Gynaecologist or midwife: who does what?
When you are pregnant, it is important to keep a close eye on your health and that of your baby. But who takes care of this monitoring? A gynaecologist or a midwife? Who does what? Who can you share your concerns with? And are these appointments reimbursed? These are all important questions for the parents-to-be.
In short, the role of the gynaecologist and midwife is as follows:
- A gynaecologist is a doctor who provides medical monitoring during your pregnancy. In particular, he or she takes care of the Non-Invasive Prenatal Test (NIPT), the OGTT (screening for gestational diabetes) and ultrasounds.
- A midwife may also provide medical monitoring of a pregnancy with no complications, in collaboration with a gynaecologist. However, midwives mostly play a complementary role. They prepare the parents for the birth (at home or in hospital), are present at the birth and help with the initiation of breastfeeding. Finally, they are your first point of contact when you return home (postnatal care).
The role of the gynaecologist
When should you schedule your first appointment with the gynaecologist following a positive pregnancy test?
Have you taken a pregnancy test and is it positive? Then it is time to make your first appointment with a gynaecologist. This is usually planned at 7-10 weeks of amenorrhoea (absence of menstruation).
How many ultrasounds are performed during pregnancy?
During your pregnancy, you are entitled to three ultrasound scans: one for each trimester of pregnancy. These allow early detection of any problems in the child. If your gynaecologist feels that your child's growth needs to be monitored more closely, he/she may schedule additional ultrasounds.
- The first ultrasound is carried out at your first appointment: at about 10 weeks of pregnancy. This is a very special time: you will see your baby for the first time and your due date will be set.
- The second ultrasound is carried out after 20 weeks of pregnancy. During the ultrasound, your doctor will examine every part of your growing baby’s body.
- At around 32 weeks of pregnancy, there will be a third ultrasound. Your doctor will check the position of your baby, the placenta and the amount of amniotic fluid. If your baby is developing normally, this will be your last scan.
In some hospitals, a 3D ultrasound can be requested. This can be done from 30 weeks of pregnancy onwards. This is a non-medical ultrasound and therefore not reimbursed. It will cost you about €100.
Advice from a gynaecologist:
Aurélie Delpierre, gynaecologist at the Notre-Dame de Grâce Clinic in Gosselies
Do parents-to-be understand the difference between the work of a gynaecologist and a midwife?
"Not always. In the hospital where I work, we offer support in tandem. The gynaecologists take care of the medical side of things, while the midwives take care of preparation for birth and breastfeeding.”
Do you consider this midwifery support essential?
“Absolutely, especially as mothers have to leave hospital increasingly early after the birth. This makes post-natal follow-up by the midwife essential.”
Do you have any expert tips for parents-to-be?
“Many parents have an image in their mind of what childbirth will be like. Some are obsessed with a breech birth, for example, while others want to make sure they get an epidural at the first contraction. But childbirth can be unpredictable and it is important not to cling to your dream birth at all costs. One word of advice: learn to let go!”
Did you know that you can receive your birth allowance as early as the fifth month of pregnancy? It allows you to cover many expenses that aren’t reimbursed!
The role of the midwife
When to call a midwife?
This can be done at any time, even during the earliest stages of the pregnancy. Midwives - at home or in the hospital - support parents throughout the pregnancy. Their role is just as important after birth. They monitor the health of the mother and baby. But they can also advise you about nutrition, useful equipment or on the administrative steps that need to be taken concerning the birth. The advantage of a midwife is the often very personal contact. Many hospitals work with midwives, but you can also have an independent midwife at home.
Advice from a midwife:
Eglantine Moity, midwife
How can the support of a midwife make a difference?
“First of all, parents who have had the support of a midwife are much better prepared for the birth of their baby. You can really see the difference at the time of delivery. After this, they manage the postpartum period better and the initiation of breastfeeding is easier.”
Do you have any expert tips for parents-to-be?
“It is essential to surround yourself with the right people. If you do not feel comfortable with a practitioner, do not hesitate to change. Too often, parents still do not dare to speak out. Yet they are the ones having the baby.
I also recommend seeing a physiotherapist or an osteopath at least once or twice before the birth. Many women neglect this complementary care, but it is really not a luxury. During prenatal physiotherapy, you can prepare for childbirth or learn to manage certain pregnancy-related ailments.” »
How do you find the right midwife?
“All you have to do is go to sage-femme.be and carry out a search based on your geographical location and the speciality you are looking for. In addition to the basic training, we all have areas in which we specialise: hypnosis, aromatherapy, homeopathy, sophrology, pool preparation, etc., so there is bound to be a midwife who will share your outlook!”
How much do these appointments cost?
Many prenatal or postnatal appointments are reimbursed. Where this is not the case, supplementary insurance often comes into play. So, you should check the terms of your hospital insurance. You don't have one yet? This type of insurance is not necessarily expensive, and taking one out is far from being a luxury. La Mutualité Neutre, for example, offers a number of packages.
What costs are reimbursed during pregnancy?
The three compulsory ultrasound scans are reimbursed by the health insurance fund. The other ultrasound scans will therefore be at your expense.
Only part of the appointments with a midwife are reimbursed by the health insurance fund. Some insurance policies cover the rest of the appointment costs as of the last three months of pregnancy, others cover only the very last month.
What costs are reimbursed after childbirth?
Post-natal consultations are fully reimbursed if the midwife is a registered midwife (i.e. if they apply the rates set out in the health insurance fund agreement). Otherwise, there is a small part to be paid by the parents but here again, this is often covered by supplementary insurance.
Midwifery care is reimbursed up to one (1) year after the birth.