Hawke's Bay midwives speak out: 'it's not okay'

Hawke's Bay midwife Sarah Glass of Napier says many local LMC midwives are on the brink of leaving the industry if working conditions don't improve. Photo/Paul Taylor.

Deprivation in the region has resulted in midwives who are already overworked and underpaid going above and beyond their call of duty, Hawke's Bay midwives say.

In the wake of what is being called a national midwife crisis, Napier woman Sarah Glass said local midwives are under just as much pressure as others in the country, if not more due to poverty in the region.

"We're now working in much more complex situations. We've got much sicker women and the number of social issues has gone through the roof.

"If they've got issues with drug and alcohol addiction, housing problems, family violence or other health problems we're referring them to the right people. As a midwife we're basically a one stop shop primary provider."

Ms Glass' emergency skills came to the fore in February when she used a Stanley knife to perform an emergency tracheotomy on her choking boyfriend at a barbecue with friends.

Her full-time job is Lead Maternity Carer (LMC) midwife, meaning she is self-employed and claims her pay from the Government.

Ms Glass said she, like most other midwives, joined the industry because she wanted to help women, but felt this goodwill had been exploited for too long.

"We're an industry made up of people who got into it because they care and that has just been absolutely abused."

After tax and expenses rural LMC midwives earned approximately $7.38 an hour, while urban LMC midwives earn around $12.80.

They haven't been able to negotiate the terms of their contract since 2007 and there has been an appeal to the Government to urgently deal with the issue.

"I'm so exhausted. This battle for funding has been going on for years. I'm paid 60 per cent less than I was when I started this job, in real terms, and it just makes you want to weep.

"I'm 45 years old, I'm looking at retirement, I have no KiwiSaver, I've worked my ring off and there is just no hope in sight," Ms Glass said.

College of Midwives Hawke's Bay subregion secretary Annie Frogley said LMC midwives felt additional pressure because maternity services at the Hawke's Bay District Health Board were underfunded.

"LMCs responsibilities under Section 88, which is basically our contract with the Ministry of Health, are to provide primary maternity care to women, and that's actually where our obligation ends.

"The DHB is funded to provide secondary care and what has happened is the LMCs are picking up the slack because the money, the bulk funding, is not finding its way into maternity care locally and around the country."

Ms Frogley said this resulted in pressure on the DHB staff which flowed down to LMC midwives, who were providing unpaid secondary care.

However HBDHB midwifery director Julie Arthur said LMC midwives had a choice in the matter.

"LMC midwives can choose to provide secondary midwifery care to their clients. Section 88 does not preclude them from providing secondary care support, it's up to them."

Ms Arthur said there was a "great deal of collegiality" between LMCs in the community and DHB midwives who occasionally supported each other when needed.

"Occasionally there are times when DHB midwives are busy and need the support of community midwives, and vice versa - DHB midwives will support community midwives if they are needed."

However, Ms Glass said no midwife would choose not to help a woman in need, of which there were many in Hawke's Bay.

"No midwife is going to walk out on a patient and say they're going to leave them and say they're sorry they're not paid for that they will just leave them there with no care."

"Everybody is getting the squeeze and the midwives are the ones at the bottom having to pick up the pieces because we can't say no."

LMC midwives in Hawke's Bay and throughout the country are now awaiting a decision on a new funding model when the Budget is delivered on May 17 this year.

"The reality is women and babies and families are the ones that are going to suffer because we have got a world-class maternity system ... but if something doesn't change soon there's going to be a max exodus from this profession because we can't pay our bills," Ms Frogley said.