Skip to Content »

Who cares about mothers and babies when ideology is at stake?

  • March 26th, 2008

An unposted snippet in this morning’s DomPost announces that TEC is funding a research project on the midwife shortage. What uselessness.

There’s not much mystery about it to the sad doctors who’ve watched the 20 year decay of their proud medical field. They lost the political battle with the the midwives union (the so-called College of Midwives). As doctors gave up obstetrics the field has become a swamp of liability anxiety, overwork stress,  and people shortage.

Search Stuff for “midwives” for a taste of looming crisis.  New Zealanders are settling for third rate in mother and child health. Those responsible are the kind of politicians who trumpet their caring character in rhetorical legislation like the anti-smacking amendment, but can not admit that their theories have failed in practice.

Yet obstetrics was an area in which New Zealand was up with the best in the world, amply supplied with eager doctors and nurses.

Poneke has blogged on the decline in breast feeding and early ejection from maternity wards. This post is drawn from my comment on that post as a symptom of ideological failure.

H Clark was Minister of Health when the rot began.

I’ve been following developments with interest since I helped settle terms of some lead provider contracts for antenatal and birthing services. Doctors warned repeatedly that the new arrangements would push doctors out of obstetrics. The warnings were were dismissed as evidence of the medical profession’s incorrigible paternalism and the self interested medicalisation of a natural function.
The mantra was “a right to choose” (translation – “kick out the doctors”).

It is plain now that doctors’ warnings were understatements. Every medical student then observed and often assisted at numerous births before graduating. Now it is common for them to assist at none, and only the luckier women students are likely to have seen one. Midwives lock the students out by discouraging patient consent.

The true victims of this reversal are everywhere in Wellington today, anxious pregnant women who can’t find midwives, and overstressed midwives. There’s no question of choosing a GP, because they’ve stopped practising in the field, specialists are rare and replacements are not coming through.


  • Anonymous
  • March 28th, 2008
  • 10:27 pm

“H Clark was Minister of Health when the rot began.”

And who was Minister of Health when the Cervical Screening Programme was set up with multiple databases and no requirement for accreditation? Set up to fail.

  • Monty
  • March 29th, 2008
  • 5:33 pm

I could not agree with you more Stephen – My wifes sister-in-law died about a year ago as a direct result of a failure in the health system (Hawkes Bay). A competant service and she would be alive today. This one tragic example demonstrates the degratation of the Health system under this increasingly inept Government who are totally preoccupied with covering up problems rather that finding solutions to systemic problems. In this case close to my own family the mother dies as a direct result a number of failures. At any point had the right decision been made she would be alive today. I wonder if there has been an increase in the number of deaths of mother / and or baby in the past ten years. Maybe something worth investigating?

  • Paul Williams
  • April 22nd, 2008
  • 12:31 pm

Stephen, when will you and your colleagues release your policies on maternity services? As interesting as your comments are, they’re no substitute for policy. Also, how is it that you advocate consumer choice in almost any and every field, accept for mothers?


Hi Stephen

Just thought I’d make a couple of comments in reply to your post.

1. I am not quite sure why you think the research into midwifery shortages is useless. You haven’t really addressed why you think there is a shortage other than midwives are overstressed. What is the evidence that midwives are overstressed because of a lack of obstetricians? The shortage of midwives and health staff is a global issue and is affected by complex issues such as young people’s attitudes to employment in health eg decisions about life style.

2. NZCOM is not a union but the midwifery professional body. Why do you say it is ‘so-called’?

3. You make a number of sweeping statements like midwives discourage informed consent around medical students – what is your evidence for this?

4. In response to Monty. I was very sorry to read about your personal experiences. There are national statistics on birth outcomes so can I direct you to the maternity reports on the MOH web site. I think you find there has been no national increase in both maternal and neonatal mortality rates.

