She was airlifted to Auckland's Starship Hospital emergency department, where police said she was in a serious but stable condition.
"The pregnant driver of the car suffered minor injuries and was also airlifted to hospital as a precaution. The drivers of both 4WD vehicles were shaken but uninjured in the crash," Mr Fitzpatrick said.
Norm Ngatai, shift manager at the St John Ambulance northern communications centre, said the two other patients treated at the scene sustained moderate and minor injuries. They were taken to a local medical centre for treatment.
"Attending emergency service personnel acknowledged the work done by several members of the public who assisted the casualties before they arrived, in particular off-duty medical staff," Mr Fitzpatrick said.
"Police would like to hear from any of these Good Samaritans who haven't already been interviewed by police."
Due to heavy traffic in the area at the time, it is believed a lot of people would have witnessed the collision, Mr Fitzpatrick said. He called for them to come forward.
"The challenge for us is many motorists in this area are visitors or maybe even overseas tourists and we need to speak to them before they leave for home or head out of the country," he said.
"For that reason we're asking that if you saw something then do something -- ring Sergeant Andrew Morrison of the Whitianga police on 07 866 4000."