Fears of midwife exodus
With the reopening of borders, Kiwi midwives are being lured across the Tasman, putting a workforce stretched by Covid-19 under pressure.
New Zealand College of Midwives chief executive Alison Eddy said pay and conditions were better in Australia, and she’d seen Australian advertisements ‘‘creeping through again’’.
‘‘It’s clear that recruitment has begun.’’ Eddy said the workforce had already been suffering staffing shortages prior to the pandemic.
Whether midwives headed abroad or not might depend on their life situation – for instance in the case of younger midwives without commitments, or older midwives whose children had grown up.
‘‘It’s difficult to quantify, but we have a sense that people have been waiting.’’
Eddy said that before the pandemic hit, some midwives went back and forth for short-term contracts between Australia and New Zealand, retaining a practising certificate here and doing casual shifts with district health boards. ‘‘We can’t stop it obviously,’’ she said. ‘‘What we would like to see is equivalent pay and working conditions here, so midwives aren’t being motivated because of pay.’’
Sian Redman has been working as a midwife in Nelson for six years now. She went back to work in April after spending eight months working in Australia.
Redman said the continuity of care model in New Zealand was good for women and for midwives, but it was a ‘‘heavy load’’.
‘‘It’s a great system but it’s not a very sustainable way to work,’’ she said.
‘‘You might be absolutely at the end of your tether having been at a birth for 40 hours, up for 40 hours and the phone might ring, and you still have to go. It’s just the relentlessness of it.’’
In Australia, however, midwives work in established teams meaning – ‘‘you have got someone to hand over to all the time’’.
Redman said this weekend she was going to be off-call, and if one of the pregnant women in her care gave birth, the midwife covering her would not be paid for that – and vice versa.
While the pay was better in Australia, it was improving in New Zealand, she said.
While midwives from other countries were expressing interest in working here, the Royal College of Midwives would like to see more ‘‘homegrown’’ midwives in the workforce, because overseas midwives tended to ‘‘come and go’’.
‘‘New Zealand-educated midwives stay here and make the most contribution to our health system, and that’s what we really want to encourage.’’
Kiwi midwives had reported that the work here was ‘‘more satisfying’’ for them, there was a higher level of autonomy, and the culture they were working within was one that’s familiar to them.
Working conditions had been challenging because of the pandemic.
As an essential service, they had to work across all level changes and traffic light settings, and because of the physical nature of the job, couldn’t retrench to online services. Wearing PPE in a close environment with labouring women for ‘‘hours on end’’ made it ‘‘difficult to use facial expressions to communicate with them in the same way’’.
Eddy said they’d seen a level of stress in the community because of Covid-19.
‘‘Women were very anxious and needing a lot of reassurance and wanting to avoid hospitals, so we saw a lot of that care shifting into the community.’’
It was difficult to quantify the extent of the workforce leaving, as there were midwives who retained their practising certificate in New Zealand, so it appeared they were in the workforce here, she said.
A Marlborough midwife, who did not want to be named, said she hadn’t had a day off since November. ‘‘We’re really short of midwives ... we’ve got a lot of older staff who will be leaving. They are recruiting, but it’s taking time,’’ she said.
‘‘When people are sick we’ve got no-one to replace them.’’
Midwifery Council chief executive and registrar Dr Susan Calvert said registrations were up for Internationally Qualified Midwives coming to New Zealand. She said there had been 54 this year, and registrations were ‘‘ up across the board’’, including recent New Zealand graduates.
Last year Nelson Marlborough Health nursing and midwifery director Pamela Kiesanowski said Nelson was experiencing the biggest shortfall of midwives in 20 years.
The 2021 Midwifery Council workforce survey showed that of New Zealand’s 3283 midwives, 467 identified as British/Irish, 136 as Asian, and 44 as Pacific peoples. The average age of midwives was 47. Six men practised as midwives and one individual who identified as gender diverse.
Redman said she loved working in New Zealand and she loved the model. ‘‘Working there [Australia] doesn’t fill my love cup as much,’’ she said.
‘‘What we would like to see is equivalent pay and working conditions here, so midwives aren’t being motivated because of pay.’’
Alison Eddy
New Zealand College of Midwives chief executive