Thank you, Sarah

[Thanks for commenting directly Sarah. I’ll reciprocate on your site when I get a moment. In answer to your questions
1) Research is likely to be just an excuse for not doing the commonsense things that private employers do all the time, usually intuitively. Because most occupations face shortages and surpluses when the employers and employees are not free to fit the terms of employment around their particular circumstances. “Work-force planning” tries to compensate but fails because people simply leave when the pay and camaraderie and achievement satisfaction and other things we all look for from work are not commensurate (in relative terms) with the effort, risks and frustrations involved. All jobs have all these things in an ever varying mix, but nation wide rigidity tends toward least common denominator terms and conditions and perennial dissatisfaction in the areas where the needs are most testing. “Research” is wasted because the cure in most industries and occupations is local and very personal. Poor employers can’t get staff, or have to pay more (in money or conditions). Good employers are constantly tailoring what they ask and offer to suit their needs and what is available, recognising that satisfying and retaining existing staff is usually the most worthwhile priority. Good employees are usually advantaged.
But in education and healthcare workers face local monopoly employers, worrying always about what their decision on any one person will do in precedent terms to everyone else.
2 I regard its claim to being a “college” as hitchhiking on the brand created by worthier bodies. Because in my long ago dealings with its leader they were far more interested in the status of their members than increasing competence and the interests of the patients. From subsequent reports in their reaction to misadventure they remain more “union’ focussed than “profession” focussed. A true professional body is even more determined to kick out unsuitable members than the employers or other disciplinary bodies, and initiates proceedings, instead of defending members.
3 Direct statement from recent graduates are the source of my comments attributing the lack of obstetric exposure during doctor training (at leat partly) to midwife discouragement of women who might otherwise permit student participation.

Finally – you say on your site that I “dislike midwives”. I dislike what has happened, and especially the loss of choice for women, but your statement has no foundation in anything I’ve said. It is like saying I “dislike rugby players” if I criticise the Hurricanes’ performance, or their coach. In fact when I first gained exposure to these issues I was highly sympathetic to the idea that birthing should be demedicalised and that women should have a choice that included allowing midwives to be the lead carers. I have always found doctors to be difficult (hard to bear) clients. They can be very patronising. But as the contract evolved the more intransigent party was NZCOM. I still kept an open mind on the issues, but it is impossible to overlook the fact that the doctor side warnings have proved to be accurate.


Hello Stephen, thanks for responding to my comments. You have given me some clarity around what you mean. To be honest, you do sound ant-midwife to me, so I was pleased to read that you are not. cheers Sarah

  • izh
  • May 10th, 2008
  • 3:07 pm

Interestingly – despite your opinions (and thats all they are – not facts) 90% of women surveyed are satisfied with the NZ maternity service. Go midwives – you are an amazing and committed profession of workers – well done!

  • mouse
  • May 10th, 2008
  • 3:11 pm

I agree – he does seem anti midwife and anti woman. I’m going to vote for someone who is more family friendly.

[NB “mouse” and “izh” share the same email address, appearing to be for a lecturer in midwifery at Otago Polytechnic.]

  • mouse
  • May 17th, 2008
  • 5:03 pm

actually IZH is my teenage son – very well informed on matters of maternity, gender, issues of power and control – but he doesn’t vote – yet…
He doesn’t have his own email address so he uses the family one. I’m bursting with pride that he bothered to comment on this though – thats my boy! Mouse is his friend – who will vote this year. Great that young people have opinions and express them. Good for you to get exposure to fresh ideas too.
Interesting idea taking it upon yourself to add my details “for me” by the way – I guess you thought you were “outing” me? That in itself is worthy of drawing comment about use of power (or mis-use?)- and is I suspect indicative of the different philosophical approaches we may have. The kids had a great discussion about your online behaviour and comments. Thanks

  • mouse
  • May 17th, 2008
  • 5:08 pm

hello again
we have just noticed that it clearly states under your “leave your comments” title “your email address will not be published on this site”. We all think you need more integrity if you are considering a political and public role of honour. The public expect and have a right to honest politicians. Something for you to think about?

[Fair complaint – that edit was done for me by someone who was not aware of the assurance. I apologise and the email address has been removed – Stephen]

  • mary
  • October 13th, 2011
  • 9:48 pm

the midwives, and I understand the obstetricians and gynaecologists to not have their charges best interests – I understand there are a number of midwives who not only do not advocate vaccinations for babies, but refuse to be tested themselves – so could easily harbour infectious disease of HIV, Hepatitis B & C, and of course the measles, rubella & chicken pox which is doing the rounds at the moment. How can the health boards employ these so called health workers who do not take the precautions to protect these vulnerable people. I know that chicken pox in neonates can be devastating, and this midwife refused to check if she had immunity – yet there was an outbreak in the neighbourhood. My trust in midwives has reached an all time low.

  • Gayle Sorgente
  • July 7th, 2013
  • 6:27 pm

In common speech, ‘vaccination’ and ‘immunization’ have a similar meaning. This distinguishes it from inoculation, which uses unweakened live pathogens, although in common usage either is used to refer to an immunization. ^””‘

Most recent content provided by our personal blog site <

Leave your comments:

* Required fields. Your e-mail address will not be published on this site

You can use the following HTML tags:
<a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>