Non-LMC services

Possible claims

• Non-LMC labour and birth (rural support)
• Urgent pregnancy care (normal hours and out of hours)
• Urgent postnatal care

Non-LMC services are in place to help support and supplement the delivery of lead maternity care (LMC).

They also represent services required on a casual basis outside lead maternity care but they do not include specialist maternity services (i.e. ultrasound scans).

Non-LMC services may not be claimed by a practitioner who is the woman’s LMC or an employee (or contractor) of the same maternity provider as the woman’s LMC (i.e. a collective maternity practice).

Non-LMC labour and birth (rural support)

Relevant clause in Section 88 - DB15

A general practitioner or midwife must provide the following services as required to women during labour and birth:

(a) urgent care and treatment to support a LMC in a rural or remote rural domicile (as defined in Schedule 2) if the services of an obstetrician or paediatrician are needed but are not available and the LMC requires assistance

(b) accompany the woman in an air/road ambulance from a rural or aremote rural domicile area

This module is designed to support an LMC in a rural or remote rural location if the services of an obstetrician or paediatrician are needed but are not available and the LMC requires assistance from another midwife with additional maternity skills. Or it can be claimed if the non-LMC accompanies the woman via ambulance or air transport from a rural or remote rural location.

The fee can be claimed at any time during a woman’s pregnancy (antenatal, labour and birth and postnatal). However, this module can be claimed once per day, per woman, per midwife.

Note-This module can be claimed if the LMC and non-LMC both ride in the ambulance/air support together with the woman. In other words, the LMC can claim the rural support fee and non-LMC can claim the non-LMC rural support fee for the same woman.

This fee is NOT to be claimed if it was part of the birth plan for the back-up midwife to be present for a home birth. The LMC should discuss compensation using the home birth fee to his/her back-up.

Examples of when this fee is applicable:

• A woman birthed at home at a rural location and she has extensive tearing. The LMC was not able to arrange for an obstetrician to assist and she calls another midwife with extra training in suturing. Said midwife arrives at the woman’s home to perform the suturing.
• A woman births in a rural primary unit and both mother and baby are in distress. The ward is short-staffed, and no core team is available to assist. The LMC calls in another midwife for help. The mother goes to a tertiary hospital with her LMC in an ambulance and second midwife goes with baby via air transport.

Example when this fee is not applicable:

• A planned home birth and designated back-up midwife was present for the duration of labour and birth.

Urgent pregnancy care - normal hours (non-LMC maternity care)

Normal hours (8AM-6PM weekdays, excludes public holidays)

Relevant clauses in Section 88 - DB12, DB14

This module is designed to compensate a maternity provider’s time and assistance to woman in need of urgent care (e.g. woman falls, APH, etc.) during the 1st, 2nd or 3rd trimester period. The following scenarios must occur to claim this fee:

The woman is away from her usual place of residence (i.e. on holiday, on business trip) OR

The woman has made every attempt and failed to contact her LMC and the back-up LMC.

This fee is not to be claimed for routine antenatal care (blood pressure reading, ordering scans and blood tests, etc).

A maternity provider may only claim 1 urgent pregnancy care fee per woman per day.

Example of when this fee is applicable:

• A woman in her second trimester lives in Auckland but is in Tauranga visiting family and she falls in the shower. She arrives at a nearby midwifery clinic around 10am, shaken and scared and wants to be sure everything is okay.

Example when this fee is not applicable:

• A woman in her first trimester arrives during a maternity provider’s clinic period wanting a scan ordered and her blood pressure taken because she does not like her current midwife and is thinking about changing LMCs.

Urgent pregnancy care - out of hours (non-LMC maternity care)

Out of hours (6PM-8AM weekdays, at anytime during the weekends or public holidays)

Relevant clauses in Section 88 - DB13, DB14

The same rules apply for claiming this module except the urgent care takes place outside of ‘normal hours’

Urgent postnatal care (non-LMC maternity care)

Relevant clauses in Section 88 - DB17, DB18

This module is designed to compensate a maternity provider’s time and assistance where urgent postnatal care is provided to the mother and/or her baby. The following scenarios must occur to claim this module:

The woman is away from her usual place of residence (i.e. on holiday) OR

The woman has made every attempt and failed to contact her LMC or the back-up LMC

Please note-There are no designated hours for urgent postnatal care (i.e. no normal hours vs out of hours). The compensation fee is the same regardless of time of day woman or baby was seen.

Example of when this fee is applicable:

• A woman has tried repeatedly and failed to reach her LMC because she worried about her baby’s feeding and she finds a midwife’s number on Facebook and asks to be seen to be sure the baby is okay.

Examples when this fee is not applicable:

• A midwife has scheduled a home visit for a woman and her baby but was called away unexpectedly to attend a birth. Her practice partner is available and agrees to visit the woman and baby.
• The woman is 7 weeks postnatal and requires urgent care as she is away from her usual residence.