Con­cern over ru­ral ma­ter­nity ser­vices

South Waikato News - - Your Paper, Your Place - MAR­GARET PITTAWAY

RWNZ con­cerned for eq­uity of ma­ter­nity ser­vices in ru­ral ar­eas.

Ma­ter­nity ser­vices have come un­der the spot­light with the an­nounce­ment that an anony­mous group of mid­wives has sent a com­plaint al­leg­ing that mid­wifery is at a cri­sis point to the Health and Dis­abil­ity Com­mis­sioner.

The let­ter is now be­ing han­dled by the Min­istry of Health. While the con­tents of the 33-page let­ter are not known to the pub­lic, Ru­ral Women New Zealand (RWNZ) has con­cerns in two ar­eas.

This let­ter comes at a time when smaller ma­ter­nity units are be­ing threat­ened by clo­sure, mean­ing that women liv­ing in ru­ral ar­eas will no longer have a choice in where they give birth and will have to go to larger ur­ban ar­eas away from home and fam­ily. RWNZ can name ma­ter­nity hos­pi­tals in Te Anau, Lums­den and Tu­tat­a­pere in the South Is­land and Te Kuiti in the North that are cur­rently un­der threat of clo­sure.

Gov­ern­ment and DHB’S will claim that the ser­vices are be­ing un­der-used, but the re­al­ity for newly preg­nant women when they must make a choice about where they will give birth, is that the un­cer­tainty of a smaller hos­pi­tal’s fu­ture leaves them with no choice than to go to an ur­ban area.

Ru­ral women are al­ready at a dis­ad­van­tage with their ma­ter­nity care.

Dur­ing the first three months of preg­nancy, the mid­wife and the mother must come to an agree­ment over the num­ber of vis­its made at home once the baby has been born.

It is ap­pre­ci­ated that dis­tance and time for mid­wives to travel to ru­ral ar­eas is an is­sue and that the seven, or more home vis­its are un­likely to hap­pen with the cur­rent level of rec­om­pense that mid­wives re­ceive.

Most will agree to one visit with the ex­pec­ta­tion that the mother will then be able to travel to a clinic for the af­ter­care that they are en­ti­tled to.

In most cases, the ar­range­ment works un­less the new mother has had a cae­sarean birth and is un­able to drive for six weeks.

Not only is she de­prived of es­sen­tial af­ter­care, in some cases they can be iso­lated from other sup­port ser­vices and fam­ily.

There may be fur­ther is­sues when the new mother is a mi­grant worker, or English is a sec­ond lan­guage, or where there is a vari­able in­come.

The de­mands of sea­sonal farm work will of­ten play their part too, and it is not al­ways pos­si­ble for a farmer to stop work over the six week pe­riod of mid­wife af­ter­care to trans­port the new mother and baby to ap­point­ments.

Gov­ern­ment and DHB’S need to ac­cept re­spon­si­bil­ity for op­ti­mum care for new moth­ers and ba­bies at a time in life when the need for guid­ance and ad­vice is cru­cial.

The early days of a baby’s life and the abil­ity of the mother to adapt and cope with new de­mands are cru­cial for the fu­ture health of the baby.

Care de­liv­ered at this early stage is an in­vest­ment in the life­time health of a child.

What­ever the out­come from the let­ter the mid­wives have sent, it will be founded on gen­uine deep con­cern for the health of mother and ba­bies, and Ru­ral Women New Zealand is hope­ful that their con­cerns will be con­sid­ered with that knowl­edge in mind.

Ru­ral Women New Zealand be­lieves that all women re­gard­less of their ge­o­graph­i­cal lo­ca­tion de­serve eq­uity of ma­ter­nity ser­vices.

123RF

Ru­ral ma­ter­nity ser­vices are un­der re­view.

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