A midwifery union saw a shortage of midwives in Rotorua "emerging" three years ago and met with Lakes District Health Board hoping to address it, its co-leader says.
Midwifery Employee Representation and Advisory Service (MERAS) co-leader Caroline Conroy says in her view the DHB has not given workforce planning "enough attention".
The DHB says the union comments are "unfortunate" from its perspective and it is working hard to recruit midwives amid an international shortage. In the meantime, it is managing thanks to the collegiality of midwives and professionals including junior obstetric doctors, obstetricians and lead maternity carers.
Conroy's comments came after a midwife spoke out to the Rotorua Daily Post about the impact of the shortage on Rotorua Hospital, saying it was "incredibly unsafe" and "stressful". Another local maternal health professional said the shortage was concerning but women would still receive high-quality care.
Conroy said union representatives met with Lakes DHB about three years ago because they could see a midwife shortage "emerging" and wanted to work with it on workforce planning.
"They told us that they had a workforce plan and to date, I've never actually seen that plan."
In her view, the DHB had not given workforce planning "enough attention" since then, but was now "willing to engage with us a bit more".
Conroy also said she believed the DHB "underinvests" in midwifery leadership.
"If you don't have sufficient investment in your midwifery leadership, you don't have people in the right roles to provide that leadership and drive change."
A Lakes DHB spokesperson said it was "very unfortunate" the union had made this statement because it knew "very well how hard the DHB has been working to fill these positions".
"Lakes DHB is 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."
DHB chief operating officer Alan Wilson said a 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 the 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 colleagues and the hospital."
Wilson said the DHB had managed so far with the goodwill and collegiality of everyone involved.
"Midwives have continued to provide amazing care to women - in spite of the constraints - and the compliments received testify to that."
He said maternity service provision always involved a team and while the services were stretched, there were other members who were part of the team who always worked together to assist. This included lead maternity carers, doctors and lactation consultants.
Too few midwives trained - union
Conroy also said she believed there had not been enough local people training to be midwives in the past few years.
"It is actually about the insufficient numbers of midwifery graduates coming out every year and that's the thing that needs to be fixed, particularly from Wintec."
Wintec was the local school for midwifery and last year had no new graduates that lived in the Rotorua area, she said.
"Wintec needs to be training a lot more midwives than it currently does given the number of DHBs it serves.
In her view: "The numbers that they have produced have been grossly inadequate for what's needed even to replace people retiring."
Wintec centre for health and social practice director Jodi Fata said Wintec had been training midwives through its Rotorua hub for years. It also delivered training in Tauranga, Whakatāne, Hawke's Bay, Hamilton and Gisborne.
Fata said Wintec enrolments for this year currently exceeded previous years' intakes.
There were two graduates in 2019, four in 2020, and for 2021, three were about to graduate in March at the end of their third semester. Six midwifery students were completing their final year of training and would graduate in early 2023.
"Wintec is well aware and acknowledges the situation that the midwifery profession is currently facing."
Fata said midwifery training included completing a high ratio of clinical hours.
"Midwifery students will spend at least 2400 hours of their degree educating in a clinical environment one-on-one with a currently practising midwife ... Those clinical placements must include a combination of training hours in DHBs and community settings.
"The increasing shortage of community and DHB midwives, impacts not only the communities they service, but also training institutions like Wintec to be able to support our students to access the placements required to complete their training."
Not 'easy' to find a midwife in Rotorua
A Rotorua resident expecting their first child in March says "it wasn't easy" to find a midwife.
Speaking on the condition of anonymity, they said they had been told by nurses and mothers to "get in quick because there's not many to choose from".
"When I first started looking, I probably contacted at least half a dozen midwives to try to find one, and they were all completely booked out for when I needed one.
"Eventually it was actually a nurse who had one that wasn't listed and put me in touch with them.
"So I did manage to get one but it wasn't easy."