Here’s what to expect at a midwife consultation

Midwives specialise in low risk births. We assist with births in and out of water, allowing mums to utilise various positions that they may find most comfortable to them at the time of birth.

All expectant mums must be assessed by their chosen midwife throughout their pregnancy to ensure that they fit the low risk profile.

A low risk pregnancy is one that has no active medical complications. The expectant mum’s physical and psychological findings must be within the normal limits, needing no medical interventions or hospital treatment (imminent admission) .

Consultations can start early in the pregnancy depending on your midwive’s protocol. Consultations are generally every 4 weeks until 28 weeks of the pregnancy, every fortnight until 37 weeks and thereafter weekly until the “big day” when labour commences.

Your midwife will offer not only physical support throughout the pregnancy, but guide you emotionally. We serve as a confidante when expectant parents feel overwhelmed, unsure, or anxious, during the pregnancy, and postpartum period.

What happens at a midwife appointment?

On the first consultation, a full medical, surgical, psychological and social history is taken down. The first consultation allows the expectant couple to build a rapport with their chosen midwife.  On each consultation, we assess your overall physical health by performing blood pressure checks, a urine test, a weight and BMI reading.

Evaluating these ensures that all medical parameters are progressing within the normal limits. Prenatal blood test will be performed and the results explained. The routine blood tests are generally the antenatal blood screen, the first trimester screening, which is discussed and offered to parents.

A haemoglobin test may be repeated in the last trimester of the pregnancy  to ensure that the iron levels are high enough and no additional supplementation is needed. Dietary recommendations and supplements may be discussed and advised to ensure good nutrition health to mum and the growing baby. 

Fetal wellbeing is monitored by abdominal measurements, Doppler heart rate checks, and some midwives may perform a basic fetal ultrasound, to assess the baby’s heart rhythm, growth and confirm the baby’s position. 

Birth preferences are discussed and realistic expectations are set. This provides empowerment and motivation to the expectant couples. It is crucial that mum’s birth wishes, cultural and religious preferences are respected at the time of her birth.

Prenatal emotional support is offered throughout, by providing prenatal education and classes to the expectant couples. Minor pregnancy ailments can sometimes feel crippling to an expectant mum, so we provide natural remedies and techniques to assist, and will refer out if symptoms are exacerbated.

Midwives work in collaboration with a multidisciplinary team. We refer all expectant mums for fetal ultrasounds at 12 weeks for the first trimester screening (which is done in conjunction with blood tests) and at 20 weeks for the fetal anomaly and developmental ultrasound.

Some midwives advise that mums see a backup OBGYN during their pregnancy. The backup OBGYN takes over in the event that a high risk pregnancy develops or a caesarian section is needed at the time of birth.

Midwives assess each client individually and a care plan is drafted according to their needs, be it pain relief options, emotional support, postnatal and lactation support, dietary recommendations etc.

Birth preparation discussions and education will take place in the last trimester. This will help in preparing for the arrival of your little one. Labour signs and warning signs will be explained and most importantly you’ll have a professional holding your hand throughout your journey and a call away at any concern.

A huge word of advice to ensure that you have a positive experience and a good birth outcome : ‘It is vital that you feel comfortable with your midwife and your birth choices’

Note:

Ruwaida Moola practises in South Africa. Your experience with your midwife might differ from what is described in this article depending on where in the world you live. However, the advice about being comfortable with your midwifery team is applicable for all expectant mothers and their partners!