5 Sep 2019

More Māori midwives needed to handle rising demand

12:08 pm on 5 September 2019

Māori midwives are too few and spread too thin across the country to handle rising Māori birth rates, and say a workforce strategy is desperately needed.

baby in flax sleeping pod

Photo: Whakawhetū

Nga Maia, an organisation for Māori midwives, said there has been no Māori workforce strategy for the last two decades. It said only 9 percent of all midwives were Māori, despite Māori babies making up over 20 percent of those born every year.

In some areas there were few midwives at all - let alone Māori midwives - and those who were practicing had waitlists of up to five months and were having to turn down whānau, it said.

When Kymberlee Maxwell, from Ngāi Tai, found out she was four months pregnant in February, she knew she wanted a Māori midwife who had the same values and worldview as she and her partner.

"We wanted to say a karakia, to have waiata, when baby came out. We wanted to tie his pito with muka and we wanted to keep his whenua to be buried at our papa kāinga- things we knew that a Māori midwife would already know and automatically lean towards."

She was given a list of all the Māori midwives in Tāmaki - only about a dozen - and tried every single one, including some outside of the region, but none were available.

She was told by the very apologetic Māori midwives that they were fully booked, and to secure a place she would need to book at least months in advance.

In the end, she found a Pākehā midwife who by chance understood the type of birth she wanted.

"Our midwife definitely was culturally competent - although to be honest she was pretty much the only home birth midwife available so I had zero choice in who I got - but she just turned out to be perfect and I think we were just lucky in that sense because I don't think all non-Māori midwives would be as competent as she was."

New Zealand College of Midwives president Nicole Pihema, who is also a practicing lead maternity carer in Te Tai Tokerau, said she's had to turn down two whānau Māori in the past week alone.

She said the shortage of midwives was particularly bad in places like Taranaki, Te Wai Pounamu and Tāmaki, and midwives were having to drive long distances to meet the needs of their communities.

"That puts a lot of pressure on not just whānau but the midwife particularly around the post-natal care so you're having to do a lot of travel post-natally and even antenatally to be able to access care to Māori midwives.

"Even though we're already short on the ground, those resources are stretched even further [by] the time taken to be able to provide that care."

"We have a colleague, Corrina, who lives on the East Coast and she travels significant distances just to see whānau so they have access to not just a Māori midwife, but a midwife, otherwise there would be no one else there. She's all on her own."

Mahia Winder, a midwife currently working at AUT, said the Auckland and Counties-Manukau DHBs were trying to recruit more Māori - but it should be a directive from the Ministry of Health.

It also needed to retain existing midwives, with many of her colleagues leaving the profession.

"A lot of them have come up against institutional racism and they're sick of fighting it... I know a few that say, no, they won't go back - into hospitals that is - and a lot of them have had enough of the nonsense really, just a few of us are holding on, holding on, holding on."

Nga Maia chairperson Beverly Te Huia said a workforce strategy for Māori midwives was desperately needed, and the Ministry of Health needed to step up.

"Our Ministry of Health have a responsibility to be meeting our needs as Māori but it needs to be done in the context of the Tiriti, in partnership with Māori who have some answers."

The Ministry of Health said in a statement that its Maternity Action Plan had "specific actions" relating to increasing the Māori midwifery workforce, but did not say what those actions were.

It also said that as part of this years' Budget, Māori health undergraduate students would be supported with a $10 million fund over four years which would provide them with wraparound services.

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