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It was disappointing that the balance in the article about research showing poorer birth outcomes for women enrolled with midwives than those who booked with a doctor (“Birth control”, October 8) wasn’t reflected in the magazine’s cover. The cover carried claims that very possibly would alarm women and families expecting babies.

Your readers may have missed that the study confirmed rates of adverse birth outcomes in New Zealand are low and comparable to similar countries such as Australia and the UK. Too little weight was given to the fact that New Zealand’s maternity system has low levels of adverse outcomes overall. It’s worth repeating the quote from Ellie Wernham, one of the study authors, that the research should be used as “a stepping stone to strengthening our maternity system”. That’s what we’re going to do.

We have a quality improvement programme already built into our maternity system, and the Ministry of Health has turned for advice to the national monitoring group for maternity services to advise us on the next steps we should consider as a result of this research. This group consists of clinical sector experts covering areas such as midwifery, obstetrics, clinical research, primary care, obstetric radiology, neonatal paediatrics and a consumer representative.

The monitoring group is helping us ensure we improve on our high-quality maternity system. We will use this research to help us do even better.

Bronwen Pelvin and Dr Pat Tuohy

Principal adviser maternity and chief adviser child and youth health, respectively, Ministry of Health

(Wellington)

It should be remembered that midwife-doctor conflict has existed for centuries. In the Middle Ages, midwives were suspect because only God could cure the unwell; those healers supporting birthing mothers were seen as handmaidens of Satan.

Physicians joined the scene in the courts of medieval Europe after midwives had already been practising for centuries and held the health wisdom of antiquity. Conflict between doctor and midwife had its beginning. During the 16th- and 17th-century witchcraft trials, many midwives were burnt at the stake, erasing centuries of wisdom.

It was in the 1800s that Hungarian Dr Ignaz Semmelweis noticed that wards run by midwives with established handwashing practices had lower death rates than obstetricians’ wards. Let’s not forget what wonderful progress has followed. Physicians and midwives now work together and provide more safe birthing options for women.

Caroline Mabry (Glen Eden, Auckland)

It was sad and disappointing to see how the maternity care study was reported by the Listener. The cover lines – “Alarming maternity research”, “Where the revolution went wrong” and “The dangers of midwives in charge” – implied that readers would find inside an article proving that our maternity care system was broken. But they would not because the article promoted on the Listener cover did not show that; it couldn’t because the maternity system is not broken.

We believe there are data and interpretation issues with the research that have been compounded by the media. Our views are supported by academics and practitioners here and overseas.

Imagine the distress a pregnant woman would feel coming across the magazine on the newsstand. Imagine the distress of midwives caring for such a woman. Imagine, also, the confusion among readers when the opening paragraphs of the article stated that no one wants to throw out the reforms that led to today’s maternity care system. Even the lead researcher confirms that “adverse outcomes are rare”.

The article was unbalanced, inadequately researched and gave undue weight to a study that had major limitations.

The concern generated by

the publicity surrounding the research prompted the Ministry of Health to join the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and the New Zealand College of Midwives to assure women that the maternity system is robust.

New Zealand’s maternity care system is admired internationally and overall we are achieving the best outcomes ever for mothers and babies.

Deb Pittam

President, New Zealand College of Midwives

(Wellington)

We stand by our coverage of the research and the surrounding issues. We believe New Zealand women have a right to informed consent and it is the role of the media to draw attention to important evidence-based research in a compelling and accessible manner. Our coverage was fair and balanced and in no way sensationalist. We chose not, for example, to include the report by the Health and Disability Commissioner – released in the same week our article was published – that is highly critical of a midwife’s care of a woman whose child was born dead after the baby’s heart stopped during labour. We did not state the system is “broken” but, rather, suggested that it has shortcomings, as it assuredly has. – Editor.

SOMME RECOLLECTION

The man pictured with a pack mule on page 16 of the story about Passchendaele (“Nothing but utter desolation”, October 8) could well be my father, Burton, who worked horses for the artillery. I once asked him about the Somme. He said, “Oh my God”, and went into a far-away look that was all he told me about the war.

