16 Feb 2021

Capital's hospital maternity service stretched 'paper thin': Midwives Union

From Nine To Noon, 9:30 am on 16 February 2021

A serious shortage of midwives at Capital and Coast DHB has seen the maternity service go into "code black" three times recently - meaning it reached capacity.

A midwife working at Wellington hospital described a shift just two nights ago where one midwife had to provide care for five women - one in active labour, another who had had a neo-natal death overnight, plus three antenatal women.

In a letter to DHB management they describe the current situation as "unsafe" with staff stretched "paper thin". Midwives at the hospital describe routinely being called in early, working late, and missing meal breaks. Nine to Noon understands three midwives recently resigned from the DHB.

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Photo: 123RF

Caroline Conroy, co-leader of the midwives union Meras, tells Kathryn Ryan there’s been a shortage of midwives in New Zealand for some time and the workloads in maternity can be highly unpredictable.

“You just can’t predict when women are going to go into labour or need care, so staffing for that need is challenging at the best of times. When you’ve got staffing shortages or peaks in workload, it makes it even more challenging.”

She says the new colour coding system was introduced by the DHB and has been helpful in revealing staffing deficiencies, particularly as code red and code black are reported to the executive leadership team and board.

“There’s much better coordination and much better awareness now when those situations arise. They’ve probably always arisen at times, but now we’re able to actually keep track of them and they get reported monthly.”

However, being in the midst of a code black is an incredibly stressful experience for staff on shift.

“You can’t close the door for maternity service. Women will continue to come in in labour or with concerns around their pregnancy and the staff put all hands to deck to make sure safe care is provided.”

She says relying on international recruitment to cover the midwife shortage is not a good long-term solution.

“We’re looking at a whole pipeline; do we have sufficient people coming through schools of midwifery, how well do we support student midwives – we know that there are real challenges for women who are doing the midwifery programme.

“We also want increased support for graduate midwives and we need some initiatives to retain our experienced midwifery workforce. There are some incredibly experienced midwives within the DHB that really hold the system together, but they need to be acknowledged and rewarded.

Meras has just started its negotiations for its next collective agreement and are looking for a retention allowance which is initiated when there’s a high vacancy rate.

“It rewards midwives who are working in that situation until that situation improves, it’s almost like a little acknowledgement for those midwives.”

Conroy says she’s requested more information on whether there’s been a baby boom due to the Covid-19 lockdown and says the DHB could be experiencing the tail end of such a boom.

“The other DHBs have seen an increase in workload over January and February, it varies around the country, but that could be one factor.”