When you need more
She refers on, and joins it up
Part of a midwife's job is recognising what belongs with someone else, and making that happen rather than handing you a phone number.
Why a midwife can do this
Endorsement widens what she can act on
An endorsed midwife holds a qualification beyond registration that lets her prescribe certain medicines, request certain tests and refer you to other health professionals. It is a formal scope of practice set by the Nursing and Midwifery Board of Australia, not a courtesy.
Practically, that means she has options other than advice. If something needs investigating, she can start it. If it needs someone else, she can send you there properly, with the background already written down.
This sits alongside your existing care. Your GP, hospital and child and family health nurse all stay exactly where they are.
Where a referral might go
The people she is most likely to bring in
Which of these applies depends entirely on what is going on, and most families never need any of them.
- Your GP, for anything that belongs with your regular doctor
- A lactation consultant, when feeding needs more than a visit can resolve
- A child and family health nurse, for ongoing developmental checks
- A paediatrician, if your baby needs specialist assessment
- Perinatal mental health services, if you need more support than a visit gives
- The maternity service where you gave birth, when the question is about your birth
The coordination half
Not being made to chase it yourself
A referral on its own is a piece of paper. What makes the difference in the early weeks is somebody making sure the pieces connect: that the next person knows why you are coming, that her notes are in your blue book, and that you are not telling the whole story again from the start to someone who has never met you.
That is the part families notice. Nothing is more exhausting at three weeks postnatal than being the only person holding the thread.
Your consent, every time
Nothing moves without you
Your midwife talks to other professionals about your care with your agreement, and she will tell you what she is passing on. If you would rather she did not contact someone, say so.
You can also ask how she handles this before you book. It is a fair question and a revealing one.
If you are not sure who to ask
Start with the person who is already coming
One of the quiet advantages of having a midwife is that you have someone to put a question to before deciding whether it needs a doctor. A lot of early worries turn out to need reassurance, not an appointment.
And when something does need more, you have skipped the hardest step, which is working out on your own which kind of professional to look for while running on no sleep.
What gets written down
The record follows you
Checks go into your blue book, which is where the next professional will look. It means the person you see after her is not starting from nothing, and you are not reciting the last three weeks from memory.
If a referral is made, ask what she has included and keep a copy. It is your record, and having it to hand saves repeating yourself later.
Talk it through
Not sure whether something needs more than a visit?
Describe it when you make contact. Working out what a situation needs is exactly what a midwife is for.