The Health and Disability Commissioner is calling for urgent action to improve outcomes for whānau in the maternity system.

“I have read the latest report of the Perinatal and Maternal Mortality Review Committee with concern, and I echo their comments about the lack of improvement over time in regards to systemic issues within maternity care. I also share their view that it is unacceptable that Māori, Pacific and Indian families, as well as babies born to mothers under the age of 20, experience worse perinatal outcomes.

“The volume of complaints received by HDC about maternity care is small, however the profile of complaints is more serious than is seen for other services, and the frequency with which common issues recur is concerning. The outcomes for the whanāu involved can often be tragic and the harm caused can have life-long consequences.

“I was pleased to see that maternity services have been made a priority in the interim New Zealand Health Plan – Te Pae Tata, and note that this is an important opportunity to attend to some of these issues. I also acknowledge that the constraints on the system are complex and will take time to fix. However, I hold concerns about the pace of progress to date – fundamental issues remain unaddressed, and in the meantime significant harm continues to occur.”

Ms McDowell further commented “The pace with which some of HDC’s recommendations around maternity care have been implemented has, at times, been frustratingly slow. For example, HDC has made a number of recommendations to the sector around the need for mandatory multi-disciplinary fetal surveillance training, however, we have continued to observe that such training has not been consistently implemented.”

Ms McDowell said the common issues in complaints to HDC about maternity care included:

• Cultural safety and inequities in care
• Inadequate management and assessment of risk during labour, and in particular inadequate monitoring of the baby’s heart rate.
• Lack of adherence to guidelines outlining when a specialist needs to be consulted by lead maternity care midwives
• Inadequate assessment and management of the baby’s growth
• Geographical disparities in access to and quality of care
• Significant workforce issues
• Inadequate informed consent processes and discussion of women’s options during pregnancy and labour.

By Office of the Health and Disability Commissioner