The lives of two people are in the hands of midwives - a mum and baby - yet professionals in the job are having to go to Australia to earn decent money, local midwifes say.
Rotorua midwives, who begin strike action today, hope to send a clear message to the Government to pay those in the profession more.
There are 46 midwives employed by the Lakes District Health Board who are joining more than 1100 others in a nationwide strike for two weeks that will see two-hour work stoppages.
The decision to strike was made on November 5 after negotiations between midwives and district health boards, which began last year, failed.
Midwifery Employee Representation and Advisory Service (Meras) Rotorua branch co-representative and registered midwife Amie Watson said striking was not something midwives took lightly.
"We are responsible for the lives of not one but two people and midwives are on the brink of burn out."
Experienced midwife Francis Kissling said she had gone to Australia twice last year for four to six-week stints and would be forced to go back again next year three times from February.
She said four of her colleagues had moved to Australia for better pay and she and five others travelled regularly to Australia in short stints to earn more.
She said her base rate in New Zealand was $32 an hour compared with $54 in Australia. Her accommodation and flights were also paid for in Australia.
"I thought this Government was saying they had a surplus but all the teachers, nurses and midwives are striking."
She said she didn't want to go because it meant leaving her two school-aged daughters, son and husband at home but her wage was less than what a bushman earned.
"I'm not saying they don't deserve it, I'm saying I feel pretty undervalued. I revive babies, stop women bleeding to death, help mammas learn to breastfeed, the list goes on.
"Is it I'm devalued and paid less because I'm a woman? Is it that women's health is devalued?"
She said the rest of the world tried to base their maternity care on New Zealand.
"We have something so unique and special that's proven to provide the best outcomes for women and babies. The rest of the world think we are special but it feels like our Government thinks less. How about reducing the amount politicians get paid instead?"
She said her work consisted of postnatal care but she also worked casual shifts at Rotorua Hospital.
"Lots of mothers don't have midwives in Rotorua and so the district health board has to pick up those in the community.
"It puts massive strain on midwives at district health boards and they are so incredible. I work casual at the hospital, they really are terribly under-staffed. It's hard to recruit also as we just don't have the midwives and the money is so bad, why would you work for less?"
Lakes District Health Board clinical midwife manager Corli Roodt said in a statement they had spent the past fortnight provision planning.
Roodt said Rotorua and Taupō birthing units, postnatal units and maternity outpatient clinics would be affected.
Roodt said contingency planning meetings held each weekday were focused on ensuring the needs of mothers and babies would be safely met.
The statement said the planning process would ensure minimal disruption to the public, with adequate cover in place during the industrial action.
"The DHB has agreed with the union for a number of midwives to be on site to provide care to women to keep them safe during the hours their colleagues are on strike. More midwives are on call if needed," Roodt said.
"Everything is being done to ensure all mothers and babies receive safe care during this time."
Staff will be in direct contact with patients if they need to change planned care.
Roodt said she wanted to reassure women there would always be someone to open the door and answer the phone at maternity services at Rotorua and Taupō hospitals during any of the stoppages.
Expectant Rotorua mother Amy Foote said midwives did a good job but she was thankful her midwife was not in the union and wouldn't be striking.
With her husband being a farmer, Foote said she was lucky he could help her if need be, but understood that not every expectant mother was so lucky.
"It would be frustrating, because you have been with them and on a nine-month journey, they know your birthing plan and what medication you want. And if they're not there it would be scary."
Minister of Health David Clark said he was not part of the negotiations but no one wanted to see industrial action.
"There is still time to find a settlement and I encourage both sides to continue negotiations."