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Who looks after you, and where your ante-natal care takes place, will depend a lot on the type of birth you want to have. If you decide on a home birth, the care will be carried out at home by a midwife and at your doctor's surgery. If you want a hospital birth your care will probably be shared between a midwife, your doctor and the hospital. If you are not registered with a doctor, or you want a home birth but your particular doctor doesn't want to assist in the delivery, or you would rather be seen by a woman doctor and your doctor is a man, you can go to see a different doctor just for your maternity care.
The actual care you get will be similar wherever you receive it, because all ante-natal care is designed to ensure that you and your unborn baby remain healthy during pregnancy.
These days, the best pattern of ante-natal care for a healthy woman is considered to be no more than nine ante-natal appointments. If you have any concerns between these appointments, you can telephone your midwife or doctor for advice.
HOME BIRTH
A home birth means you give birth in the familiar surroundings of your own home under the supervision of a midwife. If you want to deliver your baby in this way, you will need to talk to your doctor to see whether there are any medical reasons why this isn't advisable. It is also a good idea to contact the director of maternity services (or local supervisor of midwives) at your hospital in order to arrange for a midwife to come and visit you and discuss a home delivery in detail.
HOSPITAL BIRTH
Some women prefer a hospital birth because they feel safer knowing that there will be experts on hand to help if there are any complications. Also, if the baby needs special care this will be available almost immediately. Although hospitals are no longer the dictatorial places they used to be, and most try to cater for parents' wishes, not all of them are able to offer every type of birth. You will need to find out what facilities your local hospital offers. Before making your final decision talk to other mothers who have had their babies there recently. If you have any worries, discuss these with your doctor.
There are a number of hospital birth schemes that involve your doctor and midwife to varying degrees:
Midwife unit This is usually based at the hospital and is run entirely by midwives who undertake ante-natal care, delivery and post-natal care. You can choose to have your baby at home or in the unit. These units are not widely available throughout the country, so this may not be an option that is open to you.
Domino scheme The Domino scheme (Domiciliary Midwife In and out) means that your doctor and community midwife look after you throughout your pregnancy. Once you are in labour the midwife comes to your home and stays with you until you are ready to go into hospital. She then accompanies you to the hospital you are booked into, where she delivers the baby. You can usually return home around six hours after the birth. The midwife then continues to look after you at your home. Many women like the continuity this scheme gives them, but unfortunately it is not available in all areas at the present time.
Shared care Your ante-natal care will be shared between your doctor and the hospital where your baby is going to be born. The birth will take place in the maternity unit of this hospital and your doctor and midwife will look after you jointly on your return home with your young baby.
PRIVATE CARE
If you can afford it, you may like to consider having a home birth with a private, or independent, midwife taking care of you. She will provide all your ante-natal and post-natal care and will also deliver your baby. Alternatively, you can decide to have your baby in a private hospital or maternity home.
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