4 October 2019: Solving the current maternity crisis facing South Auckland could be done overnight if the local district health board was willing to utilise and assist with funding the operation of the primary birthing facility located just six minutes from Middlemore Hospital at the Mangere town centre.
Mothers Matter is calling on the DHBs and Ministry of Health to provide the 48 hours quality postnatal care for which mothers are entitled and to ring fence this funding to solve the maternity crisis that’s sweeping the country.
The call comes as Auckland DHB signals it may restrict its own maternity services to those living within its boundary. It’s a move that would affect women in South and West Auckland and on the North Shore by piling even more pressure on these areas’ hospitals, which come under Counties Manukau and Waitemata DHBs.
“Women are being dictated to by the DHBs so they can’t choose where they wish to birth and receive their postnatal care,” says Mothers Matter Founder and Birthing Centre Director, Chloe Wright.
A very real example of the DHBs’ nonsensical approach is in South Auckland. While Middlemore maternity ward is struggling to cope with demand, the newly built Ngā Hau Māngere Birthing Centre is significantly under-utilised because the DHB resists funding women who can and want to go there.
Counties Manukau DHB has resisted funding the new 20 bed primary birthing and postnatal care facility, established and supported by the Wright Family Foundation. The Mangere centre is the fourth built in the past five years by the foundation to bring equity to maternity care and show how wraparound support for mothers can significantly improve outcomes for mothers and babies.
“We built the centres as change makers, to show how great care of women can be delivered so that the children of tomorrow are well and have the best chance at life. But without DHB partnerships the centres are unsustainable,” says Chloe.
If DHB and Ministry of Health funding was available to enable women to birth and receive their postnatal care at the various primary birthing centres around the country, it would instantly alleviate pressure at the maternity wards, not just in Auckland, but Lower Hutt, Wellington, Wanaka, Lumsden and various other places currently reporting crises. This would allow the hospitals the space and resources to be able to better focus on the women who need medical attention.
The maternal suicide rates in New Zealand per capita are seven times higher than those in UK, with disproportionate numbers of Maori represented in those statistics.
“For a Government that proclaims to care about mental health and wellbeing, support for mothers has stalled. We are amid an escalating maternity and mental health crisis. They are connected,” says Chloe.
Mental health and wellbeing statistics show that New Zealand women are suffering, and as a result their babies are too. As Eisenberg said in 1989 ‘the pregnant princess has become the postpartum peasant’ and never has this been truer than now. Mothers Matter is questioning what must happen before the safety and wellbeing of mothers and their babies is taken seriously.
Many mothers do not know they have a right to 48 hours postnatal care, and even if they do, they are unable to demand it at a time when they feel most vulnerable. This is particularly the case in a place like South Auckland.
“The South Auckland area is mostly Pasifika and Maori mothers. They have the quietest voices, which are easily ignored. When we neglect the fundamental needs of our women, we are not only harming them, we are also harming the outcomes and future of our next generation of children,” says Chloe.
“It is simply shameful that we treat mothers like this. We have all the data and research we need to know that the first 48 hours after birth – known as the ‘window of opportunity’ – presents an incredible opportunity to allow mother and baby to form a lasting bond. If this is supported and honoured, a mother thrives, and in turn her baby and whanau thrive, paying dividends for generations to come.”
New Zealand College of Midwives Chief Executive, Alison Eddy, says, “Postnatal care has always been the ‘Cinderella’ of maternity care, when in fact we should be investing more in this crucial time in a family’s life. Although hospital midwives do an amazing job supporting new mothers, busy over-crowded tertiary maternity units are challenging surroundings.
“Primary maternity facilities provide an ideal environment to support women to establish breastfeeding and ‘fall in love’ with their new baby. We need more of these units and they need to be better supported”.
Mothers Matter has worked with MP Louise Upston, resulting in the introduction of a new Member’s Bill to legislate for ring-fenced 72 hours postnatal care for women, which is now National Party policy.
In light of the bill, Plunket supports a system that empowers parents to make choices regarding their maternity care. Plunket Head of Policy and Advocacy, Sonya Marshall, says, “We support increased capacity to enable individual family needs to be met, where this is in a community setting, primary birthing unit or hospital.
“Plunket believes it’s important that parents know what they’re entitled to and are empowered to make choices that suit them. When support is inadequate our staff see the ongoing impacts that can range in severity and intensity. These include but are not limited to a negative impact on breastfeeding, a lack of confidence in parenting and maternal mental health issues.”
The Mothers Matter campaign was founded by Chloe last year and has the vocal backing of birthing, first-1000 days and postnatal experts such as Dame Lesley Max and Nathan Wallis (www.mothersmatter.nz(external link)).
It’s putting pressure on the Government and DHBs to establish a ring-fenced national fund, managed by the Ministry of Health, to support a mother’s right to receive the clinically and psychologically appropriate amount of postnatal care and support at the facility of her choice, regardless of the type of birth she has had.