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

in Canterbury.

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.