FOSTERING OPTIMISM

from the president, new zealand college of midwives, nicole pihema

Nau mai haere mai ki Aotearoa New Zealand Midwife

As I write this editorial, I’m still processing the after-effects of an incredible mātauranga Māori noho marae for midwives, that I was privileged enough to attend near Ōtaki recently. The full story and a new te reo Māori translation for the word ‘midwife’ can be found on p.25.

This edition’s cover celebrates the launch of Te Ara Ō Hine – Tapu Ora, the joint project between the Ministry and midwifery education providers which will see $6m invested into Māori and Pasifika undergraduate students over the next four years. For all the details, see p.28.

Three midwives and original College members have sadly passed on in the last six months and we pay tribute to Glenda, Rhondda and Nita on p.7. Thank you to Dawn, Maureen and Juliette for sharing your memories of these wonderful midwives with members.

The first in a series of planned articles on perinatal mental health can be found in this edition, providing an overview of the issue in Aotearoa and its prevalence, and discussing some of the current challenges faced by midwives (p.16).

Guest contributor midwife Esther Caljé provides a comprehensive practice update on anaemia and its management (p.20), whilst the Well Child Tamariki Ora referral process is viewed through an equity lens on p.36.

Breastfeeding Connection addresses a challenging topic we all know too well on p.30: supporting early breastfeeding on busy postnatal wards, and on p.40 the world of postgraduate study is demystified for those of us who haven’t yet taken the plunge.

As always, we hope members will find this issue informative and interesting, and we welcome feedback and/or article suggestions and submissions for consideration.

Mā te wā, Amellia Kapa, Editor/Communications Advisor

Email: communications@nzcom.org.nz square

Ka pū te ruha, ka hao te rangatahi. As an old net withers, another is made.

A perfect metaphor for the ousting of the currently burdened, inequitable health system, this whakatauki also invites us to be optimistic about the opportunities inherent in endings - opportunities to explore new ideas and new ways of doing.

The Government’s recent announcements regarding the centralisation of health care and the establishment of a Māori Health Authority were timely for midwifery, following hot off the heels of the launch of Te Ara Ō Hine – Tapu Ora. Up until now, there has been little to no accountability on the Government’s part for the unacceptably inequitable health outcomes suffered by Māori, and the creation of the new Māori Health Authority may finally signify the start of positive, long-lasting change.

Unsurprisingly, misinformation surrounding the new Māori Health Authority is rife, with misperceptions circulating purporting the authority to be a completely separate Māori health system. Of course, this is inaccurate; a result of the very same bias that sees Māori accessing health care and receiving treatment later than our non-Maori counterparts, if in fact we receive treatment at all.

Though the finer details are yet to be released, what we do know is that the Māori Health Authority will operate in partnership with Health New Zealand, and will have commissioning rights to dictate how money is spent to ensure Māori health outcomes actually improve. In the same vein, the authority will have veto rights to shut down any proposed changes that could further harm Māori. In theory, the two organisations will work together in a truly Tiriti-honouring partnership, to transform the health system into one Māori can trust, and will therefore be more inclined to consult earlier, rather than later.

Similarly, the $6m investment by the Ministry into the increased recruitment and retention of Māori and Pasifika midwifery students heralds the beginning of even further change, presenting our profession with a fantastic opportunity to address the inequities that currently exist within our workforce.

Ultimately, increasing the number of Māori and Pasifika midwives in Aotearoa means wāhine of Aotearoa will have more choice, and will therefore be more likely to be cared for by a midwife they recognise as a reflection of themselves. The significance of this should not be underestimated; as midwives, we all recognise the power inherent in the connections we nurture with wāhine and their whānau throughout the childbearing journey, and what better way to establish these connections, than through common values and worldviews?

As I see it, these systemic developments complement each other beautifully and are symbolic of what I hope is a more fundamental shift as a nation towards true partnership, as was originally intended with the signing of te Tiriti o Waitangi all those years ago. As we know all too well, the numbers don’t lie, and there is no denying that the public health system has been failing Māori since its inception.

But I implore you to remain optimistic. At the risk of being sorely disappointed, we must keep our hearts and minds open to the very real possibility of positive, permanent change.

This is what it means to truly and completely embody tino rangatiratanga, and I encourage you all to integrate this powerful practice into your daily lives. square