Midwives are walking away from the profession and the critical shortage of midwives will only get worse without more resourcing in next year’s Budget, argues Karen Guilliland.

Karen Guilliland

Mothers and babies are beginning to experience first-hand the consequences of underfunding in New Zealand’s maternity service.

There have been reports in the media over recent months about women who have felt neglected after giving birth in some of the country’s largest hospitals. The women are not blaming the midwives though; they can see that these dedicated professionals are overworked and stretched too thinly to provide the attention they would like women to have.

The New Zealand College of Midwives has been aware for some time that a crisis was brewing in the midwifery profession and has made the Ministry of Health aware of its concerns. But these were largely ignored until the College took the momentous decision to take the Ministry to court to fight for a fair financial deal for community-based lead maternity carer (LMC) midwives. A fair deal means pay equity for these midwives. If men were midwives there is no doubt that they would be paid more than the mainly female workforce is today. The College is now in negotiations with the Ministry to redesign the system for paying LMC midwives and to achieve pay equity.

Pay equity battle far from over

But the battle is not over. The pay and conditions for the ‘core’ midwives who work in hospitals alongside LMCs are set by a different system and while the College’s focus at present is on winning pay equity for LMCs, both MERAS, the midwifery union, and the College will also be looking for pay equity for core midwives. Both groups of midwives within this vital and precious public service are under paid and midwives are reacting by walking away from their profession. Women are having difficulty in some parts of the country in finding midwives to care for them during pregnancy and when they go into hospitals to give birth there are not enough midwives to provide the truly caring service they want to.

As a result of serious and longstanding inequity in pay and conditions we have a critical shortage of midwives which, without better resourcing will be ongoing for at least ten years:

  • Student applicant places are no longer being filled
  • District health boards cannot recruit or retain midwives in hospitals because of stressful working conditions.
  • Rural areas and remote rural areas may lose their maternity care services if we do not get support
  • Most midwives work part time to cope with stress
  • They are leaving practice years earlier than in the past

We urge anyone with an interest in maternity care to ask their MPs in our new government to support the Ministry of Health’s Budget bid for increased resourcing for midwives in 2018.

We must see the LMC payment system successfully reorganised to provide pay equity and to improve resourcing for midwives’ on-call services and to give them the right to negotiate regularly in future over their pay. We also need a locum service to ensure that midwives can take emergency leave. At present this may be impossible if their regular back-up midwife is away.

Not just ‘women’s work’

Midwifery needs support as a profession. It is not acceptable to keep viewing what we do as women’s or mothers’ work and ‘just something women do naturally’. It takes a four year degree and another intern year to learn how to be a midwife plus extensive ongoing mandatory education throughout a midwife’s career.

The level of responsibility is high and all midwives face both birth and death situations in an increasingly complex social and medically-challenged population. The consequences of getting it wrong are profound. Birth rates are forecast to rise for at least the next five years. Women’s needs are becoming greater and midwives are dealing increasingly with social and poverty issues which affect the health and well-being of women and their babies.

Midwifery is a major social investment in the future health of families. The workforce must be funded on an equal basis so that hospital and community midwives can continue to provide 24 hour cover and back-up emergency care for all women and babies in New Zealand.

Karen Guilliland is a midwife and Chief Executive of the New Zealand College of Midwives

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