Rotorua Hospital: Midwife believes staffing shortage is 'incredibly unsafe'

The Lakes District Health Board says it is struggling to recruit midwives at Rotorua Hospital. Photo / Andrew Warner

A shortage of midwives at Rotorua Hospital has been described as "incredibly unsafe" and "dangerous" by one midwife.

The midwife said there should be four midwives on a weekend night shift at Rotorua Hospital but last Saturday there was only one.

Another health professional said the shortage was concerning but said women would still get "a high-quality standard of care" and it was still "safe" to have a baby.

Lakes District Health Board said it tried to have five midwives or nurses on per shift in the Rotorua maternity unit, but it was often only able to have two to three.

Rotorua Hospital was struggling to fill vacancies, the board said.

The midwife, who spoke to the Rotorua Daily Post on the condition of anonymity, said, in their view, women may get "less care than they normally would" because midwives did not have the time to help them.

They said in their opinion: "It's so short-staffed, it's dangerous."

The midwife said the staffing full-time equivalent was five midwives on most shifts for the perinatal and birthing units, and four midwives for the Saturday afternoon, night and all of the Sunday shifts.

However, some shifts only had one or two midwives on for both units. The DHB said there was "often" only two to three midwives per shift.

The Lakes DHB said there are often only two to three midwives per shift. Photo / Andrew Warner

Concerns had been raised with management and extra pay for midwives had been approved. But "most midwives are feeling quite burned out and not wanting to do those extra shifts," the midwife said.

"On the weekend there was a shift with only one midwife on the night shift ... that's incredibly unsafe and very stressful," they said, expressing their view.

The midwife estimated about six midwives had left in the past six months and had not been replaced.

"It's pretty dire. And more midwives are planning on leaving.''

"The [pregnant] women get less care than they normally would because you don't have the time to sit with them and chat or help them with breastfeeding as much as you'd like to.

In their view: "You can't provide safe care because there's not enough staff to allow you to do that."

Lakes District Health Board chief operating officer Alan Wilson. Photo / Supplied

A maternal health professional in Rotorua, who also spoke on the condition of anonymity, said the staffing shortage was "hugely concerning".

They did not know how long midwives could withstand the pressure while providing "that top quality of care".

The professional said midwives leaving had been "happening for a while" with the vaccine mandate causing the loss of three at the Lakes District Health Board.

All health board staff were required to have had their first Covid vaccination by 11.59pm on November 15.

When asked how the remaining midwives were coping, the professional said it was "awful" and it had "probably" added to some midwives' decisions to leave, cut back their hours and take stress leave or sick days.

"They're under such a lot of pressure and that's a difficult working environment when everybody is stressed and there's never enough staff to go around.

"They're torn between going to work even when they're not up to it and then becoming more stressed because they're not able to have time to be well and to look after themselves."

The professional said several registered nurses were staffing the post-natal ward because of the midwifery shortage.

Although registered nurses were "skilled and qualified practitioners", they did not have specific maternity training such as for supporting breastfeeding.

"Staff will come from other areas of the hospital and doctors will come but the first port of call is always the other midwives so when there aren't many or any of them, that's clearly problematic."

Midwifery Employee Representation and Advisory Service co-leader Caroline Conroy said many of New Zealand's maternal units had been experiencing a shortage for the past three to four years.

"The midwifery shortage has become worse, and is now impacting on the ability to roster sufficient numbers of midwives on each shift."

Midwives were doing extra shifts and were becoming very tired and exhausted as a result, she said.

Lakes District Health Board chief operating officer Alan Wilson said the board tried to have five midwives or nurses on per shift in the Rotorua maternity unit, but it was often only able to have two to three.

"Rotorua Hospital is struggling to recruit enough midwives to staff the Rotorua maternity unit.

"We have been actively recruiting midwives but it's very hard when there is a national and international shortage of midwives, and when midwives from overseas countries are unable to work as midwives in New Zealand."

There were 14.5 midwives and 4.2 registered nurses employed in the maternity unit at Rotorua Hospital, Wilson said, but he was "optimistic" the situation would improve over the next six months.

The birthing unit at Taupō hospital. Photo / NZME

"Previously we had to close the Taupō unit, which does primary births only, for some shifts due to staff shortage and that situation there has now been reversed with a move to full staffing.

"We have a strong team of hospital midwives in the Taupō unit, which is now fully staffed and well supported by the local midwives in Taupō.

"We are optimistic this will occur also in Rotorua in 2022."

Wilson said the hospital midwife was one member of the obstetric and maternity team, and in any situation where staff sickness or shortages made it difficult to staff the unit, arrangements were always put in place to manage that particular situation.

"There are junior obstetric doctors on-site 24/7, obstetricians on call, and we are grateful that the Lead Maternity Carers continue to really help out both their collegues and the hospital."

The DHB had hired experienced overseas maternity registered nurses who were "very helpful" because they came with obstetric nursing skills, which were "very useful" in the perinatal unit.

Wilson said the midwifery education model in Australia, which allowed nurses to complete midwifery training as a post-graduate qualification in a short period of time and then work as midwives, could "contribute significantly" to the availability of midwives.