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Maternal Immunisations

Immunisation is a key health protection activity. It has a strong evidence base as an effective public health strategy to protect individuals and communities from avoidable morbidity and mortality. While the Covid-19 immunisation campaign saved many lives in Aotearoa by achieving high levels of full vaccination, immunisation rates for other vaccine-preventable diseases have decreased, and pre-existing equity gaps have widened. In 2022 the College was represented on the National Immunisation Taskforce which made 54 recommendations on how to urgently and rapidly increase childhood and pregnancy immunisation rates.

The College continues to work with Te Whatu Ora and the districts on immunisation, advocating for clear and consistent messaging about immunisation during pregnancy, equitable access to services offering antenatal immunisations, and resourcing for midwives who wish to offer vaccinations as part of their antental care provision.

Key messages for midwives about vaccinations during pregnancy are:

• Pregnant women are strongly encouraged to be vaccinated against whooping cough (Tdap) from 16 weeks of pregnancy and influenza at any time in pregnancy, as early as possible in the flu season (April onwards).

• Covid-19 vaccination additional doses (boosters) are available six months after a previous dose or Covid-19 infection.

• Covid-19 additional doses are especially recommended for those people with health conditions that put them at higher risk of severe illness from Covid-19.

• Vaccines can be safely co-administered (given at the same time).

• All vaccines can be accessed in participating pharmacies. square

a ‘how to’ guide for developing, updating and reviewing college guidance

The College is committed to providing quality guidance to support optimal midwifery practice by its members. This takes three forms: consensus statements, guides for practice, and multidisciplinary guidelines. The ultimate goal is to support midwives to provide culturally and clinically safe care which leads to optimal outcomes for wāhine and their whānau. The College has developed a document which sets out the different types of guidance it produces and the processes involved in developing, updating and reviewing each of the guidance documents. We are seeking feedback from members on the document which can be accessed through your College portal. square

new draft consensus statement: unassisted childbirth

Unassisted birth can be defined as intentionally birthing without an appropriately trained health professional in attendance. These situations can be complex. The intention of the statement is to articulate the need to respect an individual’s right to accept or decline treatment or care, and the implications of this for midwifery practice, including the responsibility to provide information about the potential risks associated with unassisted birth decisions. The College has developed a draft consensus statement to identify the profession’s position and to support midwives in this situation. We will soon be emailing members to seek feedback via the College portal on the draft consensus statement. square

national consensus statement for lactate testing of newborn babies in Aotearoa New Zealand

One of the of the ACC Neonatal Encephalopathy (NE) Taskforce initiatives has been investigating the utility of testing lactate levels in umbilical cord blood as a component of newborn assessment to assist in the detection of babies who are at risk of developing NE.

As there was insufficient evidence to develop a guideline, a consensus statement has been developed. College representation was included in the working group which developed the statement and members were consulted on the draft. Last year, the College was asked to endorse the final draft of the statement. The board initially declined to offer its endorsement as it noted concerns about accessibility of equipment and the equity issues that this raised as well as concerns about how the various clinical circumstances in which lactate testing was recommended were defined. The ACC working group accepted the College’s feedback and agreed to make amendments to the statement which addressed the concerns. As a result, the College agreed to endorse the statement at its March meeting.

The College will notify members when the consensus statement is published on the Te Whatu Ora website along with an explanatory webinar video. square

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