Rural health, maternity services in crisis


The shortages in the maternity and rural health workforce impact not only the quality of maternity care of women and their babies in our region, but the mental health and welfare of our midwives.

In March 2022, the Minister for Health, Andrew Little, announced his Government was ‘‘committed to building a new national health system so all New Zealanders can get the healthcare they need no matter who they are or where they live’’.

They aim to achieve this through the Pae Ora Healthy Futures Bill, which comes into effect on July 1, 2022 and replaces the 20 district health boards with a Crown organisation, Health New Zealand.

Rural health has, however, largely been ignored in reform plans.

I’ve spoken to midwives who say they face many unique challenges in providing a world› class maternity service in rural areas.

The existing midwifery workforce works long hours and needs to cover more families spread geographically across the electorate. Some find themselves unable to take annual leave due to no›one to cover their time away.

Extended travel times in challenging conditions, road and weather dependent, and at higher costs due to high fuel prices, all add to their challenges.

In addition, midwives say they have limited health service backup for transfers of mothers and limited access to the same diagnostic and other referral services that their urban counterparts have access to.

Combined with the lack of professional development opportunities, it is no wonder we are losing midwives out of our region.

The problem extends far wider than midwives, too, with 2200 FTE nursing vacancies across New Zealand affecting aged care sectors.

The nursing shortages place an additional burden on midwives, who often have to work longer hours, or on their days off to cover for nursing staff unavailability.

When all these factors are considered together, the maternal workforce crisis can potentially put patient welfare at risk.

The first 1000 days of a baby’s life is critical to their development and quality of life, as is maternal wellbeing in the first few days after birth. The essential role of midwives in providing pre›and postnatal care to both mum and baby cannot be understated.

District health boards are responsible for ensuring an accessible and equitable maternity service for women, their babies and families.

The Southern DHB had previously instigated a sustainability package for some rural areas.

This package proved effective, helped retain the lead maternity carer midwifery workforce, and ensured pregnant and birthing women received appropriate, timely services.

Unfortunately, the withdrawal of many elements of this package has contributed to these workforce issues in the region.

The Government needs to explain why $60 million of the maternity action plan funding was redirected to health sector reforms, when that money is sorely needed by the maternity health workforce, especially rural health workers.

Any health workforce development strategy must provide pathways to grow our local midwife workforce and address nurse staff shortages, as an essential enabler of good health for rural communities.

I will continue to advocate in Parliament for our local midwives and rural health workforce and make sure their voices are heard when it comes to future debates on the state of rural health in our region.