One of Westport's two resident midwives is leaving, saying her job is financially unsustainable.
Ruth Davison, a self-employed lead maternity carer (LMC), has worked in Westport for 10 months.
Soon after she arrived another self-employed LMC left. This meant Westport's Kawatiri Birthing Unit was reliant on just two local midwifes - Davison and unit manager Mieke Siebelink, who is also a self-employed LMC.
Davison said she could no longer afford to do the job. Self-employed midwives received only nine days paid leave a year, and had to pay for a midwife to cover their caseloads when they took leave.
"Basically what I get paid is having to pay for the midwife. Really, it's just too expensive."
Davison said midwives charged between $300 and $700 a day. If someone filling in for her birthed a baby, they also received the birth fee.
The ideal arrangement was to work in a practice with a big group of midwives so they could cover each other's leave, but that option wasn't available in Westport.
Davison said she had been telling the West Coast District Health Board (WCDHB) since May that her situation wasn't sustainable and unless it found another midwife she would go.
The DHB had finally found someone else, who was starting work next month. "But it's too late."
Davison said she had planned to leave Westport in the New Year. She had changed her mind after she took five days leave recently and someone told her clients she wasn't coming back.
"They got very upset and changed midwives. I've come back to hear this and thought, 'I'm going'."
Most of her 30 clients would transfer to a Greymouth-based midwife, she said.
The Greymouth midwife would travel to Westport to hold clinics and birth women, but Davison questioned how long she could keep that up.
"Ideally there needs to be a midwife that lives here ... there needs to be Mieka running the unit and two LMCs."
She acknowledged the West Coast was a difficult place to staff.
"The West Coast DHB has put some funding into sustaining midwives, which is going to run out at the end of this year, and then I don't know what happens."
Davison assured expectant mothers they still had LMC cover and could still birth at Kawatiri "a fantastic place to have a baby".
"If they are low-risk women they will birth well. Kawatiri's got good support from the Foote Ward staff as well. I've really enjoyed my time here."
Kawatiri was a nicer environment for women to birth in than Grey Base Hospital, she said. Obstetric back-up was only an ambulance ride or helicopter ride away.
"Kawatiri is a safe place to have a baby."
Expectant mother unsettled
One of Davison's clients, who had hoped to birth at Kawatiri or at her Westport home, said she had been unsettled by miscommunication over Davison's departure and the lack of back-up care.
"I have lost a lot of confidence in the whole process," said the first-time mother, who asked not to be named.
"I had a hospital referral that wasn't followed up on - I was told the midwife who was filling in was going to set up a scan for me and an obstetrician appointment in Greymouth on Thursday. I've just spoken to radiology and they didn't have any referral for the scan.
"I turned up for my first appointment and she hadn't read my notes.
"I think I'll end up going in to Greymouth and giving birth there."
The woman said she couldn't reach any of the three midwives she phoned for help last week when she feared her unborn baby had stopped moving and she wanted his heart rate checked.
"And the Kawatiri Birthing Unit was unmanned, which I thought wasn't good enough at all - there's always supposed to be someone accessible."
The expectant mother said it took about two hours for her contact the Greymouth-based midwife, who had been en route to Westport.
"At that point I started to feel quite anxious about my baby. It was like - who's going to deliver my baby? Who am I even supposed to call? I've got four different people's phone numbers and I can't reach anybody on the phone and I don't know who my midwife is...
"It was just a brief period when no one was available, but nonetheless I don't think there should be any periods when no one's available."
The woman said she initially felt let down by news Davison was leaving, but now felt sorry for her.
"I think it's scandalous that she was having to pay for her own days off. It's a public health care service."
She had yet to find another midwife.
She said she would prefer not to give birth in Grey Base Hospital but would rather do so than be worried about her standard of care.
No DHB-employed LMCs
WCDHB Buller general manager Kathleen Gavigan said Kawatiri had not had a resident DHB-employed midwife for almost two years.
She said Siebelink had a contract with the DHB to manage Kawatiri and ensure that there was always a midwife on call. Siebelink was also a self-employed LMC.
Self-employed LMC's were independent midwives, Gavigan said. When any LMC moved on, their clients chose an alternative LMC.
All self-employed LMCs who provided care for women in Buller had access to Kawatiri.
While women were in the unit, their LMC continued to be responsible for their care and would seek support from another LMC when required.
No Westport maternity services had been curtailed, Gavigan said.
The WCDHB was unable to answer further questions before publication today.
- Westport News