What to expect from your midwife when you are having a miscarriage

It is so great that maternity services are free here in New Zealand but it can make it hard for us to know what is being paid for by the government and what is being done out of the kindness of midwives' hearts. 

 

When a miscarriage occurs your midwife will have a higher workload, even if she doesn’t personally see you again, as she will be calling you, assessing your test results, and organising necessary referrals. Midwives are trained to assess and refer, they are not trained in miscarriage treatment. This can be a little surprising if you were expecting your midwife to be with you for your entire birth journey. Since 2021, midwives receive funding to have one additional appointment with you following a miscarriage (within two weeks of the miscarriage occurring). 

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1) For the First trimester pregnancy loss module the maternity provider may provide the following services:

(a) care and advice if there is a real and imminent risk of miscarriage, the woman is experiencing a miscarriage, or a miscarriage has occurred, including:

(i) all appropriate assessment and care of a woman; and

(ii) referral for diagnostic tests and treatment, if necessary; and

(iii) contraceptive and pre-conceptual advice as necessary.

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DB16 Payment rules: Second trimester pregnancy loss

(1) Only one fee is payable per pregnancy loss event (including loss of a multiple pregnancy).

(2) This module applies to a pregnancy loss event occurring between 14 weeks 0 days and 19 weeks 6 days gestation.

(3) The maternity provider must provide a minimum of one in-person postpartum consultation.

(4) The Second trimester pregnancy loss module covers care provided for up to two weeks after the date of the pregnancy loss.

(5) In-person consultations for a second trimester pregnancy loss cannot be included in the count of consultations provided as part of Second trimester care services (DA25).

(6) The payment for Home birth planning and supplies (DA41) may be claimed where the maternity provider has attended a second trimester pregnancy loss event at the woman’s home.

(7) This module can be claimed for services provided to a woman on the same date as care provided in the First assessment, registration and care planning module as long as the pregnancy loss event occurs after the First assessment, registration and care planning consultation.

- Extracts from Primary Maternity Services Notice 2021

 

Follow the flowchart below to get an idea of when your midwife is employed to care for you and when their service has ended. Any time you are getting more care than described here it is quite possible that your midwife is going above and beyond her call of duty. Please note that the chart below does not take into account every possible outcome and is just here to give you a broad understanding of your midwife's role.