Birth unit’s partial closure temporary
The woman who set up Palmerston North’s Te Papaioea primary birthing facility, Chloe Wright, is disappointed women are being deprived of the opportunity to stay there for post-natal care.
But she is adamant the Midcentral District Health Board, which took over its management last year, is not to blame.
The board expected midwives would be happy to rotate their shifts through Palmerston North Hospital and the 12-suite Te Papaioea, but instead, it struggled to retain staff.
The plan was that women who gave birth at the hospital, as well as those who birthed at Te Papaioea, would enjoy their two days’ postnatal care at the modern unit.
But by this week the board was unable to safely staff both facilities, and it brought midwives back into the hospital and cut staffing back to 8am to 4pm shifts only on weekdays at Te Papaioea.
Wright said she was distressed to see the public backlash against the board.
She said the board had been genuine in its efforts to provide goldstandard care for mothers.
Wright had written to Health Minister Andrew Little requesting a shake up in the way maternity services were paid for, that gave women the power of choice.
For the moment, she said the board had to maintain the hospital-based maternity unit as a priority for safety.
‘‘However, yet again, our mothers are left to suffer.
‘‘It is intolerable.’’ Mothers had a legal right to expect at least 48 hours of postnatal care at a facility of their choice, she said. Community-based midwives working as lead maternity carers were not so sympathetic towards the board.
College of Midwives regional chairwoman Amanda Douglas and colleague Nicky Hamdi-Pacha said the board had not listened to midwives.
The problem was not a midwifery shortage, but that the board could not retain midwives, at least in part because they did not want to work across primary and secondary settings, they said. The women said 60 to 80 per cent of mothers giving birth were well women, and they achieved the best outcomes if they were able to labour, give birth and have their 48-hour postnatal care outside hospital.
Now that choice had been taken away.
They said they would still assist women through labour and birth at Te Papaioea if that was what they chose, but for the majority of babies, which arrived outside the hours of 8am to 4pm, they would need to bring a midwife colleague as well for safety.
They were also concerned that the board had moved its high-risk antenatal clinic to Te Papaioea.
‘‘They have done nothing but bring the hospital across the road.’’
Midwives’ union Meras joint leader Caroline Conroy said the board had made the best decision it could given its ‘‘dire straits’’ with staffing.
At least nine senior midwives had left in the past six months alone.
At least it had kept the primary birthing unit accessible to avoid all mothers having to go to the hospital, Conroy said.
She agreed part of the problem had been forcing midwives to work across secondary and primary care settings, when many preferred one or the other.
Some boards offered the choice, but Midcentral was an outlier in requiring it.
Conroy was optimistic the board managers and midwives had reached a turning point in relationships, and that the partial closure of Te Papaioea would be temporary.
Wright said she wished everyone could work together in a collegial way to provide the best choices for women.
She said it was proven that mothers and babies who received good care enjoyed the benefits for many years.
‘‘Midcentral DHB have been leaders in the field of care for mothers and cannot be solely held responsible for the regrettable temporary loss of staff to support mums.’’