The Canterbury West Coast Region of the NZ College of Midwives has been in constructive and positive discussions with the CDHB for many months regarding maternity care for women in the region.
Furthermore we are aware that women have also been included in these discussions, says Norma Campbell, acting CEO of the NZ College Midwives.
We do not wish to pre-empt the outcomes of those discussions, however, following comments in the media today and yesterday suggesting that "women and midwives prefer births to be at Christchurch Women's Hospital because there was medical, specialist and paediatric support available", we feel we have been left with no choice but to comment on behalf of our member midwives. More than 90% of midwives in New Zealand are members of the College.
Firstly, Christchurch Women's Hospital is a facility that has been designed for women or
their babies who need some level of medical care. There is a growing amount of robust,
respected and peer reviewed research* confirming that a tertiary hospital like ChCh
Women's, is not the best place for women who are in good health at the start of their labour,
to have their babies. The CDHB is acting responsibly in the view of the College, by reviewing
this current large body of literature around outcomes and places of birth, to inform the
decisions they are making in relation to services they provide to women having their babies
The results of the *Birthplace Study (UK), published in the British Medical Journal in
November 2011, was a large, extensive and well-respected study which found when it came
to outcomes for babies, that there was no difference between babies born in midwifery-led
units and obstetric units, however there was more intervention for the woman if she was low-
risk (had had an uncomplicated pregnancy) and gave birth in an obstetric hospital, such as
ChCh Women's. There is a great deal of evidence that giving birth in a midwife-led setting
supports normal birth and low intervention, and the 'Birthplace Study" is the most robust
evidence to date demonstrating that giving birth in a midwife-led unit does not increase the
risk of harm for the baby, or mother.
Canterbury currently has three midwifery-led (primary) units and has had these for many
years. The midwives who work in these units are health professionals, highly skilled at
assessing and working alongside women, and the College will have the same expectations
of the midwives who will work from any new unit.
A new modern birthing facility is another example of how the District Health Board is
reviewing all of its services post earthquake and the NZ College of Midwives is highly
supportive of such a move. In fact all DHBs will need to start to consider how they will
provide such services for women.
There will always be a need for the maternity services and expertise provided by staff in a
tertiary unit (hospital) such as ChCh Women's. The College of Midwives is also aware that it
may take some women time to feel comfortable having their baby in a primary unit. We see
this as an opportunity for women who are well and healthy at the end of their pregnancy to
commence their labour at a new primary birthing facility and then if the need arises, be
transferred to Christchurch Women's. No-one wants to see mothers and babies
compromised and currently with so many women going to ChCh Women's there are huge
pressures on their services.
It is unconstructive for some commentators to scaremonger at this stage of the discussions.
There are many things that have yet to be discussed and resolved, including ambulance
services for such a unit. The College of Midwives locally and nationally intends to continue
working and supporting the CDHB to progress their future plans for reviewing all birthing
services in the region and to ensure that the outcome is something all Cantabrians can be
proud of, well into the future.
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