After finally making the decision to go through with plan 'b,' all of sudden a whole lot of decisions had to make quite quickly about where I'd have a baby and who I would like to deliver it.
Over the last decade or so the word 'choice' has been bandied about a lot in relation to maternity care, but actually I didn't feel like I got much of it so far in relationship to my care. The where was easy. I'm all for better living through pharmacology, so I would definitely be heading to hospital where there are lots of drugs on hand and people very happy to administer them. The who part was more problematic, I needed to find a Lead Maternity Carer.
The person I would have liked to deliver my baby was my GP as I have a great relationship with her. There are not many places in Auckland where they'll ring you up the next day to make sure you are fine after presenting with a routine albeit rather severe UTI. But apparently you've got a better chance of striking big Wednesday than finding a GP who still does deliveries and is willing to take a new patient on. So I was cast off into the world of maternity care by my lovely GP with a few names and numbers to call.
The Suit would have liked to go the private obstetrician route but with all the outgoings in our household it didn't make sense to add another $4k to our bills with a baby on the way. Which left us with one option really, a midwife. And again I didn't feel like I got much choice in the matter. I tried to contact several that simply didn't bother returning calls and the others that I did manage to get a hold of were unimpressed that I dared call them at the late stage of 9 weeks pregnant. Apparently in Auckland you should be booking your midwife the minute those two lines on your piss stick turn up.
At this point I was getting a bit desperate. I needed someone, anyone really, to deliver my baby and do their darnedest effort to make sure the both of us make it through the process in as good as shape as possible. Then I suddenly remembered that one of my friends was pregnant and dropped her name into the conversation with her midwife before we got along to the dreaded due date question. Thus my lead maternity carer was chosen on the basis that said midwife is 'not a hippy' and I was officially signed on at almost 11 weeks knocked up.
The midwife in question turned out to be a highly practical no-nonsense sort and shares my general philosophy on birth: that there is no point in setting yourself up for failure by trying to have the 'prefect birth' when a good birth would do myself and my baby just fine.
Although my pregnancy had a unhappy ending, my midwife made the ordeal a whole lot better than it could of been. Within minutes of my unhappy text she had made the arrangements for me to have my D&C done a few days after I arrived back home and also kept in contact with me throughout the day as I waited for my flight. There was something deeply reassuring about having a healthcare professional so concerned about you, that she insists on the midnight phone call to make sure you arrived in the country ok. Something I don't think the expensive obstetrician or in fact my own GP would have done.
But looking back on my initial journey through pregnancy, I couldn't help but wonder if I wouldn't have felt so at sea if my local GP practice had midwifes as part of their clinical staff. Judging by the number of pregnancy packs being left at the front desk, there would clearly be some demand. I hated that my relationship with my GP has effectively been severed even though she was effectively my LMC for almost the entirety of my first trimester. Perhaps the midwives themselves might benefit from having some administrative support which a practice would have. Of course I'm sure people will come up with plenty of reasons why this is a bad idea, cost is likely to be a big factor and maybe most midwives would hate the idea of joining a practice.
Nevertheless new thinking is needed in the much-reported doctor versus midwife debate. Maybe it isn't the end of the world if GPs are no longer involved in routine childbirth, as for me at least I really appreciated having someone there even in the middle of the night to make sure I was doing ok. However it does seem odd that maternity care is so far removed from most women's main port of call for health matters. I know I would feel a lot more confident about my care arrangements if there was a good chance that the GP and midwife might actually talk to each other as the pregnancy progresses. It might have been good for my GP to know that a) I had miscarried and b) had a D&C when I presented with complications a week after the event.