Pregnant women neglect 'unacceptable'

03:00, Feb 17 2014
POOR CARE REPORT: Middlemore Hospital's maternity ward has come under fire.

Allegations some pregnant women have been neglected by maternity carers at Middlemore Hospital are "unacceptable," the health minister says.

Middlemore Hospital has been told to urgently address failings in its maternity wards after a report found vulnerable pregnant women were suffering from poor care.

Some women were "dropping out" of the system because they were so disillusioned by the health care provided in South Auckland, the report found.

One mother said her husband delivered her baby at the hospital because the midwife was off gossiping.

Health Minister Tony Ryall has asked the Counties Manukau District Health Board to report back with its plan for changes.

"The new chair of Counties Manukau DHB has an extensive background in maternity services and I have specifically asked Dr [Lee] Mathias to focus on this area," he said.


"It's unacceptable if any mother feels unwelcome or disrespected by maternity services. And I have asked the DHB to report to me on what action it is taking to address these concerns."

Middlemore Hospital is not alone in its failings in caring for vulnerable, pregnant women, a maternity expert says.

Maternity Services Consumer Council co-ordinator Lynda Williams said reviews into other regions with high Maori and Pacific Island populations would throw up similar shocking results.

She said it was "completely unacceptable" for hospitals in high-needs areas not to make Maori and Pacific Island women feel welcome in their maternity wards.

The report comes after an independent maternity review found in 2012 unborn and newborn babies were dying at higher rates in South Auckland than the national average.

"This is not good news and points to ongoing problems with maternity," Williams said.

"Pacific and Maori women do feel judged. There needs to be a lot more Maori and Pacific Island midwives - that would really help."

Counties Manukau District Health Board ordered the review into its maternity services due to higher-than-normal perinatal mortality rates.

The report found there was an unequal access to good care at the hospital, with teenage mothers and Maori and Pacific Island women most at risk at receiving inadequate care.

Hospital overcrowding, workplace rivalries, midwife shortages and poor care for at-risk women were all highlighted in the report, which sought feedback from former patients.

Young expectant mothers were also "dropping out" of maternity care and felt judged and stigmatised by medical staff and midwives.

One teenage mother said her midwife was so judgmental of her she didn't bother seeking help for her second pregnancy.

"I felt so uncomfortable so I just basically looked after myself through the whole nine months and gave birth in my own bath tub," she said.

"I didn't go to hospital."

Another pregnant young woman said the doctor told her to "give it up".

Women reported healthcare professionals didn't follow them up when they stopped going for pregnancy checks.

The maternity services report ordered urgent changes, including addressing staff shortages, prioritising high-needs women and encouraging expectant mothers to seek help in the first 10 weeks of pregnancy.

The report also pointed at the potentially confusing nature of the maternity system in New Zealand, with some teenage mothers not knowing what a midwife was.

Ryall said he was supportive of any research that identified ways to improve maternity services.

"A lot of work has gone into further improving maternity services in South Auckland since a major review in 2012," he said.

"The challenge of reaching high needs mums-to-be was identified in that review - clearly this report is part of that work."

He said some work was already under way to improve maternity services across the health system.

"One priority area is increasing the number of mums-to-be enrolled with maternity services by 10 weeks gestation - a recommendation from the health select committee in their improving child health report.

"We have six maternity integration pilot [programmes] starting, including one in Otara. One of the goals of the pilots is to find new ways to get high-needs mums into maternity services sooner.

"And a major maternity quality and safety programme is happening across DHBs."

Counties Manukau DHB maternity review spokeswoman Margie Apa said the purpose of the report was to hear women's concerns on issues.

"It's about getting our work force seeing what consumers see," she said, adding the biggest lesson was the urgent the need to get women into maternity care within the first three months.

"Women need to understand how important it is to get a midwife within 10 and 12 weeks," Apa said.

"Those first three months are really important. We can change the outcomes of babies and babies at risk."

The DHB commissioned the review following the 2012 report into maternity care, which found high-risk women were missing out on vital antenatal care.

Apa was unable to say whether the mortality rates of unborn and newborn babies had improved since the 2012 report.

Labour health spokeswoman Annette King said the review "made a fiction" of the Government's support programmes for new mums.

"Health Minister Tony Ryall promised, way back in 2009, that new and vulnerable mums would be able to stay in hospital for up to two days longer than the 48 hours all mothers are entitled to.

"Almost $40 million was to be spent on providing these longer post-natal stays, yet we are now hearing of mums being kicked out just four hours after giving birth."

King said she had received a response to an official information request that although the DHB received an extra $90,270 in funding to deliver longer stays, between 2009 and 2013 the length of stays for new mums remained static at an average 2.6 days.