Healthy Beginnings, Hopeful Futures
A year-long campaign on maternal and newborn health.
Well, I don't know if I'm ready
To be the man I have to be
I'll take a breath, I'll take her by my side
We stand in awe, we've created life
With arms wide open under the sunlight
Welcome to this place, I'll show you everything
Songwriters: Scott A. Stapp / Mark T. Tremonti.
Today is World Health Day, a global celebration promoting health awareness that has been run by the World Health Organisation (WHO) for 75 years.
This year’s theme is “Healthy beginnings, hopeful futures,” today, a year-long campaign on maternal and newborn health is launched. Its goal is to increase efforts to end preventable newborn and maternal deaths.
So it’s pretty woke, being the WHO, an organisation often derided by self-researchers fond of conspiracy theories and all about women and babies - with nothing at all for men. So probably best not to tell NZ First or there’ll be calls for an equal emphasis on paternal health, or some such nonsense.
Worldwide, nearly 300,000 women a year lose their lives due to pregnancy or childbirth, over 2 million babies die in their first month of life, and around 2 million are stillborn. That’s roughly one preventable death every seven seconds.
The key objectives of this programme are to:
Reinvigorate efforts to ensure equity in access to high-quality healthcare for women and babies.
Invest to ensure women everywhere can access health providers before, during, and after pregnancy.
Improve the rights of women and girls everywhere so they can better protect their health.
You would think that in the 21st century, these ought to be predominantly third-world considerations, but they’re most certainly not.
According to the 16th annual Perinatal and Maternal Mortality Review Committee (PMMRC) report released last year, in Aotearoa, there had been no significant decrease in perinatal (often defined as the period from 22 weeks of gestation to 7 days postpartum) mortality between 2007 and 2021.
If you think that sounds bad, wait for the next part, as described here: World Health Day puts spotlight on women’s health and wellbeing.
“The report found that ethnicity, deprivation and age inequities persisted across perinatal and maternal mortality. Although there was a decrease in maternal mortality rates from 2006 - 2012, Māori and Pacific peoples had over twice the rate of maternal mortality compared to the group with the lowest rate (European). If the Māori and Pacific mortality rates were the same as the European rates, overall maternal mortality in Aotearoa New Zealand would be 30 per cent lower.”
Isn’t that appalling?
That Māori and Pasifika have twice the rate of maternal mortality as Europeans. It makes me want to weep; not only that, but it makes me furious to hear people after the Select Committee recommended bringing the Treaty Principles Bill to a conclusion, still moaning about a referendum and so-called Māori privilege.
Where the hell is the privilege of having twice the maternal mortality rate?
I often feel awkward writing about things from an outsider's perspective, but I would like to share some of my experiences, and I hope no one finds that inappropriate.
As you might be aware, I have five children:
Alex was born at Rotorua Hospital in 1990. I had just turned 19, while Maria, who would be my first wife, was 21. When we arrived, the lady we saw informed Ria that she wasn’t in labour, which was news to her. However, it didn’t prevent Alex from arriving just a few hours later.
Two years later, my daughter Emma was in such a hurry that she arrived before I even got to the hospital, Ria having gone into labour while shopping in town with her mum.
Fast-forward to 2004, and Fi and I were expecting our first child, Johnny, who arrived shortly before midnight following a very long labour at National Women’s.
This was shortly before that hospital was closed, and it was incredibly run down; some of the floors looked as if they hadn’t been renovated since the war, and the whole place had distinct, about-to-fall-over vibes. Shortly after young Johnny’s arrival, we were turfed into the cold August night to make our way to Birthcare.
In 2006, our Thea arrived at Birthcare, another long labour as our strong-willed daughter who always knew her own mind was facing the other way. The single most terrifying moment of my life occurred after she arrived.
Fi ended up passing out on the floor after losing a lot of blood, white as a sheet. The new arrival was thrust in my direction, and the health professionals went into overdrive. For a moment, I thought I was going to be left with this helpless wee one and without my partner in life.
I will forever be grateful for the skill and love of the midwives who looked after my Fi. Thank you, Glenda.
In 2008, the last to arrive, in birth as in life, was our Matty, who always leaves things to the last minute. When he finally turned up, it was very quickly - an unplanned homebirth on our lounge floor not very long after our midwife, Glenda, arrived.
