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The closure of Birthcare’s primary birthing suites in Auckland from December 31 could increase pressure on Auckland Hospital.
Health NZ-Te Whatu Ora is prepared for any rise in births and other primary units have capacity.
The New Zealand College of Midwives warns the closure may lead to unnecessary medicalisation of births.
The closure of Birthcare’s primary birthing suites will leave a gap in central Auckland that could put more pressure on Auckland Hospital, the New Zealand College of Midwives has warned.
Health New Zealand-Te Whatu Ora says it is prepared for any increase in births that result from theclosure of all three of the primary birth suites at Birthcare in Parnell from December 31.
The wider Birthcare facility will keep operating for postnatal care - mostly mothers and babies sent by Auckland Hospital soon after birth. The number of women commencing labour at Birthcare, which is privately owned by Evolution Healthcare, has fallen from 376 in 2019, to 162 last year.
“Unfortunately, over the last few years some lead maternity carers (LMCs) who birthed large numbers of wāhine at Birthcare have retired and/or made lifestyle changes which impacted greatly on the birthing numbers,” said aNational Women’s Health annual clinical report, which reported on the decline.
Danny Wu, northern regional commissioner for Health NZ, told the Herald it had worked closely with Birthcare, “and is prepared for the closure of these suites”.
“Postnatal stays will continue, meaning new mothers and their babies will still be able to make use of Birthcare’s postnatal facilities once clinically stable.
“Auckland City Hospital is prepared for any increase in births at its labour and birthing suite. Primary births are facilitated at Auckland City Hospital with a lead maternity carer or with the Te Whatu Ora midwives. Whānau may choose to birth at home with the care of a lead maternity carer.”
Auckland Hospital bosses say maternity services are prepared for any increase in births as a result of the closure of birthing facilities at Birthcare. Photo / Jason Oxenham
Wu said other primary birth units in greater Auckland have capacity, including in Papakura, Pukekohe, Botany Downs, Helensville, Warkworth and the Nga Hau Māngere Birthing Centre. Planning is under way for a Waitākere Primary Birthing Unit on the Waitākere Hospital campus.
“Health New Zealand-Te Whatu Ora supports primary birthing as an important opportunity for whānau. We appreciate the contribution of Birthcare Auckland to providing primary birthing facilities in Auckland for many years.”
Evolution Healthcare Group referred the Herald to an earlier press release, quoting its chief executive, Simon Keating, as saying the closure decision came after consistently low monthly bookings for primary birthing.
“We feel that by focusing on high-quality postnatal care, we will provide for an extremely positive Birthcare experience while expanding our offering to mothers from the broader northern region.”
Violet Clapham, midwifery adviser at the New Zealand College of Midwives, told the Herald that women experiencing straightforward pregnancies should “be offered the option and encouraged” to give birth in primary maternity facilities or at home.
“With the recent decision by Birthcare in Auckland to stop providing birthing services, the college is concerned that the absence of primary birthing units within the Auckland metropolitan area may increase pressure on hospital services and lead to unnecessary medicalisation of births.”
Clapham said Te Whatu Ora Auckland and Waitematā maternity services already have high intervention rates, including caesarean section and episiotomy rates, and the Birthcare changes may increase this further.
“Removing the choice of birthplace will likely increase unnecessary interventions and leave midwives only able to offer home or secondary/tertiary level hospital care for low-risk women.”
Primary birth settings are associated with positives including lower blood loss and rates of infection, and increased breastfeeding rates, Clapham said.
Birthcare in Parnell will keep operating but focus on postnatal care. Photo / 123rf.com
“The evidence clearly demonstrates that women who receive effective antenatal care and are assessed to be at low risk for complications, will give birth to healthy babies and need fewer interventions if they are supported to give birth in a primary maternity unit or at home. This includes improved maternal and newborn outcomes.”
That view is strongly disputed by Jenn Hooper, the founder of Action to Improve Maternity (AIM), a charity that has helped hundreds of families affected by poor maternity care.
“The evidence actually demonstrates that birth injuries - especially to the newborn brain - are well over-represented in babies that have been born or attempted to be born in primary birth units or at home, often leading to severe disability or death,” Hooper said.
“A low-risk pregnancy is no guarantee of a low-risk birth. Women want - and always have wanted - the safety and knowledge and expertise that comes in a hospital setting.
“It’s disgraceful that the NZ College of Midwives and ministry have continued for three decades to push their own agenda and philosophy around primary birthing, and yet remain deaf to the wishes of the very consumers they’re there to serve.”
In June, the Herald reported that Health NZ was encouraging women already booked to give birth at Auckland Hospital to reconsider giving birth at home or at a primary care facility like Birthcare.
Policy at the hospital is to discharge mothers and their newborns to Birthcare for postnatal care or home three to four hours after birth, if they both are well.
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