HE MAŪNU KAUKAU WAI

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

Nau mai haere mai ki Aotearoa New Zealand Midwife

The proposed legislative changes poised to extend ACC’s cover of maternal birth injuries have set the tone for this issue. A comprehensive analysis of OASI care bundles undertaken by the College’s own Elaine Gray and Research Midwife Specialist Dr Robin Cronin can be found on pg. 18. This deepdive into perineal care explores a number of international approaches and studies, providing much food for thought in the current climate of increasing intervention.

The focus on the pelvic floor is continued on pg. 26, where Auckland-based women’s health pelvic physiotherapist Tania McLean offers her insights and experience to midwives in a Q&A. The proposed extended list of ACC-covered maternal birth injuries and further details can be found on pg. 17.

Otago Polytechnic Principal Lecturer (Midwifery) Lorna Davies challenges us - both as individual practitioners and a profession - to explore a term very much entrenched in the midwifery psyche (pg. 32). Is it as benign as we might like to think it is?

The (former) Ministry’s SUDI review, including the Expert Advisory Group’s (EAG) report and recommendations, are detailed on pg. 28. A sobering but necessary read for midwives, the EAG highlights the broader stressors foregrounding SUDI, reiterating the need for an overhaul of social policy and increased focus on achieving equity if this tragic event is ever to become a thing of the past.

Finally, From Both Sides (pg. 42) tells the story of two women whose similar childhood experiences made for an even more meaningful midwifery partnership.

Mā te wā,

Amellia Kapa, Editor/Communications Advisor

Email: communications@nzcom.org.nz square

“Āe, he maūnu kaukau wai”

Yes, like a duckling that swims about in the water

(Mead, 1891:16)

When I first learned of the proposed health system reforms and the creation of the Māori Health Authority, I tried hard to suppress my inner critic and believe that after so many years - of empty promises, heartfelt apologies, re-designs, and failures - our government might finally get it right.

In a previous issue I discussed my fears around who will hold power in these two new entities, now named Te Aka Whai Ora and Te Whatu Ora. As information comes to light about the individuals who will have the most influence determining the trajectory of women’s health, it can be likened to the reveal of each room on a home renovation series. A fresh lick of paint and an array of flash new appliances gives the impression that this is a completely fresh start, and our newest chief executives are playing the role well; fresh-faced, motivated and passionate about change. Peel back a few layers, however, and the developing strategy reveals old, rotting timber frames.

Recent history demonstrates those who have been in positions of influence within the old structures have not performed, so I struggle to see how a reshuffle of these same people into different positions, with refurbished job titles, will produce different results. As the whakatauki above alludes to, what have they achieved directly for whānau? Will they continue to swim around aimlessly, spouting big promises but achieving little? Let accountability start now.

If you are involved in webinars or waananga, ask questions and remember who said what. It’s not only Te Aka Whai Ora who are responsible for holding Te Whatu Ora accountable; we too are consumers of this system, alongside the whānau we care for. Many ideas are sure to emerge from the workstreams, so my advice is to remain connected to the whānau receiving our care. Do the ideas align with what whānau want? If so, by all means advocate for it and consult with our collective bodies - Ngā Māia and the College - for support. The course of our waka is about to change, but we need to make sure it’s being steered toward our whānau, so they can be picked up and asked what direction they want to go in.

I want this new system to succeed. I want our whānau to feel safe. I want care to start in the home, on the marae, on the street corner. Wherever our whānau are, is where we need to be, and this approach should be applied across the board in healthcare, not only in midwifery. I will do my part to ensure positive health outcomes for whānau are at the centre of what we do; not personal agendas or flash job titles. Nothing is more important than whānau and whenua. square

As the whakatauki above alludes to, what have they achieved directly for whānau? Will they continue to swim around aimlessly, spouting big promises but achieving little? Let accountability start now.