will I have a say in my labour?
Can I have a water birth?
Yes, you can have a water birth. There is a fixed bath at Ryde Hospital, and there are inflatable birth pools. Your midwife can talk to you about whether a water birth is for you. The majority of women at Ryde use the birth pools for pain relief, and many babies are born in the water. It is a lovely gentle way for a baby to be born.
Can I have a Lotus birth?
Yes. If you would like a Lotus birth, you should raise this with your midwife as it is not a common request. A Lotus birth is when the cord is not clamped, but remains connected to the placenta until the cord dries and drops off, usually 2-3 days after birth.
Who can I have at my birth?
There is no limit on whom you can bring to your birth. You should make sure you are comfortable with the people who will be with you, and let them know in advance to respect your decision if you change your mind about anything during labour. You may wish to have some people come and go, which is also fine.
Can I bring a doula?
You are welcome to bring a doula with you. The doula is your support person, and is independent from the Ryde Midwifery Group Practice. The Ryde midwives are keen for the birth of your baby to be a positive experience, and welcome anyone who will support you in this.
Can I bring my children to my labour?
Yes. If you plan to bring your children to your labour, you should also bring someone to look after them, and to be available to take them out of the labour room if it becomes too distressing for them. Before you decide to bring your children, you should consider how your response to labour pains will impact upon the children, and what will happen to them in the event of an emergency.
What are my pain relief options?
The milder pain relief options are always available. These include a bath, shower, hot packs and massage by your support person. Hot packs are provided by the hospital.When you need something stronger, nitrous oxide gas (laughing or happy gas) is available, and morphine. You should discuss these options with your midwife before labour so that you can be aware of any side effects which may affect you or your baby.
You are NOT able to have an epidural or spinal block at Ryde Hospital.
Do I have to have any drugs?
No. Some women choose not to have any pain relief drugs during labour, and instead rely on other methods to help manage pain It is recommended to administer syntocinon after the birth of your baby to facilitate the third stage – delivery of the placenta. You may request not to have this injection. Please discuss this with your midwife to help you make the decision. It is also recommended to give your baby an injection of Vitamin K after birth. The purpose of this injection is to prevent Vitamin K Deficiency Bleeding which although rare, is unable to be detected and can be fatal. It is also available as an oral dose upon request. Again, you should discuss this with your midwife if you are thinking that you will not give the medication to your baby.
What facilities are available during labour?
The hospital has a shower in each birthing room and a bath in one of the rooms. Each room has an inflatable birth pool, which has a padded floor for kneeling, a seat for sitting and holding your baby after a water birth, and handles to grip during labour. It is large enough for your support person to get in as well. The rooms are equipped with a bed, a mattress on the floor, bean bag, fit ball, birthing stool, CD player and a variety of chairs which can be used to find a comfortable position for you to labour.
What happens if I have complications during labour?
The safety of you and your baby is paramount, and will form the basis for all advice given to you by your midwife during labour and birth. Midwives are skilled and are prepared for complications. Ryde Midwives complete regular mandatory training and a higher level of professional practise review than those working in a tertiary hospital.
If any complications require additional medical support or procedures, transfer to a higher level obstetric care will be discussed between you, your midwife and the obstetric team at Royal North Shore Hospital. The transfer will be made in a timely and appropriate manner, and your midwife will go with you in the ambulance. You will be able to go straight into theatre, if necessary, as Royal North Shore will know you are coming, and have everything ready for you and your baby. You may think that it would be better to be at a hospital with an operating theatre. This is not necessarily the case as the theatre still needs to be prepared. It is the experience of the Ryde midwives that your care is not compromised in any way by the short distance between hospitals.
Can I donate my placenta/cord blood?
No. Ryde does not have the facilities to donate your placenta or cord blood.
What happens after delivery?
How long will I stay in hospital?
You will stay in hospital long enough for your midwife to ensure that you are fit and healthy and that the baby is settled and feeding. You can expect to be home the same day as you have given birth, unless your baby arrives in the middle of the night. New mums are not “sick” and the Ryde philosophy is that new families are happiest and healthiest in their own homes. You will not be officially “discharged” from the hospital until your midwife has seen you and your baby settled in at home. Your midwife will visit you at home a number of times to monitor you and your baby. When your midwife is satisfied that all is progressing normally you will be discharged. By this time, you should feel confident to continue on your own, supported by the local Early Childhood Centre.
Where do I go if I have problems with breastfeeding?
Your midwife will still be in contact with you for the first two weeks, and can help you get breastfeeding established. Your midwife will teach you how to breastfeed before you leave hospital. However, it all changes when your milk comes in, and you are likely to need extra help at this time. Your midwife will talk to you about breastfeeding, and will help you at home to make sure your baby is attached properly.
What happens if there is a problem with the baby?
Ryde Hospital is administratively part of Royal North Shore Hospital. This means that there is a seamless transfer between the two hospitals and your baby can be admitted straight to the nursery without the need for an independent assessment and completion of paperwork.Your midwife will notify RNSH by telephone if there is a problem so that they will be ready to care for your baby when he or she arrives.
What do I do in my first few days at home?
Usually before you leave hospital, your midwife will make an appointment with you to come and visit you at home. Your baby will be weighed and checked, and you will get to spend some time talking to your midwife about how it is all going, and discuss any concerns you may have. At each appointment, you midwife will assess whether you need another appointment, and if so, one will be made. You can expect 4-10 home visits, depending upon how you and your baby are progressing.As part of the hospital paperwork, your midwife will notify your local Early Childhood Centre about the birth of your baby. The community nurse should make contact with you in the first few weeks, or you can contact them directly to make an appointment.
You are always welcome to bring your new baby to WOW and show him or her off to all the other mums. It can be great to get out of the house into a familiar and supportive setting. WOW is held every Wednesday at 10am for new mums and mums-to-be. You may also find the opportunity to debrief about your baby’s birth helpful, as new mums are invited to share their experience with those waiting their turn.