ACC COVER: MATERNAL BIRTH INJURIES

ACC COVER TO INCLUDE MATERNAL BIRTH INJURIES

The 2021 Accident Compensation (Maternal Birth Injury and Other Matters) Amendment Bill proposes an expansion of ACC cover to include maternal birth injuries. A broader definition of the term ‘accident’ has evolved to include force or resistance internal to the body, from the start of labour to birth.

Currently, ACC provides cover for injuries related to pregnancy and childbirth which have been proven to occur as a result of a ‘treatment injury’. This means the injury needs to have occured either as an unexpected result of treatment, or a lack of appropriate treatment during childbirth.

The amendment bill proposes an extended list of specific birth injuries to be categorised as accidents and therefore automatically eligible for ACC cover. The provisional list of birth injuries (still under consideration) include: • Anterior wall prolapse, posterior wall prolapse or uterine prolapse • Coccyx fracture or dislocation • Levator avulsion

• Obstetric anal sphincter injury tears or tears to the perineum, labia, vagina, vulva, clitoris, cervix, rectum, anus or urethra • Obstetric fistula (including vesicovaginal, colovaginal and ureterovaginal) • Obstetric haematoma of the pelvis • Postpartum uterine inversion • Pubic ramas fracture

• Pudendal neuropathy • Ruptured uterus during labour • Symphysis pubis capsule or ligament tear.

Under the proposed legislation, mental injuries such as PTSD will continue to be included if they’re caused by a covered physical birthing injury. No changes are proposed for pēpi injured during birth; existing cover for these cases is still available.

To prepare for the anticipated increase in ACC-funded services which will result from the legislative change, ACC has been engaging with health practitioners, sector groups (including the College), Māori clinicians, birthing women, parents and whānau across the motu with expertise or lived experience in this area, to better understand what services are needed.

Public submissions made to the select committee are also assisting in informing the completeness of the list of injuries which will be included in the final amendment bill. It is expected that this list will include all injuries resulting from what ACC defines as ‘forces of childbirth’.

The proposed changes will result in updated pathways for those who experience birth injuries and practitioners, so that appropriate care, treatment and support is available for Aotearoa’s diverse birthing population. If passed by Parliament, the changes in the Accident Compensation (Maternal Birth Injury and Other Matters) Amendment Bill are expected to come into effect from 1 October 2022. square