More limitations on Kaitaia births

By TONY GEE

Kaitaia Hospital midwives have been warned by Northland Health not to induce women's labour without clinical obstetric support from Whangarei.

The midwives are understood to interpret the warning as a backdoor method of again effectively cutting maternity services they can offer Far North women at Kaitaia.

Northland Health's clinical director of obstetrics and gynaecology, Ian Page, wrote to the midwives saying women in Kaitaia requiring use of the drip syntocinon to induce labour should be sent to Whangarei Hospital.

Delivery of babies to women who had a history of needing caesarean operations was also discouraged without obstetric support from further south.

The warning comes only days after an agreement was hammered out following intervention by Health Minister Annette King to restore caesarean and other fulltime surgical services at the hospital while a three-month review tries to find a permanent solution to providing surgery and maternity services at Kaitaia.

Mr Page was in Australia during the weekend and is not due back in Whangarei until later today.

It is estimated the restrictions on inductions and deliveries to women with caesarean histories could affect up to 30 per cent of Kaitaia Hospital's maternity service patients.

Northland Health communications director Luke Worth said yesterday that Mr Page's letter outlined a process of clinical guidelines for midwives which was endorsed by the Ministry of Health and the College of Midwives.

This had resulted from a review of a case involving a woman at Kaitaia six months ago.

The issues at Kaitaia now were clinical, he said.

"As I understand them, it means Northland Health is not prepared to carry the risk of midwives carrying out these procedures in Kaitaia."

Anything done outside the guidelines meant responsibility lay with midwives at Kaitaia.

"That has been explained to them. They are aware of the guidelines and the College of Midwives has been involved in the process."

Kaitaia Hospital Action Group spokesman Ian Walker said Mrs King had been advised of the development, which the action group saw as "another demonstration of bad faith and lack of goodwill from Northland Health clinicians".

"They're not prepared to wait for the three-month review. They were pushed kicking and screaming into the agreement on Kaitaia Hospital earlier this month and now they're playing games already."

Mr Walker said the clinical managers were making decisions based on a narrow information base.

Different clinical standards were needed for different areas of the health system, instead of a national standard which tended to wipe out rural health services.

"The clinical directors are highly skilled specialists but they have no training or experience in delivering services," he said. "That should be left to skilled administrators working with community participation."

nzherald.co.nz/hospitals