YOUR COLLEGE

scope of practice submission

The College undertook an extensive process of engagement with members in order to prepare a submission to Te Tatau o te Whare Kahu | The Midwifery Council of Aotearoa New Zealand on the draft Revised Scope of Practice Statement.

There was extremely strong support for the integration of te Tiriti o Waitangi into the revised scope statement, and the elevation of cultural safety to a level of equal importance as clinical safety.

A large amount of feedback expressed confusion about the boundaries of practice and a request for more clarity around the clinical parameters of the scope and people for whom a midwife can provide clinical care. The College’s approach of maintaining the integrity of the revised scope wording, but adding text to clarify areas where multiple interpretations have arisen, was strongly supported by members.

The College also identified the need for Council to promote te Tiriti o Waitangi education and opportunities for midwives to explore the deeper meanings of the word whānau, in order to support understanding and implementation in practice. square

TE REO MĀORI STRATEGY

Te reo rangatira, te reo Māori is the first language of Aotearoa and a taonga which must be protected, promoted, spoken and respected.

The College board has approved a strategy to increase and promote the use of te reo Māori in its documents and communications, as part of the College’s wider commitment to te Tiriti o Waitangi. The strategy was developed with the support of tāngata whenua board members.

The inclusion of kupu Māori has increased within this magazine, with common kupu such as whānau, wahine and pēpi being used routinely without English translations. Less common words are increasingly being introduced.

College kuia Crete Cherrington notes the new scope of practice and recertification requirements from the Midwifery Council should also provide more opportunity (and requirement) to engage with te Tiriti and te reo Māori. square

health system reforms

The proposed operating model and high level structure for both Health NZ | Hauora Aotearoa and the Māori Health Authority was released in early May. Although there is much detail to be worked out, the Health NZ | Hauora Aotearoa structure proposes a clinical leadership team comprising four national director positions, covering:

• Medical

• Nursing/midwifery • Allied health, scientific and technical professions • Primary and community.

The College (along with MERAS and the DHB Midwifery Leaders Group) have written to Health NZ | Hauora Aotearoa Chief Executive Margie Apa, expressing our concern at the proposed combined nursing and midwifery leadership position, indicating it is inappropriate for midwifery to be represented in this way and advocating for midwifery to have its own, separate leadership position. square

HAUORA TAIWHENUA

The College board has agreed to establish a maternity chapter of the newly created multi-disciplinary rural health advocacy organisation Hauora Taiwhenua. This follows the College’s longstanding involvement with Rural Health Alliance Aotearoa NZ (RHAANZ). Rural midwives Tawera Trinder (Taranaki) and Kendra Short (South Canterbury) have been ratified by the College board as co-chairs for the chapter. The chapter is now seeking rural midwifery representatives from the College’s membership across the motu, so the breadth of issues facing rural midwives and maternity services can be included in the chapter’s work. square

SGA guideline consultation

A new national SGA and FGR guideline has been in development over the last 18 months and will shortly be consulted with the maternity sector. The guideline includes a comprehensive review

of the evidence and international guidance, with recommendations for the Aotearoa maternity context. The guideline covers antenatal screening, monitoring and birth planning for women with SGA or FGR pregnancies, and neonatal care for babies born SGA or FGR. The guideline was put together by a multi-disciplinary working group, including: midwifery, obstetrics, fetal medicine, neonatology and radiology. Midwifery representatives were from the College, Ngā Māia Māori Midwives and the Pasifika Midwives Group. An invitation will be emailed to College members to participate in the consultation in June or July. square

REVIEW OF MORTALITY REVIEW FUNCTIONS

In response to a request from the Minister of Health, in 2021 the Health Quality and Safety Commission (HQSC) commissioned a review of the mortality review function in Aotearoa, including the five current Mortality Review Committees (MRC) which are dedicated to reviewing: deaths of children and young people; babies and mothers where death is caused by pregnancy or childbirth; deaths resulting from family violence; deaths associated with surgery; and deaths by suicide.

The College’s representatives on several of these committees and sub-committees provided verbal feedback during the review process, as did the College Chief Executive when initial findings were presented to the professional associations. The College has advocated for the continuation of these committees and supports the vision of a te Tiriti-based mortality review system. The College has requested that the HQSC provide key stakeholders with the opportunity to provide formal feedback on the written report and proposed changes once they are published, so that our experience and perspective can be considered in the decision-making process about future mortality review functions. square

College kuia Crete Cherrington notes the new scope of practice and recertification requirements from the Midwifery Council should also provide more opportunity (and requirement) to engage with te Tiriti and te reo Māori.