WARNING: THIS STORY REFERS TO SUICIDE AND MENTAL HEALTH.
A mother, facing a mental health crisis, had her baby taken away because there was no help available. Similar yawning gaps exist across our maternal mental health services, including counselling for stillbirth and suicide. Thomas Coughlan reports.
In late 2022, Tauranga mum Kristy Maguire went to what she thought was a standard follow-up appointment with a psychiatrist.
Maguire had given birth to her first child, a son, Toby, a little over three weeks prior. The pregnancy had not been an easy one. She was diagnosed with preeclampsia, a condition characterised by extraordinary high blood pressure putting her at risk of stroke.
The diagnosis was so severe, Maguire was told to drive immediately to the hospital to be induced, without time even to detour by her house to grab her pre-packed baby bag. After days of painful and invasive attempts at induction, Maguire gave birth by C-section.
Unfortunately, the preeclampsia did not subside after birth, even after Maguire had returned from hospital. This condition, combined with the birth itself, put Maguire under extreme pressure.
A new mum, exhausted by birth, her body recovering from the C-section, Maguire was readmitted to the maternity ward, just a day after first leaving, where she was told she was at heightened risk of a stroke thanks to her high blood pressure. She stayed for a week.
Returning home from hospital, Maguire began to experience symptoms of postpartum psychosis, a condition that in its most severe form affects two to four of every 1000 pregnancies. This means about 100-180 women experience this severe form of postpartum psychosis each year in New Zealand.
Maguire’s life began to feel like the film The Truman Show, in which everyone was in on a great but sinister secret – everyone but her. Maguire was experiencing what are called persecutory delusions, thinking people were out to get her and Toby.
“The smell of gas made me believe the house was going to blow up, so I’d pick Toby up and I’d bolt out the door,” she said.
“Everyone was looking at me, thinking ‘oh my God what is happening?’. What I thought I was doing was saving him from an exploding house, but what they saw was a mentally unwell person picking up the baby and running outside.”
Maguire went to the emergency department (ED) twice, presenting with symptoms of psychosis; she spent two days in the mental health unit the first time before being discharged, and the second time was discharged from the ED after a few hours.
Maguire, who describes herself as a “compliant person”, had been following the rules. After her diagnosis, she took medication for psychosis and went to her mental health appointments voluntarily.
This time, however, a meeting she thought was a standard follow-up with a psychiatrist felt different.
Entering the room, she noticed the chairs set up in a circle and a psychiatrist she had not met before. She “had a feeling” about the meeting – one that was soon confirmed.
The psychiatrist told her she was being sectioned under the Mental Health Act. She would be kept in a mental health facility for five days and monitored. Toby could visit, but not stay.
Maguire was given a piece of paper detailing her rights.
She shook the psychiatrist’s hand, changed Toby’s nappy, gave her partner, Jord, a hug, and then bade them farewell.
Maguire had to say goodbye to the son she had given birth to just over three weeks previously.
She was taken to a room in the Tauranga mental health unit, whose aesthetic Maguire compared unfavourably to a bad European backpackers hostel from the 1990s.
For the next five days, she would mainly see her son through the pictures she put on the wall of her room to cover up the peeling paint.
Health New Zealand Te Whatu Ora has defended its treatment decisions.
Health NZ group director of operations, Bay of Plenty Pauline McGrath told the Herald in a statement that the organisation acknowledged Maguire “went through a stressful time” following Toby’s birth.
“When Ms Maguire raised concerns about her treatment in maternity and mental health, we undertook a careful review of her clinical notes,” McGrath said.
“Our assessments under the Mental Health Act are carried out with great care and according to strict criteria, always with the intention of safeguarding a person’s wellbeing and safety, and those around them, and we work to ensure that mental health units are safe environments for our patients.
“Based on our review, we believe the care Ms Maguire received at Te Whare Maiangiangi [Tauranga’s mental health unit] was right at the time of her clinical presentation.”
This is not the way recovery from postpartum psychosis is always treated. In some countries, it is common to allow mums to stay with their babies in mother-and-baby units, or MBUs.
Recovery tends to be better if the mother and her child are not separated. New Zealand has just two such units, one at Starship Hospital in Auckland, and the other at Christchurch Hospital.
The “postcode lottery” that the 2022 merger of District Health Boards (DHBs) was meant to end is still running and its cruel, exclusionary draws leave women like Maguire out in the cold. New Zealand’s MBUs are only for the communities they serve, with the Starship facility still serving Aucklanders only.
