Antenatal -
Pre-natal = before the birth and/or during the pregnancy.
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Birth centre care -
Provide a particular philosophy of care in a particular setting for women assessed as at low risk of developing complications. The philosophy of care usually embraces – a family centred approach, involving parents in decision making, reducing family separation and promotion an dearly return to the home environment – support for midwives as primary care givers the promotion of pregnancy and childbirth as healthy life events with minimal need for intervention in the birthing process for the majority of women. The setting is a discrete part of a hospital, often adjacent of the labour ward or a facility separate from a hospital, which comprises one, or more birthing rooms furnished in a home like manner with adjoining bathrooms and shared kitchen and lounge facilities.
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Birth plan -
A written statement outlining an individual woman's or family's wishes about the birth of their baby. It is a way of opening the channels of communication between care givers and consumers. (Health Department of Victoria, 1990, Having a baby in Victoria p.9)
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Choices of Care during pregnancy and birth

• Standard public hospital care – women attend the hospital for all aspects of care (antenatal, birth and postnatal). Care is generally provided by medical and midwifery staff at the hospital.

• General Practitioner care – women attend for antenatal care at the general practitioner’s rooms and are booked for delivery at a hospital where the general practitioner has admitting rights. The general practitioner attends the birth and visits during the postnatal stay in hospital. The hospital midwives provide care in labour and day-to-day care during the postnatal stay.

• Specialist obstetrician care – women attend the obstetrician’s rooms for antenatal care and deliver at a public or private hospital where the obstetrician is accredited. The obstetrician attends the birth and visits during the postnatal stay in hospital. Hospital midwives provide care in labour and day-to-day care during the postnatal stay.

• Shared Care – this is the formalised co-operative arrangement between a maternity hospital and a general practitioner or a community health centre in the provision of antenatal and postnatal care to women. Occasionally care is shared between a specialist obstetrician, a general practitioner and the hospital. Women attend their local shared care practitioner for most of their antenatal care, deliver their babies in the maternity hospital and return to their shared care practitioner for postnatal care following hospital discharge..

• Team midwifery care – team midwifery embraces the concept of continuity of midwifery care throughout pregnancy, labour and delivery and the hospital stay. A team of midwives provide care for women during their pregnancy and birth. For women at low risk of complications this care is their primary care, with referral to medical care only should complications arise. For women at major risk of complications, team midwifery care is provided as part of a multidisciplinary team of care givers, including the relevant medical specialists.

• Birth centre care – provide a particular philosophy of care in a special setting for women assessed as at low risk of developing complications. The philosophy of care usually embraces – a family centred approach, involving parents in decision making, reducing family separation and promoting an early return to the home environment, support for midwives as primary care givers, the promotion of pregnancy and childbirth as healthy life events with minimal need for intervention in the birthing process for the majority of women. The setting is a discrete part of a hospital, often adjacent to the labour ward or a facility separate from a hospital, which comprises one, or more birthing rooms furnished in a home like manner with adjoining bathrooms and shared kitchen and lounge facilities.
  

• Community midwife care - Community midwife care - is the provision of midwifery services from a community base, in consultation and co-operation with medical and other maternity services. Women assessed as being at low risk of complications receive antenatal care from a midwife (or a team of midwives) in a community setting such as a community health centre labour and deliver their babies under the care of the community midwife in a hospital or at home and receive postnatal care (after hospital discharge) also from the community midwife.

• Home birth - women choosing to give birth at home are usually cared for in pregnancy and birth by a general practitioner/midwife team. Should transfer to a hospital become necessary during labour the midwife usually attends as a support person with the general practitioner assisting at the delivery.
  

