Bay of Plenty midwife shortage: Midwives from other regions called to help

The Bay of Plenty District Health Board says midwife vacancies in its hospitals were leading to midwives picking up extra duties. Photo / George Novak

Tauranga women struggling to find a midwife have been calling a birthing unit "in tears", with one midwife called up from Central Otago saying the shortage in the Bay of Plenty is "critical".

Midwives from other parts of the country have been called upon to work in the region due to "significant loss", a Tauranga Lead Maternity Carer (LMC) says.

And the Bay of Plenty District Health Board says its midwives are going "the extra mile" by doing more shifts or longer hours due to the shortage.

It comes as a shortage of midwives at Rotorua Hospital was described as "incredibly unsafe" and "dangerous" by one midwife last month.

Central Otago-based locum LMC midwife Caroline Muir has been working in the Bay since mid-November and was due to finish at the end of January.

Central Otago-based locum midwife Caroline Muir. Photo / Supplied

As a locum midwife, she normally goes to regions and helps at hospitals or in community LMC settings.

She said her job was to help LMCs keep pregnant women out of the hospital because it was "overwhelmed" with the number of women going through.

"I had a full caseload of my own clients booked for me by the time I got here.

"I've had home births from Maketu right to Katikati."

Muir said the shortage in the Bay was "critical," but the "generosity" of midwives, the obstetrics team and DHB management were pulling together to get the job done.

From her perspective: "It's been okay but it's been incredibly stressful. The midwives are at absolute breaking point. And that's not just here in Tauranga but everywhere."

She knew of two other locum midwives in the Bay but said there may be more.

Bethlehem Birthing Centre clinical midwife manager Alexandra Deas said the midwife shortage was "very concerning".

"Bethlehem birthing centre receives calls daily from women trying to find a midwife. Some are in tears.

"We do our best to help but sadly there just aren't enough midwives to support these women so they are cared for by the DHB.

"The team at the DHB work tirelessly to support women and provide them with exceptional care, but they are short-staffed, like all facilities. It puts an even greater pressure on the midwives that work there."

Tauranga Lead Maternity Carer (LMC) Cara Kellett pictured in 2018. Photo / George Novak

Tauranga LMC Cara Kellett said there had been "a significant loss" of LMCs in the Bay.

An LMC worked with women throughout their pregnancy and did their delivery and postnatal care, she said.

Kellett said the community had lost "long-standing experienced midwives" which had led to "a catchment" of pregnant women with pending deliveries.

As a result, LMCs had to pick up extra births and get locums from outside of the community to care for these women. The alternative was giving birth at the DHB, she said.

"So a lot of choice is taken away from people and still is, which is really sad."

For women who did not want to engage in the DHB setting, LMCs would see them antenatally and postnatally at home.

"But unfortunately we just can't commit to all their deliveries because we physically can't do it.

"Women need midwives - there's just not enough around."

Bay of Plenty District Health Board regional community services business leader Karen Smith said the board was aware that changes required to respond to shortages may have been stressful for pregnant women as it had impacted their options for care and place of birth.

"We have strived to maintain antenatal and birthing services for all women."

The DHB had worked closely with the New Zealand College of Midwives and the Rural Midwifery Locum Support who had provided support with some locum LMC cover through the summer period.

Hospital midwives had changed the model of care to provide outreach services for women, she said.

"They have also gone the extra mile doing additional shifts or longer hours to maintain birthing services demonstrating their commitment to pregnant women."

Vacancies in Tauranga and Whakatāne hospitals were putting pressure on rosters and midwives were having to pick up extra duties as a result, she said.

Registered nurses were also being deployed to the postnatal area so midwives could focus on the antenatal and delivery suites, she said.

While the Bay of Plenty DHB was actively recruiting midwives, it says the shortage would be "an ongoing challenge for the foreseeable future". This was due to the national and international shortage being felt throughout New Zealand Maternity Services.

Associate Health Minister Dr Ayesha Verrall said strengthening the maternity system, including addressing the shortage of midwives, was a priority for the health sector and the Government.

Budget 2020 included the "largest-ever funding boost" for primary maternity services, with the Government investing $242 million over four years.

This would support a range of initiatives such as strengthening national and local maternity quality and safety programmes and supporting workforce sustainability, she said

Health Minister Andrew Little. Photo / NZME

Health Minister Andrew Little said the numbers of midwives working in DHBs nationally had increased by eight per cent over the past few years, from 1413 to 1529.

Midwives were part of the "backbone" of the health system and were caring, dedicated professionals, he said.

"We know we are playing catch-up following nearly a decade of underinvestment by the previous government, which has resulted in a workforce shortage across the health system - including midwives.

"The union, district health boards and the Ministry of Health are working together to attract and retain midwives, with a particular focus on employing more Māori and Pacific midwives."