What to Expect from Your LMC: Your Guide to Support During Pregnancy and Birth

What You Can Expect from Your Lead Maternity Carer (LMC)

Your Lead Maternity Carer (LMC) plays an essential role in supporting you throughout your pregnancy, birth, and postnatal care. From the early stages of pregnancy right through to six weeks postpartum, your LMC is your primary point of contact for all things related to your maternal and baby care.

Download a guide called How to choose your Midwife on our Freebies page.

Here's a breakdown of the key responsibilities of your LMC, so you know what to expect during each phase.

An LMC can be any of the following:

• A self-employed midwife cares for you during your pregnancy, labour and birth, and when you are at home with your baby.

• Hospital employed midwives work within a team. Together they will care for you during your pregnancy, birth, and when you are at home with your baby. 

• A private obstetrician cares for you during your pregnancy, labour and birth and works with self-employed midwives when you are at home with your baby. A private obstetrician charges a fee. Having a private obstetrician does not mean you will get private care if you birth at Auckland Hospital.

Your chosen LMC may provide all maternity care, or may share care with one or more practitioners.

Questions to ask your LMC before deciding who will support you:

• How many women do you care for who are due to give birth each month?

• How long can I expect my antenatal appointments to be? 

• How does your backup system work when you are not available? 

• What choices do you offer regarding place of birth? 

• What is your philosophy regarding keeping birth normal wherever possible, and how would you support me to do this? 

• Do you usually visit women at home during early labour? 

• Are you happy to support me in using water during labour and birth if this is appropriate? 

• What is your philosophy on the use of episiotomy during birth? 

• How long do you provide care for following the birth? 

The Early Stages: Pregnancy Assessment and Planning

• information regarding the role of the LMC and contact details including arrangements for ‘back up cover’ if your midwife is unavailable

• information about midwifery care, maternity services and options for referral for additional care should you need it

• a comprehensive pregnancy assessment including physical examination, assessment of general health, family and maternity history

• information about a range of screening tests (blood and ultrasound tests) and referral for these if you choose to have them

• information on self care and lifestyle choices

• information about the availability of Pregnancy and Parenting Education courses

• information about Paid Parental Leave

• development and documentation of a Care Plan to be used and updated throughout your pregnancy, birth and after birth

• a copy of your clinical notes (updated at each visit)

Second & Third Trimester:

• Continued assessment of your health and well being and that of your baby

• understanding the changes taking place for you and your baby

• updating your Care Plan and knowing when to contact your midwife

• one-to-one education regarding healthy pregnancy, childbirth and parenting preparation

• consideration of options for birthing including place of birth

• monitoring and assessment of you and your baby’s progress including any follow up that may be required

• any follow up blood tests and other screening tests

• updating your Care Plan and confirming place of birth preference

• one-to-one education regarding healthy pregnancy, childbirth and parenting preparation

• planning for labour and birth including the role of your support people, what to expect in labour, care of the placenta, supporting your baby’s transition including skin to skin with baby and breastfeeding

• information about early labour recognition and self care and when to make contact with your midwife

• arranging for you to meet any other maternity carers who may be involved with your care

• planning for your postnatal care

Labour and Birth: Providing Continuous Care

• Initial assessment at home or at a maternity facility

• regular assessment of the progress of you and your baby including whether additional care is needed

• review and support your birth plan in consultation with you and your partner/support people

• facilitating skin to skin contact with your baby and initiating breastfeeding

• examination and assessment of you and your baby’s early adjustments

• monitoring and identifying your physical well being and providing care as needed

• honouring plans for the care of the placenta and cutting the cord

• notifying your baby’s birth to the Registrar of Births

Postnatal Care: Supporting You and Your Baby

• Detailed clinical examinations of you and your baby throughout the first 4-6 weeks

• 5–10 midwifery home visits and more if clinically needed

• support as you develop your confidence as a parent

• assistance with and advice about breastfeeding and nutrition for you and your baby

• recognition of signs of postnatal depression/baby blues and the support available if needed

• options for the immunisation programme for your baby

• access to screening programmes for your baby as outlined in the Well Child Tamariki Ora National Schedule

• information on support agencies and other community organisations

• advice about contraception

Concluding Care and Transfer

• a final detailed clinical examination of you and your baby prior to transfer from the maternity service

• transfer of your baby’s care from the midwife 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 you and your baby’s discharge from maternity services

Throughout your journey, your LMC will be there to offer expert guidance, support, and advice every step of the way. Their goal is to ensure that both you and your baby have the healthiest and most positive experience possible.