Ma¯ori and Pasifika are ‘definitely

Ma¯ori and Pacific women are disproportionately being denied the chance to have a family, with the system used to determined access to free fertility treatment labelled ‘‘unfounded and unfair’’.

The fixed body mass index (BMI), which creates a score looking at a person’s weight with respect to their height, is used to classify people underweight, normal, overweight or obese. The Ministry of Health describes the BMI as a ‘‘crudemeasure’’, but still uses it to determine access to care, including fertility treatment.

To get publicly funded fertility treatment, a woman must have a BMI of 32 or under. Those with a score of 30 and above are classified as obese, and at ‘‘substantially increased risk’’, the ministry said.

Because the scale has been modelled on European body types, it doesn’t account for differences in body composition seen in diverse populations. An Otago University study said BMI was ‘‘likely to be an inconsistent measure of obesity in Ma¯ori and Pacific patients’’.

Fertility New Zealand president and chair Juanita Copeland believed using BMI to determine who can access free treatment ‘‘definitely disadvantagesMa¯ori and Pacific people’’.

The organisation has called for the threshold to be raised to 35. ‘‘The BMI system is not a fair one and would certainly stop some people seeking the treatment they deserve out of fear of judgment, whakama¯ or being made to feel their infertility is their fault.

‘‘While lifestyle factors do impact fertility, we believe that the current BMI requirement is unfounded and unfair, especially to Ma¯ori and Pasifika populations and is not always the sole contributing factor to infertility,’’ Copeland said.

Ma¯ori woman Rachel Leafa, 25, of Whanga¯rei, has spent the past six years trying to get pregnant with her Samoan husband Elijah. With her BMI at 43.4, she was constantly told to lose weight.

She managed to get her BMI under 30 over seven months and recently started publicly-funded invitro fertilisation (IVF). However, the process has taken its toll, with her menstrual cycles ceasing as she battled to drop her weight.

Despite making her feel good, Leafa said she stopped exercising because adding muscle saw her BMI increase, and now followed a

Rachel Leafa spent seven months trying to lose enough weight, so she and her husband Elijah could be considered for public fertility treatment. Women must have a body mass index of 32 or less to be eligible.