My experiences, going back decades, are of a rundown public health system, more modern private-style birth care facilities where you pay for the privilege of staying longer or having your own room, and the most wonderful group of health professionals you could hope for.
I’m not just talking about the births, all of the antenatal and postpartum care; these are awesome people and, as far as I'm concerned, some of the most important people in our society.
Can you imagine how much midwives would be paid, given the importance of what they do, the pressures they face, and the hours they work, if it were a role performed mostly by men? Be a damn sight more, wouldn’t it?
As of January this year, changes mean that low-risk births can still occur at Whakatāne Hospital with the assistance of midwives. However, any patient requiring intervention—such as an emergency caesarean—would have to go to Tauranga Hospital - 90km away.
From the 2023 Census: About 650 babies are born at Whakatāne Hospital yearly. It is the only hospital in the eastern Bay of Plenty, serving a population of about 55,000, just over 50% of whom are Māori.
According to the midwife who spoke anonymously, “Pregnant women with risk factors including but not limited to a high Body Mass Index, pre-existing medical conditions that could impact a pregnancy, and any current or previous pregnancy complications would be recommended to birth at Tauranga Hospital.”
That’s a lot of people having to go a long way for essential medical services, and as the midwife who spoke out said - it’s going to kill someone.
Some women are struggling to simply have access to a midwife. Leaving them with no choice but to go to the hospital to have their babies and be cared for by whoever is rostered to the shift.
College of Midwives chief executive Alison Eddy said, “In an ideal world, every woman and their family would be able to choose a midwife to be their lead maternity carer.
“There's a growing portion of women that we know are receiving this more fragmented care because of the workforce issues and the challenges the system is facing.”
Meanwhile, in the smoke and mirrors department, National is looking to extend hospital stays for mothers from 48 to 72 hours without additional resourcing.
Mothers and newborns across the country could be offered a minimum of a three-day hospital stay if a new bill is successful, but there are concerns the maternity system does not have capacity.
Founder and CE of Birth Trauma Aotearoa Kate Hicks said:
“Currently, maternity systems and services across Aotearoa are very stretched, and sometimes it is even the cause of people's psychological trauma relating to birth.
So what we need to know is how will the extra day be recognised and resourced.
Many of the organisations and individuals I've talked to, that's been one of their central concerns. It's a brilliant idea, the intention of the bill is fantastic, but how is it going to be realised, how are we going to resource these changes.”
National MP Catherine Wedd, who introduced the bill, said, “Resourcing needs will be better understood once this policy is in place.”
Maybe I’m old-fashioned, but in my years of managing and delivering projects, it has been my experience that you want to have a high-level understanding of your resource requirements upfront rather than discovering them as you go later.
By all means, adapt as information comes to light, but I would’ve thought it was pretty obvious to everyone by now that there is no spare capacity in our health system for new initiatives that sound good but merely add to the workload of people who are already stretched.
In the US, we see women’s health rights under attack, and when I look at our government benches with people like Luxon, Brown, and Penk, I’m not convinced women here should relax either.
Our Health System is underfunded and struggling to deliver despite the often heroic efforts of the people who are there to care for us. It is hard to see this government taking on initiatives beyond things that sound good on the news but haven’t been resourced.
This makes no sense. Not only is it unacceptable not to do all we can to prioritise maternal and newborn care from a moral imperative, but it also makes sense for the country in the long term. I can’t think of anything more important to invest in.
According to the WHO: “In low and middle-income countries, every $1 invested in maternal and newborn health is estimated to yield around $9 to 20 in return. Evidence shows that spending on maternal and newborn health leads to economic development and happier, healthier societies.”
Seems like a better investment than more roads or tax cuts for landlords, don’t you think?
Have a good day, all you lovely people. If there is someone you think might be interested in reading today’s newsletter, you’re most welcome to share it. 🙂
Fi and I drove to Maketu the other weekend from Rotorua and, coincidentally, were talking about the distance to Whakatane. It's awful, places like the eastern BOP, Northland, East Coast, etc. The services aren't good enough and are getting worse—and these are places that elect the Nats.
Where are all the "pro-life" people agitating for better maternity services? Conspicuous by their absence. If they really meant what they preach, they'd be on this.