Appointments & Availability

How many people do you care for who are due to give birth each month?

My practice partner and I limit our caseload to a maximum of 8 families due to give per month. Our caseload is split evenly between the two of us in a shared schedule, with each of us seeing each client throughout the pregnancy.

How long can I expect my antenatal appointments to be?

The initial visit and 36-week home visit are scheduled for an hour minutes, and I set aside 30 minutes for all other routine appointments.

Do you offer weekend or evening visits?

I understand the unique demands of parents with busy schedules, and I offer flexible appointment scheduling with some weekend and evening visits available on a first-come first-served basis. As a team, my practice partner and I provide 24/7 availability for urgent concerns.

Site of birth

What choices do you offer regarding place of birth?

My practice partner and I take a particular interest in supporting community births at home and in our three local birthing centres.

I have specialized training and experience in supporting home births in special circumstances, including:

• Vaginal Birth After Cesarean (VBAC) including two or more cesareans
• Breech Birth
• Twin Birth

Do you usually visit people at home in early labour?

I tend to encourage rest and hydration in early labour, however if a physical assessment or in-person visit is warranted based on my clinical judgment or your request, I will be there. If you are worried about having continuous support at home prior to active labor, you would likely benefit from having a doula attend to you in addition to a midwife.

How long do you provide care for after the birth?

I will visit with you and your pēpi at least 7 times in the 6 weeks after you give birth. I also remain on-call for urgent concerns.

Quality & Safety

who regulates midwives in Aotearoa new zealand?

In Aotearoa New Zealand, midwives are regulated by the Midwifery Council of New Zealand. The Council is responsible for making sure all practising midwives are qualified, competent, and fit to provide safe, high-quality care. They oversee midwifery education, registration, continuing professional development, and handle any concerns about a midwife’s practice. Their role is to protect the health and safety of the public while supporting the profession of midwifery.

what happens if you are not available?

For non-urgent appointments, I may reschedule to a different time or day if I'm unavailable.
If for some reason I am not available for your labor, such as if I am already at another family's labor, I will make arrangements for one of my trusted backup midwives to be available to you for your care. This is an uncommon scenario.

​What is your philosophy on the use of episiotomy during birth? 

Episiotomy is a surgical cut of the perineum. I treat episiotomy as a lifesaving emergency procedure meant to make space to speed up the birth of a baby who is not well. I have only required the use of this procedure at a handful of births in over 10 years. My experience is that episiotomy is used much more frequently in Aotearoa NZ than where I trained in the US, and I do not feel this can be accounted for by any difference in the population here or their anatomy. 
If I am offering someone an episiotomy, it is with a thorough explanation of the benefits, the risks, the alternatives (such as position changes, pushing technique changes, or warm compresses) as well as an educated guess of what could happen if I didn't do it, and what could happen if it was delayed. I would also be making this recommendation with enough time to offer adequate pain control for the procedure. I do not perform surgical procedures without consent. 

​What is your philosophy regarding keeping birth normal wherever possible, and how would you support me to do this? 

I have a deep, respectful understanding of physiologic birth as a set of physical processes, as well as it just as importantly being a monumental rite of passage. I know that the role of the midwife must be versatile, and must be individualized to each person who embarks on this process. In supporting families, I expect that pregnant people can lead their own care and that I can center their own priorities, providing support and encouragement as well as responsiveness if they express they want or need different support from me. Sometimes, my work as a midwife is as an observer, or as encouragement. Sometimes it is my job to facilitate more privacy and space for the process to unfold. I am also available, and skilled, to provide routine care through a technocratic lens, as well as course correction should the labor or birth require help. Any intervention I may provide is considered an offer, and I expect families to engage in the process of informed choice. 

Home birth

what pain relief options are available at home?

Pain is a normal and healthy part of giving birth, and I may make suggestions to help your labor be more comfortable and efficient.

​These suggestions might include:

• Eating food and drinking fluids throughout labor
• Changes in position
• The use of water (such as a a shower or tub)
• The use of heat (such as a heating pad, hot water bottle, or warm compresses)
• Changes in activity
• Breathing techniques
• Techniques to help your baby be in the best possible position for birth

​I do not offer medications for labor pain at home.

If you are concerned about labor pain but want to give birth at home, I strongly recommend that you hire a doula. Ample research suggests that doulas can decrease labor pain, and in addition they can lower the rate of cesarean birth, shorten the length of labor, and help babies breastfeed more easily.
​
​There is no reason to not have a doula at a home birth.​ Doulas and midwives fulfill different but equally necessary roles. 
​If you would like a referral for doula services, contact Madeleine today.

home birth: how many people will be here?

I will call an additional midwife to attend to you, your baby, or your family around the time you give birth. This may be just for standby services, or it may be to take over care if the labor has been long and I feel someone else may provide more well-rested care than I can. 

Regarding guests at your birth, some families like to have many people present for the birth, and some parents prefer birth to be a quiet and intimate time. My midwifery practice is accommodating to the needs and desires of your family. I will work carefully for you to have a safe birth with your chosen support.

is my home suitable for a home birth?

I have attended out-of-hospital births in many settings, including houses, apartments, trailers, and hotel rooms.
Being in a small or shared home does not exclude you from a community birth.

My midwifery practice requires the following for safe home birth:

• Motivation for a safe home birth from everyone who plans to be present.
• ​A home with running water, electricity, heat year-round, and air con in the summer. If you are having issues accessing any of these utilities, let your midwife know and she will refer you to a resource that can help.
• A clean bathroom.
• A place for the midwives to rest.
• Emergency vehicle access.

What types of help can you offer my baby in an emergency?

I am trained and experienced with neonatal resuscitation, a process of facilitating a healthy transition for your baby in the minutes following the birth.

​This process can include brief stimulation of the baby, breathing for the baby (using a bag and mask or a mask attached to an oxygen tank and blender, depending on the circumstance), clearing the baby's airway, performing chest compressions, and/or administering oxygen.

Although most babies need absolutely no help with their transition when they are born, I am prepared and equipped at all births in the event that your newborn needs assistance. 

do you offer water birth services?

Definitely. Clients are encouraged to use a tub during labor, birth, or both.
Tubs can be accessed at home or in any of our local birth centres.

what supplies do i need for a home birth?

I will provide a list of items that are likely to be helpful for a birth at home. Additional supplies are necessary if you plan to use a tub in labor.