Midwives taking part in strike action later this month say the District Health Boards' offer does not reflect how qualified they are or how much responsibility they have.
The midwives have rejected the latest pay offer and yesterday gave notice that they will strike for two hours, up to twice a day, every day for two weeks from 22 November.
They turned down a 9 percent pay rise over 18 months, two pay step increases and a lump-sum payment, saying they want differentiation from nurses.
Eighty percent of the Midwifery Employee Representation and Advisory Services, or MERAS, members voted in the ballot, 90 percent of which voted to reject the offer and strike.
One of the union's negotiators is Caroline Conroy, a part-time midwife in Auckland who has been in the profession for 30 years.
She told Morning Report midwifery was a separate profession, with different skills and responsibilities, which deserved higher rates of pay.
But DHB midwives were expected to accept the same agreement as the Nurses Organisation (NZNO), she said.
"They negotiate with NZNO and then just offer us what they offered and expect us to roll over and take it and we've not been any part of those negotiations," she said.
"We've been very clear from the start of the negotiations, that we wanted a pay difference from nursing.
Midwives' roles in clinics, assessments, and ante- and post-natal care were not well understood by people outside of the maternity sector, she added.
Ms Conroy said the strikes were designed to cause maximum disruption to the District Health Boards (DHB) with minimum impact on women and babies.
The strikes would mean it was likely that clinics and elected procedures such as caesarians would be delayed, but the safety of women and babies would not be compromised, she said.
By law the midwifes have to provide life-preserving services, which means that if women need care or services during the hours of strikes, they will get it.
She said the strike action was not just about conditions, it was about pay and recognition.
Midwifes have to study for four years, a year longer than nurses, and have more responsibility which Ms Conroy said was not recognised in the pay rates.
"Women can be pregnant and come into the hospital ... be cared for by midwives, go home and never once need to see a doctor, none of that responsibility or those skills are currently recognised in the current pay scale," she said.
Michelle Archer has been a midwife since 2002, works for a DHB and is also one of the negotiators.
Mrs Archer said midwives were leaving the profession because they could do jobs with better pay and less responsibility and midwives were burning out.
For the first time in Dunedin - which has a midwifery training school - there was a struggle to get midwives, she said.
There weren't a lot of leadership positions to go to for midwives, so many were practising at the highest level they could for years, and their pay plateaus around the mid-60s, she said.
The needs of the women they were looking after were becoming greater and midwives workloads have got bigger, but that has not been reflected in the pay, she said.
"There's been more responsibilities added on to us but the pay's stayed exactly the same and I've just seen the stress and the burn out of midwives since I've been a midwife and it's at crisis level now."
The DHB said it was still hoping to avert strike action from midwives.
It said the biggest focus for the DHBs would be on ensuring women and babies were safe during this period of strike action.