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. It would be great if there was education and funding for midwives to continue to care for women who experience miscarriage but that is not currently the case.  

 

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. 

 

Have you signed up with a midwife to register them as your lead maternity carer (LMC)?

yes
no

Your midwife will discuss your symptoms with you and help you to determine your next course of action.

Midwives are not technically employed in your service until you have signed the paperwork, so anything that they do for you will be unpaid.

Is your miscarriage complete?

yes

Your midwife will talk to you about what has happened and let you know that there is nothing more that she can do for you. She may suggest that you see your GP for further support. 

no

Your midwife will refer you for appropriate testing and discuss the results with you. Some midwives end their service here.

Which management option do you choose?

expectant
medical
surgical

Your midwife will let you know what to expect and who you should contact if you have any concerns. 

Your midwife will refer you to a hospital and let you know that you are now in their care.  

How does your expectant management progress?

it completes

Your midwife will talk to you about what has happened and let you know that there is nothing more that she can do for you. She may suggest that you see your GP for further support. 

you change your mind

If you change your mind and want to use another management option, you can ask your midwife for a referral or see your GP for a referral.

you have concerns

If you have concerns about how your miscarriage is progressing you can contact your midwife. If it is after-hours you can contact Healthline. In an emergency call 111 or get someone to drive you to hospital.

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