18 Oct 2017

Auckland Hospital staff shortage hits midwives

9:14 am on 18 October 2017

Chronic staff shortages are resulting in a lack of adequate care at Auckland City Hospital, a woman who gave birth there this year says.

A photo of a newborn baby's feet

Photo: 123RF

Earlier this year a quarter of full-time midwife positions at the hospital's maternity ward were vacant, and even now one in eight roles remain unfilled.

The woman, who wanted to remain anonymous, said her birth was delayed because there were not enough midwives, she had to wait hours for pain relief, and it was clear the midwives were stretched and over-worked.

"I was induced because my baby stopped growing, but then I was told I couldn't deliver that night because while there were enough rooms there were not enough midwives," she said.

"I felt helpless. As the more time went on the more danger my baby was in," she said.

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After giving birth she was in hospital for a week because her baby was small. During her stay things got harder by the day.

"We had multiple problems feeding our baby and getting her to gain weight - so we basically always needed assistance but we never knew when that was going to come because there were so few midwives."

After five days she asked to talk to management, but it became clear her concerns were one of a list of many, she said.

"We felt pretty desperate in the end. To be honest, we just couldn't rely on the help.

"When it came it was fantastic, the midwives there do a great job, they are passionate, but just waiting for them to come put us under enormous stress."

She said midwives had told her if they complained about their working conditions to management they would get into trouble.

Midwives concerned

Her independent midwife - who also wanted to remain anonymous - said conditions in the birthing unit were unsafe, and dire.

"There isn't enough midwives, there was a change in management and the new way things are done has made it a lot harder for the midwives and there has been a mass exit."

The midwife said she had to stay and induce a woman whose baby had not moved in two days, because there were not enough staff in the hospital.

"The state it is in makes me angry, because the intention of all midwives is to take care of women and give them the best possible experience but they're struggling to do that under the stretched conditions."

The hospital said it could not discuss individual cases.

However, the Director of Women's Health at the hospital Dr Sue Fleming said in a statement over the past five months they had invested in an extensive recruitment campaign to address the maternity workforce shortage.

Dr Fleming said the ward operated with 104 full-time midwives. Five months ago they had 26 vacancies but that had since reduced to 13.

"Patient safety is Auckland DHB's highest priority. We are proud of the excellent safety record of our Women's Health service, and the care our dedicated maternity staff provide to women and babies.

"We take the wellbeing of our staff extremely seriously and thank them for their dedication and professionalism throughout a period where we have not always had as many maternity staff as we would have liked," Dr Fleming said.

Although the hospital has a busy and demanding maternity service, staff provided an excellent standard of care, she said.

Bad experience 'not a one off' - College of Midwives

College of Midwives midwifery advisor Alison Eddy said it was sad to hear of another woman having such a distressing time.

"I don't think her case is unusual, sadly, I think we've been aware for some time that some of our tertiary hospitals are short of midwives.

"I think the thing that was really tragic about her situation as the emotional distress that she was feeling, I'm sure the midwives were feeling it too."

Ms Eddy said some areas were coping better with the midwife shortage than others, but Auckland was struggling to retain and recruit the numbers of midwives needed.

"We hear frequently that people leave and they are not replaced because there is a squeeze on recruitment so HR don't advertise positions until the shortage is there," she said.

"There are a lot of issues that could be addressed in the short term that I think would make a difference."

Hospitals needed to create good working environments for midwives to work in, with strong leadership so retention levels could increase, she said.

The Nurses Organisation said nurses and midwives working in larger District Health Boards were concerned about staff shortages, which put them under pressure.

The organisation said midwives and nurses are working in understaffed highly acute environments which is leading them to burn out.

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