How can we mend the divide in midwifery care in New Zealand?

The New Zealand health system is a socialised, universal health care system, with maternity care free to all New Zealand resident women, from primary to tertiary level, unless a woman chooses to pay for a private obstetrician. A key point of difference of the New Zealand maternity service from many other countries is that the majority of women are cared for by autonomous, self-employed midwives who are contracted to the state.

This midwifery-led continuity model is often promoted as the gold standard for maternity care for low risk women who report fewer interventions and higher satisfaction than with other models such as medical-led or shared care. It is also touted as a major contributor to the reduction of inequity, even so, maternal health inequity persists in outcomes, care processes, and women’s experience within the New Zealand health system.

However, there are issues that need to be addressed. Midwifery students say they are being used to plug roster gaps in the health system, which is grappling with a shortage of this critical health workforce, as more and more choose to head overseas or not renew their certificates

With more than four out of ten students currently dropping out due to financial pressure and burnout, the College of Midwives warns the government's plan to boost trainee numbers will fail if it is not adequately funded and supported.

In addition, in recent years there has been increased attention paid to the sustainability of rural midwifery in New Zealand. Concerns have been raised that there is a growing crisis within the rural maternity services, which is compromising women’s and babies’ safety. 

According to the health workforce taskforce report, New Zealand needs to triple the number of midwives it trains for four years to address the current workforce deficit, and even then it will not close the gap until 2031, when they all graduate.

More needs to be done.