Woman left to birth on side of the road
While the spotlight is on under-pressure hospitals, healthcare in our communities is also struggling. As part of Life Support, a week-long Stuff investigation into the state of our health system, Sophie Harris investigates reports of nursing and midwifery shortages.
Teresa Howell, 35, was 20 weeks pregnant with her second child when her midwife quit. ‘‘She was just absolutely overworked, and I think Covid just pushed her over the edge.’’
The only other midwife in her Coromandel hometown of Whangamatā was booked, the closest she could find was in Papamoa, two hours drive away on the southern side of Tauranga. Which left her unable to use her local birthing centre.
Instead, she booked in at the Bethlehem Birthing Centre, an hour’s drive away.
But on the night in March when she went into labour, the birthing centre was closed due to staffing shortages.
The couple tried to drive to Tauranga hospital, but there wasn’t enough time.
Howell gave birth in her car on the side of the road – her partner delivered their baby.
‘‘We were both in shock, it was quite surreal, I don’t think it was until after that we realised how scary it really was.’’
Months earlier, in August last year, Ren Finn, 34, also gave birth to her first child with no midwife present. Her partner, who had no medical training, delivered the baby.
The Hastings couple had planned for a home birth, but their midwife didn’t answer her phone, nor did the backup.
They kept calling, but by the time they realised she would not come, it was too late to go to the hospital. Their son arrived with the umbilical cord wrapped around his neck. He wasn’t breathing.
‘‘He seemed lifeless, he wasn’t opening his eyes.’’
As her partner revived their baby, Finn lay in the birthing pool bleeding heavily as she had torn during the birth.
‘‘It felt like I was dying. The pool was going down in temperature, I was going into what felt like shock, I couldn’t move, I couldn’t get out of the pool.’’
What happened to Howell and Finn was devastating, but it wasn’t rare.
New Zealand College of Midwives chief executive, Alison Eddy has been a midwife since 1996. She says the midwifery staffing crisis is the worst she has seen.
Shortages were chronic in both hospitals and in the community.
Midwifery Council data shows nearly 200 midwives have left since 2021. Aotearoa had 3273 practising midwives in 2021, that number dropped to 3085 this year.
Last year, Nelson Marlborough Health nursing and midwifery director Pamela Kiesanowski said Nelson was experiencing the greatest shortfall of midwives in 20 years while in June this year health chiefs reported maternity centres in Dunedin and Invercargill had fewer than half the staff they needed.
A Health New Zealand spokesperson said strengthening the maternity system and addressing midwife shortages were priorities for the health sector.
‘‘We’re very aware that some DHBs are carrying high numbers of midwifery vacancies and face challenges recruiting and retaining midwives to their workforce.’’
The spokesperson said recruitment campaigns to bolster the health workforce, including midwifery, were underway.
Where is the help after your baby is born?
‘‘Isolated there is really no other way to describe it,’’ says Auckland woman, Claire Edgington.
After the birth of her first baby she received little community healthcare. ‘‘I have never seen a Plunket nurse in my life.’’
We only received two phone calls, she says. She reached out to Plunket for mental health support, but was told it would be a three-week wait. No one followed up.
Edgington, whose baby was born five weeks before Auckland went into lockdown, said it felt like the needs of babies and new parents weren’t being prioritised.
For four months last year Whā nau Ā whina Plunket’s face-to-face services ceased in Auckland, due to a Covid-19 lockdown.
Plunket chief nurse Dr Zoë Tipa says it had been a challenging couple of years for everyone. They, too, had been impacted by nurse shortages, with currently 36 full-time nurse vacancies across the organisation.
NZNO kaiwhakahaere Kerri Nuku says the community nursing sector had struggled with Covid-19, understaffing and burn-out.
‘‘There is a lot of attention paid to hospitals, but a lot of the flow is reliant on how resourced primary community carers are.’’
Nuku says as EDs become overwhelmed, patients are diverted into the community, but the capacity to deal with them isn’t there.