Midwives call for better treatment
Midwifery is a profession characterised by dedication, but bad pay means more and more midwives have had enough.
into the ministry’s payment schedule,’’ Campbell says.
‘‘If a midwife brings in another midwife to support her, that cost is paid out of the set amount. There have been times when I’ve worked for less than the minimum wage.’’
The average yearly income for community midwives is estimated to be $53,000 before tax, once costs and business expenses are paid.
The midwife shortage is best illustrated at some of the country’s biggest hospitals as health bosses look overseas to plug vacancies.
Waikato District Health Board are currently looking as far away as the United Kingdom to fill seven vacancies at its maternity unit.
Capital & Coast DHB, which runs Wellington Hospital, and Auckland and Counties Manukau DHBs are also battling to fill positions.
The New Zealand College of Midwives has described understaffed maternity levels at some larger hospitals as an emergency situation.
Waikato DHB Women’s Health Commissioner Tanya Maloney says Waikato has a good supply of midwives, with 180 working as lead maternity carers in the community.
Waikato Hospital’s maternity service employs 84 permanent midwives and 12 casual midwives, making up 58 fulltime equivalent positions.
Additionally, four positions are filled by registered nurses on a fixed-term basis.
That 180 figure is disputed by some in the industry who say not all of the region’s registered midwives have active caseloads.
What is agreed, however, is DHBs have to do more to attract midwives to work at their hospitals.
Guilliland says making it compulsory for midwives to work in hospitals upon graduation would not fix the shortage.
‘‘All midwives work in hospitals during their training . . . it is not lack of exposure to Waikato Hospital — it is the conditions they see there that are being rejected: Inflexible rosters, poor staffskill mix, enforced protocols that are not woman-centred [shows that] midwifery is not valued by the organisation.’’
In February, Maloney and Waikato DHB chief executive Dr Nigel Murray met with college representatives to discuss the staffing shortage.
Maloney says there is a variety of reasons why midwives opt not to work in large tertiary hospitals: midwives train with a focus on primary care so the medical high-risk environment is less attractive to many; and midwives may not be able to work at the top of their scope in a hospital environment.
To address this, the Waikato DHB has embarked on several initiatives, including a new Maternity Day Assessment Unit, which opened at Waikato Hospital on April 3.
The unit will cater for high-risk women who need support and monitoring during pregnancy.
Maloney says the new unit is another step on the journey to transform the Women’s Health service at Waikato Hospital and improve maternity, obstetric and gynaecological services.
The unit will also provide midwives with an opportunity to use their full skill set.
DHB-employed midwives report lower levels of empowerment and professional recognition compared to self-employed midwives.
Another initiative aimed at attracting midwives to work at Waikato Hospital is a 12-hour shift trial.
Providing the option of working an extended shift responds to midwives’ desire to be present for the early part of labour through to birth.
Guilliland says pay equality and better working hours and resources would be a start to making the profession more attractive.
‘‘On-call rates for core midwives is $4 [per hour] all up and recently, doctors on call during the junior doctor strike [at Waikato Hospital] got in excess of $450 to $500 an hour.
‘‘In general, this is a problem of priority. All women-dominated health services face the same issue.
‘‘There is little value placed on the caring nature of midwifery, nursing, social work, mental health, rehabilitation and aged care.’’
For Campbell, the struggle to improve the working conditions of midwives reflects wider gender inequality issues.
‘‘We are highly professional group . . . and yet why is it that we haven’t been able to advance our working conditions? My hope is that the Ministry of Health and the DHB can attend to the maternity workforce crisis and our world-class midwifery system, which New Zealand women fought so hard for, is not lost or compromised. Recognising midwives is recognising the value of women in New Zealand society.’’
And it’s recognising that value which saw Valentine choose to become a midwife.
It may seem an unpopular choice for a man, but for Valentine, it was the only career he wanted.
He currently has 14 women booked with him.
‘‘Sometimes the partners of the women aren’t too sure about me but because I’ve been in that position before, I can relate,’’ he says.
‘‘At my first birth, I knew I had chosen the right path.’’
MIDWIFE WORKFORCE
From the 2016 workforce survey (as of August 2016):
3023 midwives with a current practising certificate
Seven male midwives (Glen Valentine graduated in 2017) Average age of a midwife is 47 NZ European and other European make up 88.2 per cent of the workforce
1591 midwives worked for a district health board
The average caseload for a midwife is 40.3 women