Loss of Te Anau's only midwife tip of iceberg in Southland and Central Otago midwifery crisis

The loss of Te Anau's only midwife is the tip of the iceberg of the midwifery crisis being felt across the Southland and Central Otago regions.

An increasing number of midwives are leaving the profession due to feeling undervalued, overworked, and having ongoing questions around funding structures. Maternity staff shortage is an ongoing issue that I have actively raised with Ministers responsible for Health, Immigration and COVID-19 Response over a prolonged period.

In June 2021, I wrote to the Minister for Health, Andrew Little, requesting him to take urgent action to improve access to maternity services for women and their babies in Central Otago, Queenstown Lakes, Northern Southland, and Fiordland areas.

My concerns relate to the significant shortage of midwives in the region, the wellbeing of those employed in the health workforce, and the significant risks the combined factors pose to the safety of mothers and their babies.

When the Lumsden Maternity Centre closed in 2018, the Government said they would ensure expectant mothers would still have access to good primary and secondary health care services.

Their solution since has been to fly mothers needing critical care to hospitals in other cities just to find that some hospitals, at times, did not have enough medical staff or hospital beds to accept the incoming patients.

If flying isn’t a viable option, mothers and babies face long trips via ambulance.

Anyone who lives in Southland will be able to testify to the region's at times treacherous road infrastructure in winter and especially if combined with extreme weather challenges.

In my letter to the Minister, I used the example of an expectant mother who, unable to be admitted to Dunedin and Invercargill, was referred to Timaru Hospital. In an already potentially fatal situation, Timaru could not be accessed by helicopter due to weather, which meant a four-hour trip by ambulance.

I also raised issues about the wellbeing of our midwives and maternity nurses. Health care worker shortages have contributed to their problems due to intensifying workloads and unsustainable work hours.

The lack of evidence-based immigration policy has contributed to the crisis we face. According to answers to Parliamentary written questions by Ministers, midwifery is not currently considered a long-term skill shortage.

In the Minister's response to me in December 2021, he acknowledged that New Zealand is experiencing a shortage of midwives.

He said 'the Government recognised the importance of midwives and have made it a top priority to bolster the midwife workforce’.

He quoted Budgets 2020 and 2021 provisions that allocated $242m over four years for maternity services. The $35m Maternity Action Plan and 2021 Notice would ‘compensate midwives working in the more remote parts of New Zealand’.

Associate Minister of Health, Hon. Dr Ayesha Verrall also responded by outlining $5m in funding for clinical coaches at District Health Boards to improve midwives' working conditions.

In a press release on 14 July 2021, the Associate Minister declared, "To support them, clinical coaches will stand shoulder to shoulder with midwives on the maternity wards, caring for pregnant and birthing women's health and medical needs."

However, answers to Parliamentary questions to colleague Hon Louise Upston, Opposition Spokesperson for Social Development and Employment, suggest that the Minister could not tell how many midwives were supported to date by clinical coaches and how much of the money had already been spent.

She said that the Ministry of Health did not 'currently hold the data' nor would it be available for some 18 months.

In the meantime, while the South Canterbury District Health Board (SDHB) has echoed my concerns around midwife shortages, the DHB continues to offer fewer primary and secondary maternity services and facilities per head of population than many other district health board catchments.

SDHB has been given funding to support rural midwives, and I intend to get answers about where and how that money was spent.

With the Government steaming ahead with its centralised health restructuring efforts and using money from the maternity action plan funding that could instead be used to improve midwifery conditions, it comes at the expense of mothers and their babies in our Southland and Central Otago regions.

This Government has failed to recognise midwives' vital role in supporting mothers and their babies.

Our women and their babies deserve the same access to maternity services as other Kiwi women, and all children across the country deserve the best possible start in life.

A National government will fund a minimum of a three day stay in post-natal care for mothers and their babies and address pay claims by independent midwives. We understand the challenges of remote and rural communities. We have a track record of supporting birthing units where the evidence is clear.

In the meantime, it's time for the Ministers to act now, not wait 18 months for data that will tell them that mothers and their babies in our regions need care now.

Notes to editor:
- Copies of Joseph Mooney letters to the Ministers and their responses
- Links to Parliamentary Written Questions and their responses:

  • Midwifery clinical coaching fund - https://www.parliament.nz/en/pb/order-paper-questions/written-questions/document/WQ_04384_2022/4384-2022-hon-louise-upston-to-the-associate-minister
  • Notice 21 fund rural categories - https://www.parliament.nz/en/pb/order-paper-questions/written-questions/document/WQ_04357_2022/4357-2022-hon-louise-upston-to-the-associate-minister
  • https://www.parliament.nz/en/pb/order-paper-questions/written-questions/document/WQ_04370_2022/4370-2022-hon-louise-upston-to-the-minister-of-immigration