The interislander ran aground overnight, the Tauranga mayoral race begins to heat up and the HMNZS navy ship gets an upgrade.
Women booked to give birth at Auckland Hospital are being told to expect to be sent to Birthcare or home within three to four hours - and encouraged to consider a primary care facility or home birth instead.
Te Whatu Ora-Health NZ is sending the official advice towomen booked to give birth at the hospital.
“Your lead maternity carer (LMC) – either your midwife, obstetrician or GP, has booked you in to birth at Auckland City Hospital,” states the letter from the women’s health team.
“However, if you are well and have a healthy pregnancy, we support your choice to give birth at a primary care facility such as Birthcare or at home. Please discuss this with your LMC.
The quick-discharge policy comes as Auckland City Hospital struggles to meet the demand for its women's health services. Photo / 123rf
“If your pregnancy is not straight forward or there are complications which may require medical intervention or specialist obstetric or paediatric care, then Auckland City Hospital is the best place for you to give birth.
“If you have your baby at Auckland City Hospital then you will either be discharged home or transferred to Birthcare three to four hours later, or when you and your baby are well.”
Like other hospitals, maternity and birthing services at Auckland Hospital have been under sustained pressure, including because of workforce shortages.
However, Jenny McDougall, the acting director of women’s health at Te Toka Tumai Auckland (formerly Auckland DHB), said the letter’s advice wasn’t related to resourcing, and discharge timeframes had been standard practice for many years, and weren’t absolute.
“We last updated this information in our communications to whānau in 2020, to help ensure they are fully informed ahead of time ... discharge times reflect the best care options for our māmā and pēpi, and have the ability to flex should they need to stay with us longer.
“It’s important to note that our relationship with our wāhine builds over the pregnancy, and communication is key. The LMC and whānau also have a relationship and a birthing plan, so all parties are clear on what to expect throughout the journey and in different circumstances.”
Most women and newborns transfer to Birthcare for their postnatal stay, McDougall said, but some who are well enough prefer to go home, where they are visited within 24 hours by their LMC, who they can contact 24/7.
Women who have a lower (uterine) segment caesarean section usually stay in hospital for 24 to 36 hours, then transfer to Birthcare or home.
Jenn Hooper, the founder of Action to Improve Maternity (AIM), a charity that has helped hundreds of families affected by poor maternity care, said in her view the letter was clearly intended to dissuade women from sticking with their choice to give birth at the hospital.
“It’s not okay. No one should be trying to manipulate women into choosing something different, because of their resourcing issues or ideology.
“They should be seeking out innovative ways to fill those resourcing gaps and provide the service New Zealand women are entitled to and deserve.”
Hooper said about 90% of NZ women choose to give birth in a hospital, which is the safest place to do so. Funding and resources, including of midwives, need to reflect this, she said.
One first-time mother told the Herald she was surprised to be sent on from Auckland Hospital, within three hours of giving birth to her daughter in August last year.
She had an epidural and gave birth vaginally at 1.40am, and was discharged at 4.30am, to the nearby Birthcare facility. The ward was quiet, she said, so being moved on didn’t seem related to the need to free up space, which she would understand.
“Because I was in a pretty okay position, I didn’t raise any questions. It was a shock to me. Because it was my first child, I didn’t know what it was like for everyone else.”
Her midwife helped her to the carpark in a wheelchair, and her husband nervously drove the new family around the Auckland Domain to Birthcare.
“It did feel too soon. I would have felt more comfortable if I could have stayed another half day, just to make sure myself and the baby were doing okay.”
National Tukituki MP Catherine Wedd and her daughter Sophie, 13. Photo / Warren Buckland
Postnatal care is in the spotlight because of a member’s bill put forward by National MP Catherine Wedd. Her Pae Ora (Healthy Futures) (3 Day Postnatal Stay) Amendment Bill would provide women with “publicly-funded inpatient postnatal care” for a minimum of 72 hours, if desired.
Women are currently entitled to up to 48 hours of postnatal care (such as that provided by facilities like Birthcare), but Wedd said many women don’t realise this.
The pressure on maternity and birth services is nationwide. At Te Toka Tumai Auckland, hospital bosses have proposed a quota on the number of caesarean sections done by private obstetricians, as well as a limit on women using the specialists but who live outside its central Auckland boundaries (mostly in West, North, East and South Auckland).
An internal document on that proposal, written in July last year but not yet agreed, outlined how the number of births at the hospital is near the maximum that can be coped with.
“Even this workload puts both staffing and facilities under pressure throughout the year. As it is unlikely resources will increase, Te Toka Tumai’s interest is to ideally reduce this workload, but at very least, to ensure the workload does not increase, through increased volumes and/or increased caesarean section rates,” the document stated.
