Culturally appropriate maternity services in responding to the needs of whanau around birthing are fundamental to our community. Many of us understand that cultural misunderstandings or unconscious bias have contributed to the appalling state of Maori health.
We know this because Maori tend to have fewer prescriptions and lab tests. Perceptions of non-compliance amongst Maori prevail and Maori receive significantly shorter consultations than Pakeha. Conversely, improvements in communication, promotion of comprehensive treatment plans, awareness of Maori and other worldviews or learning about existing support mechanisms through whanau, can help to create the best environments for health gain.
To do this we need cultural competency from our health providers from the highest level.
It means that a good health professional will be one who doesn't just write a prescription or recommend a therapy without also explaining what the therapy means, what the patient can do themselves to reduce the issue, and how the whole whanau could be involved in prevention or management of conditions. In short, a good health professional knows how to empower their patients to be active partners rather than passive recipients of care.
It's alarming to read then that Maori and Pacific women in the Counties Manukau District Health Board (CMDHB) region have one of the highest perinatal mortality rates (fetal deaths and early neonatal deaths) in the country - so I welcome the recommendations of the External Review of Maternity Care in the Counties Manukau District that seek to improve access and culturally appropriate services for Maori and Pacific Women. Providing educational material in a variety of languages, employing more Maori and Pacific Island staff and taking into account the cultural diversity of women in this region are steps towards cultural competency.
It is great to see recommendations around early pregnancy assessment, access to care, and prioritising care for high-risk and vulnerable women. Research shows that the earlier women receive antenatal care the better the outcomes are for their unborn children.
I also welcome strategies to monitor smoking and to reduce the number of pregnant women who smoke.
The negative effects of smoking on unborn babies is well documented. As plain packaging comes into force in Australia I look forward to our Government taking up the challenge - despite threats from the tobacco giants to sue over intellectual property rights - to rid our country of smoking and help lay the foundations for a healthier future for our children.
I'm reminded of the struggle in my own electorate for access to emergency birthing facilities where cost is becoming the predominant factor for our families being able to receive specialist or unplanned emergency care.
I know that recruiting obstetrics and gynaecology specialists into the Whanganui area has been challenging for our local DHB, as is the case with other communities. We need community-wide solutions to address these issues while maintaining safety for families, mothers, the midwifery workforce and the hospital management. Our children are our future. Let's ensure their entry into the world is a safe one.