Midwives are welcoming more ACC cover for maternal birth injuries but the sector says it's puzzled by news the government's Maternity Action Plan has also been updated, saying it's been kept secret for two years.
Proposed changes announced today will make up to 18,000 women a year who sustain birth injuries eligible for ACC cover.
Associate Health Minister Ayesha Verrall has also announced an updated Maternity Action Plan, from the Ministry of Health, will improve maternal mental health services and focus on maternity care to under served groups such as Māori and Pasifika.
The New Zealand College of Midwives chief executive Alison Eddy welcomed both announcements, saying expanded cover for birth injuries was much needed.
But she said the sector had not been able to see the finished Maternity Action Plan since it was first consulted about it in 2019.
"Minister Verrall has asked for the ministry to refocus more around some of the most strategic priorities of the government, particularly around an inequities. I think there's a number of things in there, but the sector is very interested in seeing the document because we understand it's been in place for a couple of years now, and we haven't actually seen a copy of it officially.
"It's a bit bizarre."
The college had not been consulted on the updated plan, Eddy said.
Verrall said the updated plan would be available online in the next few days.
"We have announced and completed, or are progressing, all of the things in the original Maternity Action Plan - which we engaged with the sector on.
"Budget 2020 allocated $35 million over four years to implement the Maternity Action Plan. So far, around $22m has been committed to continue or expand existing initiatives and to stabilise the midwifery workforce.
"We've set some priorities for the remaining funds, which are guided by recommendations from the Perinatal and Maternal Mortality Review Committee, and ensure a focus on equity. We know that to address persistent inequities in the maternity sector, the health system must work in partnership with Māori, Pacific peoples, and other disadvantaged groups.
"We are committed to ongoing engagement and consultation with the maternity sector."
In a statement today she said the plan was being updated as part of the government's commitment to and delivery on improving wellbeing and safety throughout pregnancy.
"Budget 2020 saw a significant increase in funding for the maternity sector with a further $180m of new spend. That included $35m to progress initiatives in the Maternity Action Plan, and deliver high quality, safe and equitable maternity services for everyone," Verrall said.
"Progress so far includes moves to strengthen the Maternity Quality and Safety Programmes in every district health board, changes to how midwives working in the community are funded, and the introduction of clinical coaches to provide additional support for DHB midwives.
"But there is more to do. Work is underway to improve maternal mental health services, including developing a bereavement pathway to better support whānau experiencing the loss of a baby.
"For too long the system has not delivered for Māori, Pasifika and those with complex clinical or social needs. We have refocused the Maternity Action Plan, to build on what's been achieved, while addressing inequalities that persist in the system.
"This new focus will ensure that as we prepare for the health system reforms, our maternity services better meet the Crown's Te Tiriti o Waitangi obligations and provide equitable outcomes for whānau Māori, Pacific peoples and other populations who are disadvantaged," Verrall said.
Eddy fully supported the changes to ACC to allow more cover for maternal birth injuries. "It's really gratifying to see that the minister and the government have listened to the feedback from the sector.
"We are very pleased to see that our feedback, along with that from many others in the sector, was taken seriously and ACC's approach to this category will be reviewed. It is our view that every institution operating within the health sector has a responsibility to ensure barriers to health care are reduced, and maternity care should be no exception to this.
"Whilst severe birth-related injury affects only a very small percentage of wāhine in Aotearoa, the trauma extends beyond the physical, and these wāhine/whānau need support to easily access the services that will enable the shortest route to recovery.
"The extension of ACC cover to include a broader and less severe range of birth-related injuries means wāhine no longer need to waste time and energy battling the system to get the care they deserve."
National Party ACC spokesperson Simon Watts agreed the changes were "sensible."
"We're pleased to see they've done the sensible thing to cover these injuries. Birth injuries affect many women, between 17,000 to 18,000 a year, and that can be debilitating. They should be able to expect to cover for ACC when they're injured just like every other New Zealander."
My Birth Story founder Kate Hicks, who runs a charity providing information about birth trauma, said the changes would help many women, but she wanted to see all birth trauma covered.
"We need to ensure assistance for all injury and particularly psychological trauma that arises from childbirth. Caring for the body but not the mind is only a battle half won."