Maguire had a tough recovery during her five days in the Tauranga mental health unit. A general facility, it had little in the way of specialist care for mothers.
The experience was at times humiliating.
She was given cabbage leaves to put down her bra to stop milk production and stopped eating because whenever she went to the common area for meals, she was “hit on” by one of the other patients.
“It felt like I was being punished for being unwell,” she said.
Maguire is realistic about the strains on the health system. Speaking to the Herald for this story, at several points when she was pressed, said she did not want to give the impression she was critical of the people working in the system, who seemed overworked and under considerable stress.
She does, however, believe she received the wrong treatment and that the Government needs to keep mums and babies together and invest in more mother-and-baby units so that mothers receive better care.
After initially feeling embarrassed and isolated by the episode, Maguire found her experience was more common than she thought. She found Perinatal Anxiety and Depression Aotearoa, a group that advocates for better perinatal mental healthcare.
The group recently held a breakfast at the Beehive, where Maguire spoke on a panel attended by Mental Health Minister Matt Doocey and MPs who held mental health portfolios. Maguire has also launched a petition for better mental health services for mothers.
There is an appetite in Parliament for change.
The Mental Health Bill, which would repeal and replace the one Maguire was sectioned under, is currently before the House.
The Health Select Committee, in its report on the bill, recommended it “explicitly provide that birth parents not be separated from their newborn babies unless specific circumstances apply” and that a birth parent under compulsory care is “entitled to have their baby remain with them in hospital” unless certain conditions apply.
To Maguire, that change, if adopted by the House, would be welcome, but it doesn’t solve the fundamental lack of units for these parents, particularly those outside of Auckland and Christchurch.
Her petition explicitly calls for more of these units and says they should be better funded. New Zealand is likely to need more units if, as expected, the new Mental Health Act creates an assumption that mothers and babies are kept together during treatment.
In a 2023 report, the UK’s Royal College of Psychiatrists said MBUs helped to assess and treat mental health whilst also delivering non-mental-health-related postnatal healthcare.
The organisation estimated there is a need for about 0.4 MBU beds per 1000 deliveries.
New Zealand records over 55,000 live births a year.
The Starship unit has just three beds. At a ratio of 0.4 beds per 1000 deliveries, it should have closer to eight beds just to serve Auckland, to say nothing of the rest of the country.
A request for information about capacity at MBUs went unanswered.
In 2021, Paraparumu mum Serra Clark was pregnant.
It wasn’t an easy time to be carrying a baby. Covid pandemic restrictions meant hospital visits were often conducted alone.
The pregnancy went “smoothly” until late in the term.
“I was constantly having these thoughts, ‘has she died – why’s she not moving?’" Clark said.
“But that’s what every pregnant person thinks, I remember thinking.”
Tragically, however, Clark was correct. Her baby had died.
“We went to the hospital. I was keeping the fears to myself, I didn’t want to bother other people,” she said.
“I had to go in on my own, due to pandemic restrictions at the hospital. We had a wonderful midwife and doctor at the hospital who confirmed she had passed away.”
Clark said the time was “very isolating” and it was painful discovering this on her own, seeing her child “floating lifelessly” on the hospital ultrasound.
“I went into shock ... I felt like I was watching the whole thing happening to another family,” she recalled.
Clark delivered her baby via C-section.
She said the “realities” of having a stillbirth are not something many people contemplate or discuss prior to birth.
For obvious reasons, these realities are simply not discussed with expecting parents, leaving parents with little knowledge of what’s coming.
After delivery, Clark was taken to a separate room for bereaved parents. Pandemic restrictions made the room seem “isolated and lonely”.
Clark’s midwife said that a referral would automatically be made to maternal mental health for support following the stillbirth.
Sadly, however, the midwife was incorrect – Clark would not get maternal mental health support because of her stillbirth. In fact, it was precisely because of her stillbirth that she was denied it.
In the eyes of the health system, Clark was not a new mum.
“What I found out is that in order to access support through the specialist mental health teams under Te Whatu Ora, you need to have a living baby in your care.
“If your baby passes away, if they are stillborn or if they pass away after birth, you are excluded from funded mental health support,” Clark said.
In 2023, after Clark’s stillbirth, Health NZ published an environment scan of services available to bereaved parents. It reiterated a finding from 2019 that services were “fragmented”.
The report found that the “level of standardised and structured support” available to parents with living children had not been extended to those whose children had died.
It is estimated that 700-900 Kiwi families lose a child every year through stillbirth, foetal abnormality or Sudden Unexpected Death in Infancy (SUDI) and more than 13,000 suffer a miscarriage before 20 weeks gestation.
