Let us all love, love, love our maternity care system

iStock_000017004343XSmall_midwife_1

Unbeknown to many Kiwi mums-to-be, globally New Zealand is regarded as having one of the best maternity care systems on the planet, alongside Holland. We are the only country in the world that operates the government funded continuity-of-care system where every woman is entitled to have their own LMC (lead maternity carer) who looks after them antenataly (with say an average of 14 half-hour appointments); attends their labour-birth (routinely in the middle of the night); and provides seven or more postnatal visits in the first five weeks or so (including at least five home visits).

On an international scale, this is quite literally, a phenomenal level of maternity care. Even just across the ditch in our neighbouring Aussie, postnataly women may get one phone call a few days after birth, then a lucky few get one midwife home visit. Instead there are drop-in clinics where women can go to get their baby weighed. In American hospitals where there is no nitrous gas pain-relief option, and usually compulsory continual fetal monitoring, women are expected to receive an epidural and hormone drips (with the subsequent substantially worse birth statistics). Then they are routinely discharged home within twelve hours of birth and given their free sample of infant formula, to then receive no further follow-up care whatsoever.

And that’s just how it is… they just don’t expect anything else. Yet somehow here in God’s Own we have developed this extraordinarily fantastic maternity care system, and at the same time have created a culture of complaint … because the obstetrician was grumpy, or the midwife was busy, or the toast was friggin cold.

Yes, the Obstetrician was a bit grumpy. It had been a tough shift. Just an hour ago he’d heroically saved a woman’s womb from a hideous ectopic pregnancy, after already being up all night without any break because Birthing Suite was manic. He’s exhausted. He’s dedicated. He’s highly skilled, so appreciate it.

Yes, the hospital Midwife was busy. She’s always busy, but the ward has been insanely busy for the last 11 hours, and this is her fourth night in a row. She wasn’t even rostered to work, but someone called in sick so she agreed to miss out attending her daughter’s dance recital, simply because she’s here to help you, and all the other demanding women on her ward that night. Plus she’s still getting over the emotionally draining and incredibly sad 23-weeker fetal abnormality late-termination she needed to attend earlier in her shift. It always takes her a couple of days to shake off those memories.

And as for our LMCs. Good grief, they’re amazing women (and men). On-call 24-hours a day! Every time they lay down to sleep, they don’t know if they’ll get to sleep through that the night, or instead will be woken out of a deep sleep in the middle of the night, need to throw on clothes and gulp down a coffee while dashing to a client’s labour … while also knowing they have no idea when they’ll be back home, no idea when they’ll next eat, and no idea when they’ll next even sleep, let alone when they’ll next talk to their own children. Honestly who would want to do that job?!

Then on top of that they get vomited on, wee’d on, have to wipe women’s poo and sew up perineums – all in the middle of the night when the rest of us are peacefully sleeping. But even then women have the entitled audacity to complain we weren’t “satisfied” with her sensitivity, or they way she responded to our questions, or how she wasn’t at all times super easy to talk to – yet we’d drive her slightly nuts by ringing her on a Friday night to ask if Chinese takeaways is safe to eat, and texting her at 8am on a Sunday morning to double-check our antenatal clinic appointment time the following Wednesday (which is written in our Pregnancy Diary, but we’ve temporarily misplaced it).

So hey, one mum to another mum-to-be, could we all stop whinging and whining about what is wrong with the care we’re receiving – especially from our LMCs – and instead thankfully be grateful by celebrating graciously what incredible midwives – and obstetricians – we have FREE access to. With grace, let us all love, love, love our maternity care system.

Categorised: Pregnancy
Please note that this blog represents the views of the writer and does not necessarily represent the views of Kiwi Families Ltd.
  • Thalia Kehoe Rowden

    Brilliant!

  • Midwife Abroad

    Fantastic article to be printed off and put up at work I think! As a UK midwife working in NZ it’s so apparent to me that families here don’t know how incredibly fortunate they are. I am a Community Midwife by tradition (LMC) but now work shifts in hospital because I would never be able to dedicate 100% of my life to midwifery as the NZ LMCs here do, often to the detriment of their own health, families and marriages. Well said Anonymous Midwife!

    • http://www.kiwifamilies.co.nz/ Rochelle Gribble

      I totally agree, Midwife Abroad- I don’t know how my gorgeous LMC midwife does it and I sure know that I couldn’t!! 

      Rochelle

  • http://www.kathyfray.com/ Kathy Fray

    Brilliant, inspired, real.

  • Frustrated first time mum

    Well. I’m afraid to say that I don’t particularly love the level of care I have received. I live in the wairarapa where there have been no midwives available to me as LMC because we only have 3 independent midwives in the region and they were fully booked when I found out that I was pregnant at 7 weeks. I was able to be registered with the 1 GP-OB who unfortunately died two months ago. I have now been passed to the DHB team whom I have seen once, and they are still deciding whether or not they can take care of me or if they will send me to Wellington. I am 36 weeks pregnant, have no idea what I am doing and no one in this system cares a stuff about me or my baby. I have friends in Wellington and the wairarapa who are having similar experiences based on a shortage of midwives and no GP-OB’s. but, yay! What a marvellous system we have.

    • Kathy Fray

      Yes, like the West Coast of the South Island, the Wairarapa does have a crisis of lack of local LMC Midwives. Thus it’s not that you’re receiving poor midwifery care – it is more that you’re receiving no LMC care. But do know it’s not that no-one in the system cares about your baby or yourself (that is indeed very far from the reality). I saw yet another notification today with the Wairarapa and West Coast DHBs both trying to attract more LMC midwives to their regions because they’re so acutely aware of their current midwifery shortages. They’re offering short or long-term work; hospital shift-work or LMC case-loading; negotiable time-frames; support with travel and accom expenses; attractive support packages to relocate. Any new midwives would be welcome with open arms.

      However a large part of the problem I see it, is government funding: LMCs have just received their first pay-rise in 7 years, a truly pathetic 2.5% – and they needed 18% just to have kept up with inflation! We are loosing our midwives in droves to overseas, especially Australia, where they’ll earn a better income with a lower case-load. Then there’s the few GPs who continue to operate as LMCs – the few that do so, do it purely for the love of the job, not for the income, as their LMC attendance income (after the local hospital receives the Midwifery care income) is truly a small token amount.

      The issue is complex, for the Govt insist to LMCs that they have no further funds available to pay any maternity care providers a better income.

      Of course our healthcare system is not perfect – but in general terms we still, even with these issues, have some of the best care in the world provided to women – when we truly compare with what is received in the majority of countries on the planet. Though we appreciate this is of no assistance to you directly of course.

      KIWI FAMILIES IN-HOUSE MIDWIFERY EXPERT

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