Having a home birth in the Eastern Bay of Plenty is getting trickier because it requires two midwives - and there aren’t enough.

Mums-to-be in the Whakatāne area who are asking about home births have been told they can’t be guaranteed the two midwives and that they should go to the maternity ward at the hospital.

The Whakatāne Beacon has spoken to one mum considering a home birth without a midwife present. Another is still hoping she can have her baby at home, but isn’t sure it’s possible.

The midwife shortage is being felt internationally, according to health authorities, and the local branch of Te Whatu Ora – Health New Zealand says there’s a continual recruitment drive and new midwives have recently been appointed in both Eastern and Western Bay of Plenty.

Midwives say the situation is dire countrywide.

Bella Johnson, a doula (labour assistant) in Whakatāne, said women’s options were being restricted because of the shortage of LMCs, or lead maternity carers, who are contracted by the Ministry of Health to provide independent midwifery in the community.

Mums also have the option of care through the hospital’s maternity unit.

Another concern is that mothers are not receiving the continuity of care which is recommended and leads to a better outcome for the mum and baby, and a better experience for the mother.

“I have been contacted by quite a few new mums who are really excited to fall pregnant, excited to connect with a midwife. And then they find out, actually, everyone is busy, and now they just go to the hospital, and they meet with whoever is rostered on that day.”

Johnson said there were mothers wanting home births who were being told that they would not know if the midwives were available or not until they were in labour.

“This is creating a situation where there are some mothers who will go ahead with having a home birth whether or not a midwife will attend.”

Danielle Noblett is due to have her third baby in three weeks and is considering having an unassisted home birth.

She had an unpleasant experience with her first labour in hospital in Rotorua and a “beautiful experience” with a home birth with her second child in Whakatāne, where two midwives were present.

“I really just felt empowered and safe. My midwife was so supportive ... she just settled all our concerns and she said anything that could likely happen, we will know in advance so we can get you to the hospital.”

Noblett said her previous midwife had recently moved from being a lead maternity carer, working in the community, to the maternity ward at Whakatāne Hospital. No other midwives are prepared to commit to a home birth as they cannot guarantee two midwives will be available.

“The only other option is to have an unassisted birth at home. And if there are any concerns, and I am well aware of the concerns, I am absolutely fine with going to hospital if I have to, because I want baby to be safe. But as long as I am healthy and baby is healthy, home is the best place for me.”

Another Whakatāne mum-to-be, who did not wish to be named, said she had an amazing home birth with her first child, but she was unsure if she could have another home birth for her second child in October.

“Short of birthing with your partner there, or not having a medical professional present - which is probably not advised - it is really hard. And as there is no birthing centre in Whakatāne, the maternity ward is the only option.”

She’d heard from her midwife that not so long ago there were eight midwives she could call on in Whakatāne to help at home births, but now there were only two.

A midwife, who did not wish to be named, said midwives contracted by the Government were not permitted to comment to the media, and the situation was dire.

“It is so sad, and it is the state of maternity services in the country ... we went from 15 midwives about four or five years ago, and now there are three LMCs full-time and one part-time in Whakatāne.”

Many were leaving because of burnout or retirement, while a few left because of the Covid mandate.

The midwife said with more retiring this year, the region could be left with only two midwives in Whakatāne and two in Ōpōtiki.

“Which means there are no choices for mum. We can’t provide home births because legally you have to provide two midwives at a home birth.

“It is heartbreaking for the mums, and it is also heartbreaking for the midwives, because we love home births.”

Former midwife Kim Mullooly, who lost her job because of the Covid vaccination mandate, agrees the situation is dire.

“We all did home births and I guess that has put pressure on the remaining midwives.”

She said potentially there might be mums out there who would choose to birth on their own because no midwives were available.

“That is not recommended, but I am not the first person to suggest that it is a possibility and so that is a concern. “

She also raised concern about lack of continuity of care.

“For 24 years we were able to offer continuity of care, they would have the same midwife throughout, and so that is becoming less of an option.”

Shortage felt everywhere

Health authorities say the shortage of midwives is being felt nationally and internationally.

Te Whatu Ora – Health New Zealand Hauora a Toi Bay of Plenty acting director of midwifery Judith Madsen said they were in a continual recruitment drive for midwives.

“And there is also work being undertaken on a national level to address midwifery recruitment issues. We have recently appointed new midwives both in the Eastern and Western Bay of Plenty.”

With the shortage of LMCs, it is expected more women will be using the antenatal services at the hospitals.

“Where at all possible, our primary care services will provide continuity of care for our clients to reflect our continuity of care model.

“Our outreach clinics are staffed in a way so that women are seeing the same midwife, unless someone is sick or on holiday.

“We have recently employed four new midwives for the ward and clinic for Ko Matariki Maternity.”

Madsen said staff had been working extremely hard to meet the needs of all their clients.

The Ministry of Health also commented that it was very aware that some DHBs were carrying high numbers of midwifery vacancies and faced challenges recruiting and retaining midwives to their workforce.

“Strengthening the maternity system, including addressing the shortage of midwives, is a priority for the health sector and for this Government.”

Credit: Whakatāne Beacon