College of Midwives Throws Support Behind Petition

“Women’s birth experiences have an impact beyond the act of giving birth. The care they receive has an influence over the following weeks, months and even years, as they and their whānau adapt to life as new parents.”

That’s what Alison Eddy, CEO of the New Zealand College of Midwives, believes is under-recognised within the wider context of maternity service provision in Aotearoa New Zealand.

“Having a baby, becoming a family is a formative time in our lives. As well as high quality clinical care, women and whānau need to have the emotional, psychological and cultural aspects of their wellbeing nurtured. Our maternity service has the potential to be fully responsive to all of these needs, but when the service is under pressure, it is stretched to its limits,” she says.

The issues highlighted in *Kirsten Van Newtown’s petition demonstrate that currently, maternity services are struggling to provide holistic care and are limited to only addressing clinical concerns, leaving women with unmet needs  and utilising only one aspect of midwives skills and knowledge.

“Sadly, the issues that the petition has raised have not happened overnight. Midwives have been raising concerns around under resourced maternity services for years,” says Ms Eddy. “We have the solutions and have presented them time and again. Politicians should listen to the voices of women – they are telling us what they need from our maternity services – we should all be paying attention.”

“We have a world-leading maternity system; many countries around the word uphold our maternity system and the continuity-of-care model, integrated within the wider health system as the ‘gold standard’, and are in fact trying to implement something very similar in their countries. When our model is well resourced, it meets the needs of women. It is not our model of care that is the problem, it’s the appropriate resourcing that urgently needs addressing.”

The College says midwives are the backbone of the maternity service and they must be better resourced to keep doing what they are trained and educated to do for New Zealand women and their babies.  Alison Eddy adds that although the maternity service is under huge pressure, there are more midwives with annual practicing certificates than ever before.

“We need to ask ourselves why midwives are not working in our system, and what needs to be done to attract and retain them.” As the petition identifies, intermittent and stop-gap funding which does not appropriately address the pressures on the maternity service is not the answer. The worsening situation within the service is indicative of that and the question must be asked: How many more women and whānau are to be subject to experiences like Kirsten’s, before someone will listen?” says Ms Eddy.

Wellington College of Midwives representative, Sarah Gilberston, will be at the petition presentation. She is available for comment. Apologies but Alison Eddy is unavailable due to the rescheduling of the petition presentation, from a fortnight ago.

www.midwife.org.nz

Additional

The case for midwifery: the potential of midwives for improving quality of care (World Health Organisation):

• 83% of all maternal deaths, stillbirths and newborn deaths could be prevented with the full package of midwifery care (including family planning);
• 62% of effective practices within the scope of midwifery show the importance of optimising the normal processes of childbirth and early life, and empowering women to care for themselves and their families;
• 56 maternal and neonatal outcomes were found to be improved through midwifery practice and philosophy of care;
• 87% of service needs can be delivered by midwives, when educated to international standards;
• 82% reduction in maternal mortality possible with universal midwifery coverage;
• Midwifery is associated with more efficient use of resources and improved outcomes when provided by midwives who are educated, trained, licenced and regulated in international standards.  Midwifery is a ‘best buy’ investment:
• Midwifery is associated with reduced maternal and neonatal morbidity, reduced interventions in labour, improved psycho-social outcomes and increased birth spacing and contraceptive use;
• Community based midwives have been found to rank positively for economy, efficiency and effectiveness;
• Midwifery should be considered a core part of universal health coverage. Quality midwifery care is central to achieving national and global priorities and securing the rights of women and newborn infants;
• Quality relates to the right for women and newborns to the highest standard of health and is synonymous with women-centred care. Providing quality care is most efficient through midwifery care for all childbearing women;
• There were no adverse outcomes associated with midwife-led care but significant benefits, thus it is recommended that all women should be offered midwife-led continuity models of care;
• Case loading midwifery care is safe and cost effective;
• Midwives have the potential to provide excellent quality of care but socio-cultural, economic and professional barriers must be overcome to allow them to practice to their full potential.

Continuity of Midwifery Care and outcomes – a synopsis

Internationally, there is increasing recognition that continuity of midwifery care is best practice for all pregnant women. The evidence is clear that there are numerous health benefits for women and babies and the cost of continuity of midwifery care is significantly less than that of standard care.

Continuity of care midwifery care is defined as where the midwife is the lead maternity professional who plans, organises and provides maternity care from the time of confirmation of pregnancy through labour and birth and into the postnatal period.