We need to take a look at how our maternity system is funded and whether it works for all women in New Zealand - or are some missing out?
We have the right to expect a maternity system in New Zealand that is a high standard, yet with the recent media about mothers being forced to give birth on the side of the road and others being encouraged to leave hospital within 2 hours of giving birth, you would be right in thinking that our maternity system is letting us all down.
A maternity system that works for everyone is fundamental to good public health. A women’s wellbeing not just during pregnancy and childbirth, but also during the postnatal period is the single most important influence on the future health of a child and the health and wellbeing of a mother.
We live in New Zealand with a Government who’s kaupapa is to make our country the best place in the world for children.
“Yet, we are sadly neglecting the very point in time that will have the most impact – when a child is born.
There are many women who have good birth and postnatal experiences, who have their baby and are to stay in a maternity facility of their choice, one that is supportive and meets the needs of a new mum, her baby and family. However, the distressing stories, and there are many that don’t make the media, about new mums and their babies who are forced to leave hospital early and don’t receive the postnatal care they are entitled to are becoming common-place.
If we are really serious about making our country the best place in the world for our children then we must put the health and wellbeing of our new mothers and their babies at the centre of our maternity services.
“A roadblock to achieving this the way our maternity system is funded.
For a maternity system to work and be effective, the funding needs to follow the woman and her choice of birthing and postnatal-recovery facility. It is a fundamental right to choose where you give birth and in New Zealand, this doesn’t happen. At the moment, a DHB gets to decide which maternal facility is made available for a woman to give birth in and receive her 48 hours, funded, inpatient postnatal care.
The way our maternity system is funded is complex which is possibly why many women are not getting the services they are entitled to. While a woman gets to choose her lead maternity carer (LMC - the midwife, obstetrician or other health professional who take care of her during her pregnancy, birth and postnatal recovery), she cannot actively choose the location for her care. That decision is the DHB’s - they receive the funding, they get to choose how to spend this and they get to choose which maternity facility they would like to fund.
“This is postcode maternity care - living in a different region or a rural community should not deny a woman and her baby the right to the same maternity services as women in other parts of New Zealand.
Clearly this system doesn’t work and requires change. The introduction of a ring-fenced fund (as proposed by National MP Louise Upston(external link)) for our maternity system would shift the focus back to being women and baby centric and ensure we have a maternity system that needs of all women in New Zealand.
A ringfenced fund would put a stop to the inequitable access and would take away a DHB’s discretion to choose the maternity facilities they want to fund and ensure the maternity budget is spent how it is intended.
Not only does a ringfenced fund make sense, its not going to cost our country anymore instead it is ensuring the funding allocated for maternity services is used for exactly that purpose and it will go a long way to ensuring our women have the best start to motherhood and their babies the best start to their new life.