Eps 13. You’re Pregnant… But Did Anyone Tell You That You May Be Able to Have Your Own Midwife?

You find out you’re pregnant.

You make an appointment with your GP. You get your blood tests. You talk about hospitals. A referral gets sent off.

And before you know it, you’re inside the maternity system.

But somewhere amongst all of that, there’s a question I don’t think enough women are being encouraged to ask:

Who do I actually want caring for me throughout my pregnancy and birth?

Not just which hospital?

Not just public or private?

But who will actually be beside me?

Because depending on where you live and the hospital you’re booked into, you may have access to something called Midwifery Group Practice (MGP).

And if you’ve never heard of it before, you’re definitely not the only one.

I genuinely thought more women knew about this

Recently, I shared a Reel explaining MGP.

It wasn’t something I expected to take off.

Honestly, I thought I was sharing fairly basic information.

It was simply one of those posts where I thought, Maybe there’s a pregnant woman following me who doesn’t realise this exists. Let me explain it.

Then it was shared more than 75 times.

Women were tagging other women.

Sending it to pregnant friends.

Messaging me.

Asking how they could access it.

Asking why they’d never heard about it.

And I realised something.

There are women going through entire pregnancies without knowing all of the maternity-care options that may be available to them.

That is the bigger conversation here.

Because this isn’t about convincing every woman that MGP is the model she needs to choose.

It’s about making sure she knows that she may have a choice in the first place.

So, what actually is MGP?

MGP stands for Midwifery Group Practice.

It’s a model of midwifery continuity of care where you’re usually allocated a primary midwife who provides most of your care, supported by a small group of backup midwives.

Rather than meeting different people at different appointments and then potentially having completely unfamiliar care providers when you arrive in labour, the idea is that you build a relationship with your midwife throughout your pregnancy.

Depending on the program, that continuity can extend through pregnancy, labour, birth and into the early postnatal period.

Imagine the difference that can make.

You don’t have to walk into your birth space and explain yourself from the beginning.

Your midwife already knows you.

She knows what matters to you.

She knows the conversations you’ve had throughout pregnancy.

She knows your preferences.

She knows your concerns.

She knows your history.

And perhaps most importantly, you know her.

For such an intimate and vulnerable experience, that relationship can matter enormously.

Midwives aren’t the “assistant” in the birth room

I think we also need to change the way we sometimes talk about midwives.

There can be this idea that the doctor is the main maternity-care provider and the midwife is somehow assisting them.

But midwives are qualified health professionals specialising in pregnancy, labour, birth and postnatal care.

For women experiencing healthy pregnancies, midwifery-led care isn’t a “lesser” version of maternity care.

And when complications arise?

That’s where collaboration matters.

Midwifery care and obstetric care don’t always have to be an either/or situation.

A woman can receive care from her midwife while also receiving medical or specialist input when it’s required.

The goal should be the right care, from the right professionals, for that individual woman.

And the evidence around continuity is worth knowing about

This isn’t only about having a familiar face at your appointments.

Research into midwife continuity models has found meaningful differences.

A large Cochrane review involving more than 18,000 women found that women receiving midwife continuity of care were more likely to experience spontaneous vaginal birth and less likely to experience caesarean birth or instrumental birth compared with women receiving other models of care.

Women also generally reported more positive experiences of their care.

That doesn’t mean choosing MGP guarantees you a vaginal birth.

It doesn’t.

It doesn’t mean interventions won’t happen.

It doesn’t mean complications can’t arise.

And it certainly doesn’t mean obstetricians aren’t important.

What it does tell us is that continuity itself deserves to be part of the conversation when women are choosing maternity care.

“Okay… so how do I actually get into MGP?”

This was probably the biggest question I received.

And unfortunately, there’s no single application process that applies to every hospital.

Different NSW maternity services run their programs differently.

That means one woman’s experience of applying for MGP may be completely different to yours.

Some hospitals may ask for MGP to be listed as your preferred model when your GP sends your maternity referral.

Others may have an additional expression of interest or application process.

There may also be catchment requirements, eligibility criteria and limited places.

So if you’re interested, ask early.

As soon as you’re discussing your maternity referral with your GP, ask:

“Does the hospital I’m being referred to offer Midwifery Group Practice?”

If it does:

“How do I request it?”

“Can you put MGP as my preferred model of care on my referral?”

And then don’t necessarily assume that’s the end of the process.

Contact the hospital maternity service or check their website and find out whether there’s anything else you need to complete.

The exact process matters because every service can be different.

