Wānaka midwives are not impressed with the way the Southern District Health Board (SDHB) is managing the maternity services, even after it became a national scandal. “The maternal and child hub’s concept is an unproven and unevaluated strategy that has been poorly implemented,” said Deb Harvey, Wānaka midwife.
Wānaka midwives are still the most remote midwives in NZ, located the furthest from a hospital. There is a GPs service in Wānaka, however they no longer do obstetrics, and call on midwives for most emergencies relating to pregnant women. “There is a midwife clinic room and an out-of-business hours room for emergencies at the WLHC. I understand that the Hub is still just an empty leased space in Gordon Road, a semi-industrial area without access to the helipad,” said Harvey.
Harvey is one of the only two midwives practising in Wānaka, certainly not a number big enough, considered that there about 200 pregnancies in Wānaka each year. “There are two of us, although some midwives from outside the area care for women in the greater Wānaka region. There is now a weekend relief for those midwives allowing 60 hours downtime after being on call for 12 days 24 hours per day,” said Harvey.
“Wānaka midwives provide a professional service to women and are and will be available for women who need care when it is needed. If midwives are taking time off or leave, as stated above, the SDHB is providing funded locum cover to ensure that there are always at least two midwives available 24/7 in Wānaka. Women receive excellent care from their midwives, throughout pregnancy, labour and birth and the postnatal period, up to six weeks after birth. Midwives provide holistic care, as well as caring for the woman and babies physical wellbeing, they also provide individualised education and support which also meet psychosocial needs. The majority of women have uncomplicated pregnancies and can choose to birth closer to home, those women who should or wish to birth in a hospital, discuss in detail with their midwives how that will play out,” commented Harvey.
In Wānaka, calling out a midwife in the middle of the night costs less than requiring a local electrician coming over for an emergency. The system of remuneration for a midwife is not at all equally compared to their importance of their performance, as explained by Harvey; “Community midwives are paid via the Section 88 Primary Maternity services notice. This is a modular fee for service contract, which pays a set price for each trimester of pregnancy care, labour and birth and postnatal care. There is an additional payment for travel for the post-natal fee for midwives, who are caring for women living in rural locations. The fee structure and the terms and conditions of the contract do not reflect the work required of midwives in 2019 and are particularly disadvantaging for rural midwives,” she said.
“The New Zealand College of Midwives has been in negotiations with the Ministry of Health for a number of years regarding a revised contract framework, which better reflects the service that women and babies need from community midwives. Until this is finalised, DHBs are being required to put in place solutions in order to retain their community midwifery workforce”.
Future mums in Wānaka deserve a much better service, which naturally can’t happen before midwives will have better working conditions to operate in, as the Maternal and Child’s Hub, to start.