Midwife care in NZ slated

New Zealand's midwife-led maternity system has been slammed.

Obstetricians have warned Australia not to introduce the system, citing the poor state of care in New Zealand.

The Australasian professional body for obstetricians has also called for the immediate release of a report detailing maternal deaths in New Zealand, which are believed to have doubled since the introduction of midwife-led care.

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (Ranzcog) this month sent a scathing letter about New Zealand's maternity system to its members.

The letter said New Zealand's system had problems, and "clearly the college is opposed to the introduction of a New Zealand-type system for Australian maternity care".

Australia is reviewing its maternity system.

The letter raised concerns about a "quarantined maternal mortality report which reportedly shows a doubling in maternal mortality since the introduction of midwife-led care".

Associate Health Minister Steve Chadwick, who is responsible for maternity issues, said a committee had been formed in 2005 to investigate maternal deaths and the deaths of babies around the time of labour.

It was always expected the process would take some time and a report, which would include mortality figures from 2006, would be released in the next few months, she said.

Ranzcog president and author of the letter, Dr Christine Tippett, said she understood a special report into maternal deaths had been with Health Minister David Cunliffe for some time.

It should be released immediately, she said.

Tippett said New Zealand had great trouble recruiting obstetricians and gynaecologists because of systemic problems such as a lack of collaboration with midwives and a lack of information about outcomes for women.

A national maternity inquiry completed recently after the death of a baby in Wellington Hospital demonstrated the range of problems in New Zealand, she said. The country was just starting to compile data about outcomes for mothers and babies, which was "irresponsible", Tippett said.

New Zealand's Ranzcog representative, Gillian Gibson, backed calls for maternal death figures to be released, saying it would help people in the sector understand what changes were required.

Chadwick said the Government was committed to retaining New Zealand's lead maternity care model because it was women-centred and provided women with the services they needed.

The latest maternity services consumer satisfaction survey showed 90 per cent of women were happy with their maternity services.

"We acknowledge that there is more we can do to strengthen maternity services, to build a more collaborative model of care which encourages better communication between the team of health professionals," Chadwick said.

New Zealand College of Midwives chief executive Karen Guilliland said Australian obstetricians and private maternity services were extremely strong and because of this the public system had serious workforce shortages, with many women having difficulty accessing care.

The Australian system was heavily privatised and could be extremely expensive for families, she said.

As a result, Australian health authorities were recommending midwives be able to make claims on the public insurance system.

This was in the same way as doctors providing maternity care.

National Party health spokesman Tony Ryall called for the information on maternal deaths to be released, saying there was great interest in it, and withholding it unnecessarily created suspicion.


The Press