You’ve just found out you are expecting a baby – congratulations! Whether you are a first time parent or a seasoned mum, each pregnancy and child is different. Your first pregnancy may have been a breeze, but now at fifteen weeks you are getting this ache in your lower back and a cracking sound every time you roll over in bed. Perhaps you are filled with dread about the upcoming birth, the unknown trials of being a new parent and where to go if you need help.
Worry no longer mumma bear as I guide you though some common concerns around prenatal or pregnancy and birth, post natal, mental health and breastfeeding care to help you make decisions and how to access support should you need it.
The first contact for most mums is the family doctor. You can continue to be under the care of your doctor through your pregnancy if you choose, or you can opt for full midwife and/or obstetric care. In Canberra, all mums are eligible for free midwife care offered through Calvary, the Canberra Hospital or there is John James Hospital for private patients.
This is where things can become complicated for first time parents because there are varying models of care within the midwife programs. Calvary Hospital offers continuity of care through its Birth Centre where you are allocated one midwife, usually from sixteen weeks gestation, to follow you through the pregnancy, accompany you in the birth and provide post natal care for about a week. The Birth Centre model of care is centered on low risk, minimal intervention and return home within 24 hours of the birth.
The Canberra Hospital offers three models of continuity of midwifery care offered through the Birth Centre and/or antenatal clinic:
- Birth Centre midwives provide full continuity of care as per the Calvary Hospital model;
- The Continuity at Centenary Hospital Program (CatCH) provides continuity care for women who may have risk associated with the pregnancy and/or birth with the option to birth in the Birth Centre or ward;
- Pregnancy Enhancement Program (PEP), supports women with complex mental health or substance abuse issues with a continual midwife during and post birth, however not during labour; and,
- ‘Step Ahead’ Program for young parents with a continual midwife during and post birth, however not during labour.
Calvary Hospital and the Canberra Hospital both have antenatal clinics for women who do not wish for midwife continuity care, or mums who prefer a joint model of midwife and obstetric care.
Yay! Bub is born and you have your little family. Most of your care will go ahead as it did before the birth, with regular usually daily midwife appointments through your hospital, before being referred to the general system for further advice. This may be your GP or the support services as follows.
- MACH: Maternal and Child Health (MACH) Nursing Service offer clinics and education support as well as hooking you up with a mothers group (for new mothers only). MACH run immunisation, sleep and breastfeeding specialist sessions and booked appointments for check-ups. MACH also has an outreach program for high needs clients. This program has weekly, fortnightly or monthly home visits from a midwife with the view of integration into the community service after a cycle on the program. I required two cycles on the program. I was referred straight after Master X was born due to my prenatal diagnosis of anxiety, and then referred again when I returned to Canberra after being in my mum’s care for postpartum psychosis.
- QEII: The QEII Family Centre provides a residential program for families with young children (0-3 yrs) experiencing difficulties in the postnatal and early childhood periods. In lieu of a mother and baby unit (the nearest one is in Sydney) many women with PND get referred to QEII for support. Unfortunately though the midwives are not specialists in psychiatric care. It is important to align your care with the other services alongside QEII and know this gap in their care if you are ever admitted.
Your first point of contact for mental health related issues during the perinatal period should be your main caregiver who is likely to be your GP, midwife and/or obstetrician.
There is also a range of specialist services that you can link in with for targeted support:
- PANDSI: The Post and Ante Natal Depression Support and Information(PANDSI) is a free service for women and their families who are experiencing pre and post natal mental health issues. They offer regular support and education services and specialist groups to support mothers and their families through their journey.
- IMPACT: a coordination service for pregnant women, their partners and their young children (less than two years of age) who are clients of Mental Health ACT and/or are receiving opioid replacement therapy and require assistance to manage their involvement with multiple services.
- Perinatal Mental Health: I find the page for this area of service to be fairly vague. This service is for acute conditions such as antenatal anxiety and/or depression and complex health needs such as mental illness. They offer a free psychiatrist if required. Their support persons are qualified counsellors and work closely with the psychiatrist and other services, if required. Perinatal is my go-to service alongside my GP as both of these places hold the best information and understanding of my complex needs. When I rang perinatal for a referral to CatCH, they did so without readmitting me into the service. I like how they operate at the best interest of the mother and advocate with the psychiatrist and your GP, if required.
You can make some headway with breastfeeding preparedness by chatting to your GP and midwife about your feeding plans. I also registered with the Australian Breastfeeding Association (ABA) and was hoping to do one of their classes but bub came early!
If you do need extra support through breastfeeding, here are some useful links and contacts:
- ABA: The Australian Breastfeeding Association is a volunteer run organisations that offers support in breastfeeding support, training, education and resources and public advocacy. They have area catch-ups (Belconnen, Inner North, South Canberra etc.) that are organised through private Facebook groups, and we have accessed their telephone counselling service on many occasions.
- The hospital: If you have symptoms of acute mastitis the hospital have a range of services to support you including ultrasound imaging of the breast tissue to look for abscess, ultrasound breast massage to break up any lumps and lactation consultants.
- GP: MY doctor was awesome but she also referred me to a specialist GP. In Canberra the certified GP is Dr Libby Goodchild (who was also the GP resident at QEII when I was admitted there in 2015).
- Tongue Tie: This can cause affliction to the feeding relationship so it is ideal to see a specialist. Unfortunately most of the support services are in Sydney. We had Master X’s snipped privately in Canberra in 2015. Will need to update this section in the future!
Raegina is not a health professional. The information here is provided only as a guide and I accept no responsibility for the currency or use of this information in deciding healthcare options.