The tough reality of midwives
For those who help bring new life into the world, stress is high and money low but they ‘‘do it for the love of it’’ – however, the reality for community-based midwives is that the love is beginning to wear thin.
For Bridget Kerkin, words fail when it comes to describing the responsibility and emotional weight of being a midwife, a role she’s had for more than 20 years, but when it comes to the pay and conditions, she has plenty to say.
Spurred on by seeing their fellow midwives reluctantly leave the profession as well as media coverage of midwifery issues around the country – particularly in the Hutt Valley – Kerkin and others wanted to make their voices heard for the sake of the profession’s future.
‘‘I think our passion at times has been used against us in the way we are paid.’’
The pay structure for New Zealand midwives is a complicated one, with two distinctly different groups – those based in a hospital working for, and paid by, a DHB; and those working in the community, paid by the Ministry of Health.
While neither system is seen as perfect, it’s the latter that has drawn recent criticism, particularly from the Wellington branch of the New Zealand College of Midwives.
For each woman they worked with, a community-based midwife gets a certain amount of money for antenatal care, another amount for the birth and finally one more payment for postnatal care. Under the current structure, ‘‘the money was all in the birth’’.
That meant, especially for midwives working in rural areas, that the job had become – or was becoming – unsustainable, Wellington chair Siobhan Connor said.
‘‘These women are getting care rurally thanks to [midwives’] partners who are earning reasonable money to support them to do their job, the one they love.’’
The fixed fees, set by the Ministry, were not up for negotiation regardless of the complexity involved with a pregnancy or the travel time required to care for a woman.
Midwifery forums were littered
with concerning stories from midwives, with one speaking of doing 250 kilometres of driving over seven visits to a woman living rurally – she earned just $200.
In the past two years, an
estimated two-thirds of the community midwife workforce in Hutt Valley had chosen to leave the profession, with fears the number could drop below 20 by the end of the year.
Burnout, financial instability and ‘‘a lack of professional respect’’ were all factors, midwife Sarah Gilbertson said.
‘‘I spoke with a midwife yesterday who has resigned as an LMC [lead maternity carer], and she said ‘I’ve had to let go of the job I love’ because she just can’t keep going.’’
The woman, who marched on Parliament, when midwives gathered to make an impassioned plea for pay equity had been ‘‘hanging on by a thread’’, Gilbertson said.
‘‘This is us voting with our feet. It’s not rocket science; improve the pay and conditions and we’ll come back to work.’’
Having already worked with the Ministry of Health in a mediated, legally binding manner to reach an agreement, community midwives were at a loss as to why the new system had yet to be implemented.
‘‘The delay and wasted public money going over the same ground needs to stop. A solution was worked on, our job has been ‘scoped’. Pay equity must be fasttracked,’’ Gilbertson said.
Mother-of-three Karen Gault saw her role as someone to champion midwives in their fight for better pay and conditions.
‘‘I think our passion at times has been used against us in the way we are paid.’’ Bridget Kerkin Midwife