“The choices or models of care are not universally available: the range of models is greater in metropolitan as compared to country areas, general knowledge in the community about different models is limited and access may be further restricted by such factors as cost, legislative restrictions on midwifery practice, medical risk criteria and social or cultural appropriateness.” (Health Department Victoria, 1990, Having a baby in Victoria, Final report of the ministerial review of birthing services in Victoria. Health Department Victoria. Chapter 3, pp 24-59) A number of health professionals can help you find out about the choices of care in your Shire as well as choices of care outside of the Hume Region.
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Community midwife care -
is the provision of midwifery services from a community base, in consultation and co-operation with medical and other maternity services. Women assessed as being at low risk of complications receive antenatal care from a midwife (or a team of midwives) in a community setting such as a community health centre, labour and deliver their babies under the care of the community midwife in a hospital or at home and receive postnatal care (after hospital discharge) also from the community midwife.
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Continuity of Care -
often women who receive care from one primary care giver or a small team feel greater satisfaction with the care provided. This may be related to the continuity of care and the opportunity to develop a relationship with the care giver. (Health Department of Victoria, 1990, Having a baby in Victoria p.28)
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Domiciliary Visits -
These are visits made by a midwife to your home after you have arrived home with your baby. At this visit you can talk about any difficulty you are having now that you are at home, including breastfeeding or settling your baby to sleep as well as having a quick physical check up. At least one domiciliary visit is offered to all women, irrespective of whether they were discharged from hospital early or not. They are funded by the Department of Human Services. In the Victorian Study, the majority of women interviewed reported satisfaction with the service and recommended it (Health Department Victoria, 1990, Having a baby in Victoria, Final report of the ministerial review of birthing services in Victoria. Health Department Victoria, p 118)
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General Practitioner care -
women attend for antenatal care at the general practitioner’s rooms and are booked for delivery at a hospital where the general practitioner has admitting rights. The general practitioner attends the birth and visits during the postnatal stay in hospital. The hospital midwives provide care in labour and day-to-day care during the postnatal stay.
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Home birth -
Women choosing to give birth at home are usually cared for in pregnancy and birth by a general practitioner/midwife team. Should transfer to a hospital become necessary during labour the midwife usually attends as a support person with the general practitioner assisting at the delivery.
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Lactation Consultant -
An informed health worker who has completed special training in breastfeeding. They have up to date knowledge about breastfeeding as well as awareness of popular knowledge and attitudes about breastfeeding, including cultural variations in attitudes to breastfeeding. The Lactation Consultant can act as a guide to useful services, groups and books for the new mother. They can help women to successfully breastfeed and answer concerns or questions for women intending to breastfeed. (from the DHS, 1998, "Promoting Breastfeeding" – Victorian Breastfeeding Guidelines)
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Postnatal depression -
a condition characterised by feelings of sadness, guilt, worthlessness and anxiety; thoughts about suicide and death; difficulties in concentration and decision making; disturbances of appetite and sleep; and lack of interest and energy. These symptoms are not transitory and can persist in varying degrees for a number of years. Postnatal depression is accompanied by a range of symptoms that women often cannot make sense of and find overwhelming. (Milgrom J, Martin P and Negri L, 1999, Treating Postnatal Depression, Wiley & Sons, England).
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Models of Care -
This is how health providers describe the arrangements for care during the pregnancy and birth. See Choices of Care.
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Risk Assessment -
this involves a review of past and current factors, mostly medical and reproductive but sometimes including social elements as well. These factors may be ones which suggest the need for concurrent medical care during pregnancy. There may be factors which predict a greater probability of specific pregnancy complications or ones which are associated with a higher risk of perinatal death. It is common for risk assessment to continue through pregnancy and labour with consultation and referral to a different setting and care giver if complications develop and risk status changes. (Health Department of Victoria, 1990, Having a baby in Victoria p.44/45). Sometimes the risk assessment is very important for example in a smaller country hospital where specialists may not be readily available.
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Shared Care -
this is the formalised co-operative arrangement between a maternity hospital and a general practitioner or a community health centre in the provision of antenatal and postnatal care to women. Occasionally care is shared between a specialist obstetrician, a general practitioner and the hospital. Women attend their local shared car practitioner for most of their antenatal care, deliver their babies in the maternity hospital and return to their shared care practitioner for postnatal care following hospital discharge.
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Specialist obstetrician care -
women attend the obstetrician’s rooms for antenatal care and deliver at a public or private hospital where the obstetrician is accredited. The obstetrician attends the birth and visits during the postnatal stay in hospital. Hospital midwives provide care in labour and day-to-day care during the postnatal stay.
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Standard public hospital care -
women attend the hospital for all aspects of care (antenatal, birth and postnatal). Care is generally provided by medical and midwifery staff at the hospital.
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Team midwifery care -
team midwifery embraces the concept of continuity of midwifery care throughout pregnancy, labour and delivery and the hospital stay. A small team of midwives provide care for women during their pregnancies and births. For women at low risk of complications this care is their primary care, with referral to medical care only should complications arise. For women at major risk of complications, team midwifery care is provided as part of a multidisciplinary team of care givers, including the relevant medical specialists.
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