Don’t wait until halfway through your pregnancy to ask

If MGP sounds like something you’d like, enquire as early as you can.

One of the biggest limitations of these programs is simply availability.

A hospital may only have a certain number of MGP midwives, with each midwife caring for a limited caseload.

So sometimes a woman doesn’t miss out because there’s anything “wrong” with her pregnancy.

The program is simply full.

That’s why I don’t want women thinking:

“I’ll worry about all of that later.”

Your model of care is worth thinking about at the beginning of pregnancy.

Not when you’re 30 weeks and suddenly starting to think seriously about birth.

What if you’re considered “high risk”?

This is where I want women to be careful about ruling themselves out.

Some MGP programs have clinical eligibility criteria, and some primarily care for women experiencing uncomplicated pregnancies.

But those criteria aren’t necessarily identical everywhere.

There are also services expanding access to women with more complex care needs where clinically appropriate.

So if you’ve been told you’re “high risk”, don’t automatically decide:

MGP isn’t for me.

Ask the actual maternity service.

You can say:

“Does my particular condition exclude me from your MGP program?”

“Can I remain under midwifery continuity while receiving specialist care?”

“Do you have another continuity model for women who need additional medical care?”

Let the service assess your individual circumstances rather than assuming the answer before you’ve even asked.

And if MGP is full? Don’t end the conversation there.

This is another part women often don’t realise.

MGP isn’t necessarily the only continuity option.

Depending on your hospital and location, there may be other models available.

For example, NSW public maternity services can include MAPS - Midwifery Antenatal and Postnatal Service where a known midwife provides care during pregnancy and after your baby is born, while birthing-unit midwives provide your labour and birth care.

Depending on where you live, there may also be birth centres, midwifery clinics, GP shared care, publicly funded homebirth programs, private midwives and other specialised maternity programs.

So if you hear:

“Unfortunately, MGP is full.”

Try following it with:

“What other continuity-of-care options are available to me?”

One question can open another door.

This is actually about something much bigger than MGP

The more I thought about the response to that original Reel, the more I realised that MGP wasn’t actually the part that surprised me most.

It was the number of women saying:

“I didn’t know.”

That’s the problem.

You don’t know what you don’t know.

If nobody tells you there are different models of maternity care, you may naturally assume that you simply go wherever you’re referred and follow whatever process you’re given.

And you absolutely can choose standard hospital care if that’s what you feel comfortable with.

But it should be a choice, not simply the default because nobody told you anything else existed.

This is something I speak about constantly in my work with women.

You can’t advocate for an option you don’t know exists.

Awareness comes before advocacy.

First, I know what’s available.

Then, I understand my options.

Then, I ask questions.

Then, I make the decision that’s right for me.

That’s informed choice.

If you’re newly pregnant, start here

You don’t need to become an expert in the maternity system overnight.

Start with a few questions.

Ask your GP or maternity service:

What models of maternity care are available at my hospital?

Do you offer Midwifery Group Practice?

How do I apply?

Do I need to apply separately from my hospital referral?

Are there eligibility or catchment requirements?

If MGP is full, is there a waiting list?

What other continuity-of-care models are available?

Then go away and look at your options.

Ask more questions.

Talk about them with your partner.

Think about what matters to you when it comes to your pregnancy and birth.

Because maternity care shouldn’t simply be something that happens around you.

You are part of the decision-making.

I wish every woman was told this at the beginning

That’s ultimately what I took away from watching that Reel spread.

Not that every woman needs MGP.

Not that MGP is perfect.

Not that every woman will be eligible or receive a place.

I simply wish every woman, when she first enters maternity care, was shown the different pathways in front of her.

“Here are your options.”

“Here’s what each one looks like.”

“Here’s what’s available where you live.”

“Now let’s talk about what might suit you.”

Because birth is too important for women to discover their options accidentally through Instagram.

If you’re pregnant right now, ask.

Even if you think you already know what your hospital offers.

Even if you’ve already been referred.

Even if somebody has told you that you’re high risk.

Ask what is available.

Ask about continuity.

Ask who will provide your care.

And if you’re reading this thinking, I wish I’d known this earlier send it to the woman who still has time to ask.

Because sometimes one piece of information changes the entire way a woman approaches her birth.

Know your options. Ask your questions. And remember that your voice belongs in the room.

This article provides general education and isn’t individual medical advice. Maternity models, eligibility requirements and availability vary between hospitals and health services. Speak with your maternity service or healthcare provider about the options appropriate for your individual circumstances.