From supporting high-risk pregnancies to providing neonatal care, midwives play a varied role in ensuring the health and well-being of mother and baby throughout pregnancy, birth and beyond. Midwives can take on many different specialisations in their careers, allowing them to dive deeper into specific areas of maternal and infant health. We take a look at these different specialisations in Australia, and how they contribute to better outcomes for both mothers and babies. Whether it’s caring for high-risk pregnancies, supporting home births, or offering perinatal mental health services, each specialisation allows midwives to provide more personalised and focused care.
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Speciality One: Neonatal Care
Bringing a baby into the world is an amazing experience, however, a safe delivery doesn’t end there. Neonatal care focuses on the health and well-being of newborns in the early hours and days after birth.
Midwives specialising in
neonatal care are trained to monitor and assess newborns for any signs of distress, abnormalities, or complications that may arise during or shortly after birth. With this expertise, they can ensure that newborns receive the care they need straight away, resulting in better outcomes.
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Midwives with a neonatal care specialisation are skilled in neonatal resuscitation and can carry out
assessments to monitor newborn health. This includes assessing the
Apgar score (a quick test used to assess a newborn’s overall health), checking vital signs (temperature, heart rate, respiratory rate) and observing feeding and bonding. Early detection of problems such as jaundice, dehydration, or feeding difficulties can lead to better outcomes.
Speciality Two: High-Risk Pregnancy Care
High-risk pregnancies need specialised care to ensure the health and safety of both the mother and baby. Midwives specialising in high-risk pregnancy care are trained to identify, monitor and manage conditions throughout pregnancy and birth. They work closely with obstetricians and other healthcare professionals to help minimise the potential for complications. This includes:
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Hypertension
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Diabetes
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Heart disease
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Autoimmune disorders
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Gestational diabetes
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Pre-eclampsia
Fetal growth restriction
Early detection of these conditions enables midwives to intervene in collaboration with obstetricians, to reduce the likelihood of severe complications.
Specialisation Three: Home Birth and Out-of-Hospital Birth
Many women dream of being able to give birth away from hospitals and in the comfort of their own home, and midwives are helping this happen by providing safe, supportive and personalised care. Midwives specialising in home births are trained in managing low-risk pregnancies outside of a hospital setting and provide continuous support to the mother during labour, offering pain relief options such as breathing exercises, water births and massage.
Midwives make sure the home is safe, setting up the necessary equipment, such as sterile delivery kits, oxygen and emergency medications, in case complications arise. They also inform mothers about the benefits and risks of home birth to help them make informed decisions. This involves making the mother aware of the potential for emergencies that may require a transfer to the hospital, such as postpartum haemorrhage, fetal distress, or the need for medical interventions.
Midwives specialising in
home births have training in neonatal resuscitation, emergency medical interventions, and managing complications such as shoulder dystocia or postpartum haemorrhage. They carry emergency medical equipment and are in constant communication with a nearby hospital in case a transfer is necessary. Midwives specialising in out-of-hospital births are part of a wider network of healthcare professionals, including obstetricians, paediatricians and anaesthetists, with whom they collaborate to ensure the safety of the mother and baby.
Speciality Four: Lactation Consultancy
Breastfeeding is a completely natural experience, yet it can be very tricky for many mothers to establish. Lactation midwives are focused on supporting breastfeeding mothers and helping in this endeavour. Midwives are trained to offer support from the early stages of breastfeeding, beginning with breastfeeding shortly after birth. They help mothers with proper latching techniques, which is important for feeding effectively, pain reduction, and preventing issues such as sore nipples or engorgement.
They can manage common challenges such as:
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Sore or cracked nipples: Midwives guide mothers on techniques to improve latch and provide advice on nipple care, such as using lanolin cream or warm compresses to reduce pain and encourage healing.
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Low milk supply: Midwives offer strategies to increase milk supply, such as frequent breastfeeding, pumping, hydration and more.
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Engorgement: If the breasts become overly full, causing discomfort or difficulty for the baby to latch, midwives help with techniques such as hand expression or using cold packs to reduce swelling.
Speciality Five: Perinatal Mental Health
Perinatal mental health, which includes mental health during pregnancy and the first year postpartum, is important. Midwives specialising in perinatal mental health provide support to mothers by addressing emotional and psychological well-being alongside physical health during the perinatal period.
Mental health challenges include:
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Perinatal depression
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Anxiety
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Postpartum depression (PPD)
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Post-traumatic stress disorder (PTSD)
Midwives are often the first healthcare professionals to see the signs of mental health issues during pregnancy and after childbirth. They are trained to carry out routine screenings for perinatal depression and anxiety using standardised tools such as the
Edinburgh Postnatal Depression Scale (EPDS). By screening mothers early, midwives can identify potential mental health concerns before they escalate, allowing for earlier intervention and support.
Midwifery is a multifaceted and evolving profession, with specialisations that span beyond pregnancy and childbirth. From supporting neonatal care and high-risk pregnancies to offering lactation consultancy, midwives play an important role in supporting women through all stages of their reproductive journey.