Thirty-five years ago, I was on a train from Amsterdam to Paris. A man who spoke some English said to me, “You might be interested to know that is the Somme.”

An ordinary, placid creek, filthy water, not a fence in sight and perfect, deep long pasture on both sides. Nothing besides remains. I, too, said, “Oh my God.” I did remember to thank him. JR Murrell

971914 Gnr CMT (Manapouri)

BRASH TREATY TREATMENT

Don Brash focuses on just that one part of the Treaty of Waitangi (Article 3) that suits his ideological bias ( Life, October 15), choosing to ignore Articles 1 and 2, which give iwi and hapu chiefs ongoing decisionmaking preference in New Zealand’s governance.

Every social statistic belies Maori are privileged. White middle-class Pakeha are 65% of New Zealand’s population yet hold 98% of local government representation, revealing who are the real privileged. Generations of them have done very well out of iwi land confiscation and economic deprivation – including my own family.

If Brash cannot deal with the whole Treaty, he should butt out of Treaty discourse. Gary Clover (Richmond, Nelson)

SHARES VERSUS HOUSES

You knocked my socks off with “NZ stock exchange value

– $121 billion; rise in house values in a single year – $123 billion” ( Editorial, October 15). But you then went on to say that the problem is that the debt, saving and investment in housing are too large.

I think, oppositely, that the sharemarket is too small. It doesn’t provide a sensible option for diversification of saving and investment. How can it? We’re too small to have a viable sharemarket on our own (the NZX 50 has done relatively little since 1986).

To make the NZX a consumer-friendly saving and investment medium requires that we open it up internationally, which we can’t do with the current foreign investment fund (FIF) tax legislation, which discriminates against foreign financial investment.

We need to get rid of the

FIF tax and replace it with an across-the-board capital gains tax that exempts the first $500,000 of owner-occupied house value.

That aside, do we have enough saving and investment? The general economic wisdom is that there is too much saving in the world, and that it’s concentrated excessively in non-productive investments

– housing being one.

The general prescription is to channel savings into infrastructural investments (so-called “social overhead capital” – SOC). Some of this SOC investment could be financed through taxes (capital gains and more tax progressivity), but recourse to bonds (that is, more debt) is needed to put upwards pressure on interest rates. Higher interest rates would dampen house prices and make bonds and shares more attractive to savers.

John Key’s past suggests he’s aware of all this, but as a politician he’s too timid to assert his fiscal authority. If he wants a fourth term, we should demand that he step up and get rid of the FIF tax, enact a “normal” capital gains tax and increase the progressivity of our income tax regime. In fact, I’d include a negative income tax bracket for those with too low an income.

Robert Myers (Auckland Central) GERMAN MULTICULTURALISM

Cathrin Schaer’s column ( Bulletin, October 15) about German attitudes towards refugees should not go unchallenged. I was born and lived in Berlin and have just come back from a two-month visit. Schaer’s assertion that Germans expect an AfricanAmerican (why American?) to give up his seat on a train is pure fiction.

Yes, sometimes a young person of varying ethnic background offers me a seat, but I am certain that this is because of my advanced age, not my Aryan appearance.

The Alternative für Deutschland (AfD) party was founded in 2013, before refugees became an issue. It opposed the euro and the EU after it had become clear that German taxpayers had to bail out their spendthrift southern neighbours. Admittedly, by now this party has attracted every disaffected misfit, particularly in the former East.

They would vote Donald Trump for Chancellor any time.

Yes, there is sentiment against multiculturalism when migrant men treat their girls and women as second-class humans; or when swaggering young machos mentally undress any woman with a short skirt because she is a “whore”.

But Schaer insults the hundreds of thousands of Germans who donated clothing, toys and food for the refugees, and the tens of thousands who still volunteer to give free language lessons and help the refugees settle in a strange country. The Germans are not doing as badly as Schaer would have us believe. Peter Kammler (Warkworth)