CRYING SHAME
Her son spent the whole night wailing but hospital staff were too busy to realise he was starving. Michelle Duff reports.
Newborns suffer in midwife shortage
In the early hours of the morning, Aimee Alexander had never felt so alone. She looked down at her newborn son, who had been bawling for hours. No-one in the hospital had enough time to help.
Her son’s birth the night before seemed like nothing compared with this fresh hell.
As midnight approached, Alexander became concerned. ‘‘He was crying a lot, and I would try to feed him but I didn’t know what I was doing. He was just screaming and screaming; I buzzed a midwife and no-one came.’’
At 2am, she tried again. A midwife ran into her room, where Alexander and her son were both in tears. ‘‘I was just bawling, and I said ‘I can’t make him stop crying’.’’
The midwife turned off Alexander’s buzzer and left. At 4am, she buzzed again, pleading for help – it did not come.
To a new parent, every second their baby cries can stretch interminably. A minute feels like an hour. By 8am – on day two of her son’s life – Alexander was a wreck.
When staff at Auckland’s National Women’s Hospital checked her son, he had lost 15 per cent of his body weight. He had been crying all night because he was starving – in hospital.
‘‘They said ‘he’s severely dehydrated’. I was like: ‘You could have checked on him, you could have told me.’ I just felt so guilty,’’ says Alexander, who gave birth to her son in January 2017.
‘‘I was a new mum, I didn’t know what I was doing. It would have taken five minutes for someone to say ‘this is really distressed crying’. You were just left to fend for yourself. I thought: ‘Are they understaffed, or is this an acceptable level of care?’ ’’
Internal documents released to Stuff , under the Official Information Act, show Auckland Women’s, Christchurch Women’s and Waitemata rank among the hospitals where staffing levels have been considered unsafe over the past year.
Former director general of health Chai Chuah was alerted to the current maternity crisis in February 2017, according to Waitemata District Health Board documents.
Auckland’s women’s hospital, which at its worst was down 26 midwives, considered its service during July and August to be at ‘‘significant risk’’. It is now short 12 midwives.
Shortages mean staff are often seconded from other wards. Over one June weekend, Christchurch Women’s twice escalated to ‘‘unsafe staffing’’ levels. Nurses on those shifts did not know how to look after newborns nor provide antenatal care. Also last year, Waitakere and North Shore hospitals received a combined 35 formal complaints from women who felt a lack of maternity staff had impacted their care. During this time, the two Waitemata DHB hospitals had 22 staff vacancies – a number it now says has dropped to four. The board declined to provide the content of these complaints.
But women spoken to by
Stuff said they felt unsupported during their deliveries; that hospital staff were too busy to help with basic baby care; and some were left traumatised.
‘‘I would ring the buzzer and a midwife would come and say ‘We’re too busy, we can’t stay with you at the moment’,’’ said Lucy Davies, 30, who gave birth to her son at Wellington Hospital in late 2015.
‘‘After my birth, I was high as a kite, off my face on morphine and exhausted. I fell asleep with my baby on my chest and was left like that for five or six hours. In hindsight, I realise how risky that could have been . . . I would have been safer at home, because at least someone would have been looking after us.’’
In January, Kerry Thomas, 41, who is the chairwoman of Te Awamutu Federated Farmers, gave birth to her daughter in Waikato Hospital. It is short 13 midwives.
The shared ward was so busy that Thomas was attending to fellow patients.
‘‘There were three other women in the room . . . I would help by getting one a drink of water or handing one her phone. Once I got taken out by pain . . . another woman was trying to help me.’’ T he Ministry of Health and the College of Midwives have been in a holding pattern since August 2016, as they try to reach an out-of-court settlement on a gender pay equity case. Yesterday, they released a statement saying the deal was being finalised.
While the claim did not directly affect hospital-employed midwives, College of Midwives chief executive Karen Guilliland said it would add to the value and sustainability of midwifery as a profession and arm the Midwifery Union for its own pay equity case.
Meanwhile, babies keep being born. Each year, some 60,000 newborns require adequate care, and staff working on the frontline say this is not always the case.
‘‘You wonder to yourself ‘Is it actually safe to leave a mother who is on morphine holding her baby?’ ’’ said one Auckland midwife, who has since left the profession because of stress.
‘‘The answer is no but you have to . . . what new mother in pain wants her baby crying in the cot because there is no-one to help her?’’
Community midwife Aimee Jones worked at National Women’s for three years before leaving four years ago. Now she frequently attends deliveries at the hospital.
‘‘It’s always been ‘there’s no staff’. The midwives that work there are amazing, they give good quality care but are spread too thin. You couldn’t pay me enough to go back to that . . . it’s toxic.’’
For pregnant women, this can mean lengthy waits on the birthing ward before they are assessed, or long labours that end with a caesarean section that might have been avoided. ‘‘This makes a situation which is intense for them anyway much more frustrating. That’s one way in which we’re failing women.’’
National Maternity Monitoring Group chairman John Tait said maternity wards needed to be treated like emergency wards, and staffed that way.
‘‘We need enough postnatal staff so that women feel comfortable when they go home about breastfeeding and caring for the baby,’’ said Tait, who is also an obstetrician at Wellington Hospital.
Currently, the ‘‘niceties’’ of maternity care are missed out. ‘‘The emergency stuff is done really well but the postnatal care is perhaps not as good as it should be, in terms of things like breastfeeding help and avoiding maternal distress, because the staff are not there.
‘‘This is one of the things we keep pushing – if we can get maternity services working well . . . the benefits for society down the track would be immense.’’
Stuff repeatedly requested an interview with Auckland DHB’s director of women’s health, Dr Sue Fleming. She has since retired.
In a statement, Auckland DHB said the public could have confidence in the service it provided to mothers and babies. ‘‘Like all maternity services in New Zealand, Auckland DHB has been impacted by the global shortage of midwives. This shortage . . . has been a focus for our leadership for over a year.’’
It had apologised to Alexander for her care, following her April 2017 complaint.
Capital and Coast District Health Board said Wellington Hospital’s maternity ward was fully staffed.