Health NZ had promised a “new pathway” of care for parents of bereaved parents resulting from that 2023 review. The pathway design was meant to be finalised in March 2025.
When the Herald asked what had happened to this pathway, it was directed to a website saying the pathway was still under development.
Clark was not completely shut off from mental health support. She was told some counselling was available, but this was through a clinic that offered counselling to people before and after having an abortion.
“I’m all for people choosing what they want to do in regards to that, but it felt it would be far too confronting to be in that space, where people are in different stages of pregnancy,” she said.
For Clark, part of the problem is that stillbirth is a very particular and specific experience. It has practicalities that most people don’t think about. These parents need support from experienced people about what to expect.
A stillborn child’s appearance “changes very rapidly”, Clark said.
“You can have your baby with you for as long as you want ... but the natural process after someone has died – they change quite rapidly,” she said.
Other practicalities, like deciding on a post-mortem, need to be decided quite quickly.
“I didn’t know anything about a post-mortem. That’s something from crime TV,” Clark said.
“I didn’t know what to ask, or I was afraid to ask things,” she said.
Clark said it “would have been helpful” to have someone guide her through the system.
Health NZ did not directly answer the Herald’s query about mental healthcare exclusions relating to stillbirth.
McGrath told the Herald that following a stillbirth, a mother was “typically referred to grief and loss services as a first step”.
“If a mother is already engaged with the Maternal Mental Health Team, that team would continue to provide support and co-ordinate with grief and loss services as needed.
“We are committed to supporting all individuals through their mental health journeys and encourage patients to contact us directly with any concerns or feedback,” McGrath said.
Alastair Taylor has become an advocate for better perinatal mental health since losing his wife Kristin Taylor to suicide in August 2020.
After Coroner Peter Ryan released findings into her death in 2022, Alastair Taylor became a staunch advocate for better perinatal mental healthcare.
Kristin Taylor had experienced some mental health challenges as a teenager, but by the time she met her husband, he recalled “there were no real issues”.
“She was taking medication and everything seemed fine — she’d had a very successful career, built that," he recalled.
She also had a difficult pregnancy and birth, which ended in an emergency C-section early in the morning.
It was after birth that her mental health began to slip.
“The only thing I’d put it down to is almost a reaction against the whole Instagram mum-Instagram baby thing,” Alastair Taylor said.
“Mum’s at home, she’s used to working and being busy. Now you’re at home, looking after a baby with all of the fun and the pain and the hassle that brings, and whenever you go on social media, which if you are sitting at home, you generally do – everyone else has got a perfect life. Everyone else has got a perfect baby, everyone has a perfect nursery room.”
As her mental health deteriorated, Kristin Taylor began making attempts on her life.
“The journey to losing Kris started in that winter of 2019 and over a 15-month period Kris made eight or nine attempts to take her own life,” Alastair Taylor recalled.
He said the care was good, but “nowhere near good enough”.
She was treated at the mental health inpatient facility at Hutt Hospital, which has since closed.
“We have three small dogs, I wouldn’t leave them there overnight, let alone my wife,” he said.
Other facilities were “marginally better” but not somewhere “you would want to put a loved one”.
“They feel more penal than therapeutic,” he said.
Kristin Taylor ended up spending a lot of time in hospital, recovering from the physical injuries incurred from her suicide attempts.
The care was “fantastic”, Alastair Taylor recalled.
But it caused him to draw the terrible conclusion that these physical consequences of her suicide attempts were being given far better treatment than the mental health condition that was causing them.
“A mental health illness, we park you in some place that feels like a penal institute,” he said.
Taylor said that after months of suicide attempts, both he and his wife were “absolutely broken”. Despite it being fairly logical that after months of suicide attempts, the couple would be completely shattered, no one seemed to recognise it.
“That support wasn’t there,” he said.
Finally, one of her attempts was successful. She took her life in the ensuite of the family home at Paraparaumu.
In 2022, a report by Holly Walker from the Helen Clark Foundation noted our maternal suicide rate is seven times that of the United Kingdom. More than half the mothers who have died by suicide between 2006 and 2022 were Māori.
The Perinatal and Maternal Mortality Review Committee analysing data from 2006 to 2020 found suicide to be the largest single cause of maternal death in New Zealand – it made that finding in 2024, 2021, 2019, 2018 and 2017 and regularly in its mostly annual reports.
Suicide was the leading cause of death in the very first Maternal Mortality Review Committee report to have comprehensive data. That report is from 2008, using data that goes back to 2006.