Q How long have you been a midwife? And where have you worked before?
I’ve been a registered midwife since 2013. I did my bachelor of midwifery degree from 2010 to 2012 through Otago Polytechnic in Dunedin. I’ve only worked in Wanaka as a midwife.
Q What has changed since you started working as a midwife in Wanaka in 2013?
We moved here in 2009 and Wanaka had a lovely small-town vibe. Albert Town and Hawea were also much smaller and quite separate from Wanaka. You recognised most people, could always get a park in town and the schools could hold a whole school assembly.
The population grew a little in the winter and summer months for the skiing and holidays. Peninsula Bay was a windy empty new development and from the top of Mt Iron the brown Central Otago landscape spread in all directions.
I’m not sure when the boom started, maybe after the Christchurch earthquake. Now everywhere you look there is development or green paddocks for dairy farming, there is no real difference between Wanaka and Albert Town, Peninsula Bay and Riverside are full of new houses and Lake Hawea has three large new housing developments.
All the school rolls have almost doubled and they need to build a new primary school just after finishing the last one. Parking, or the lack of, is a huge frustration; there’s no just nipping around town any more, the town doesn’t feel prepared for our tourist numbers.
There is no shoulder season any more. People who moved here for work-life balance are flat out busy. House prices and rentals are out of control. The supermarket is a new level of hell.
Jobs were few and far between but now there’s always jobs advertised; people want to come and work but it’s too expensive to rent and [there’s] a severe lack of rental accommodation, but that doesn’t seem to be slowing things down.
When I started studying midwifery in 2010, there were seven midwives in town. By the time I graduated there were only three.
We had five of us for a while but, yet again, midwives left due to stress or for the sake of their families. For a job that is about building families, it’s really not a family-friendly job for the midwife.
We’ve always have the distance to base hospitals and even to the primary unit in Alexandra, but the increasing population and decreasing number of midwives makes providing care more stressful. We’ve always been on call at the weekend but still able to take down time, but now we seem to work every weekend.
Q You will be joined by two locum midwives next month, after your colleague Morgan Weathington resigned because of the toll the job was taking on her. How serious are the current midwifery issues in Wanaka compared with past issues?
It’s the same problems year in year out. More and more requirement is put on to the midwives to provide secondary-level care. To clarify, primary care is provided by midwives. This is routine care for normal pregnancy, e.g. antenatal visits, monitoring blood pressure, measuring growth and discussing the woman’s wellbeing.
However, if a woman has a complicated medical or obstetric history or presents with an acute obstetric emergency (bleeding or premature labour), due to distance we are expected to respond to these situations. This is secondary-level care. Even if there is an opportunity for the woman to be seen by an obstetrician, we still have to manage the complicated pregnancies in our locality. It’s stressful and we do not get paid for the provision of this secondary-level care.
Up to last year we used to travel all over the district to provide labour and birth care. Even if we’d worked all day, then got into bed, if the phone rang, we’d head off, tired and in all weathers, for the three-hour drive to Dunedin, work all night and part of the next day, and then drive home. It was so dangerous, it’s a miracle none of us ever died at the wheel. I’d often stop off on the road for a sleep, it was so unsafe.
It was a big decision to stop travelling to the city for labour and birth care, as this had been the norm for years and the women expected it, but we could see this midwifery shortage looming, and if we were in Dunedin then who would be covering the workload locally?
Q You have had to speak out about midwifery issues before. How does it make you feel when you have to go public like this?
Yes, I raised the concern around emergency transfers in 2016.
We had a near-miss where I struggled to get a helicopter retrieval for a complicated birth. The hospital insisted I transfer by ambulance but I could see things were progressing quickly. There was poor understanding about what an ambulance transfer looks like from Wanaka. One crew to go from Wanaka to Cromwell, a wait while the Alex crew comes to pick us up. Then a slow transfer through to Dunedin, often with a St John volunteer driver and poor mobile reception.
As a midwife, I have to accompany the woman through to Dunedin and we transfer to the obstetric team on arrival. On the way home we either got stranded in Dunedin, if the crew had to return immediately, or got as far as Alex. Husbands or colleagues had to turn out in all hours to pick us up. What other health professional would end up in this situation?
Going to the press isn’t easy. I am bound by patient confidentiality and journalists ask a lot of questions, but despite that the outcome was good. We now have authority to control the mode of transfer.
Q You work hard for the Wanaka community; you probably barely have time to answer these questions. Why is this such an important issue to you/what drives you?
Women in Wanaka deserve the same service as the women anywhere else in this country. We all work hard and pay our taxes. Yes, we chose to live in Wanaka, but Wanaka isn’t a sleepy little town any more; it’s growing and we deserve better services. It grinds my gears when I hear ‘well, it’s the price you pay for living in paradise’. Just because we live in a "resort" town, we aren’t on a permanent holiday. Everyday life is just the same for us as it is for you in the city.
Q What would help improve the midwifery situation in Wanaka in the short term, and how can that be achieved?
I can’t be the only midwife, so we need at least two locums to fill the gap when Morgan leaves in April.
Q In the long term, what do you envisage being the ultimate solution for the district?
We actually need a secondary hospital for the whole region for all our health needs. Preferably in Cromwell to cover Queenstown, Wanaka and surrounds, Cromwell and Alexandra.
In the shorter term, and I mean by spring 2018, Wanaka needs a maternity hub. This is a building dedicated to maternity care, with employed midwives available to provide antenatal, labour, birth and postnatal care, including lactation consultancy services. The current model of midiwfery clearly doesn’t work in remote rural regions and we are tasking the DHB or the community to build a trust to ensure the sustainability of maternity services.
Q Anything else you’d like to say/add?
Midwives love the job they do. It’s incredibly rewarding but the goodwill and patience has run out. Colleagues are leaving the profession because of the conditions and pay. We need the public to get behind us and campaign their MPs. We greatly appreciate what the women in Wanaka have done for us; now it needs to happen elsewhere in the country. Midwives’ complaints get ignored at ministry level and we get criticised in the press. Women and their families’ support will make a difference, as they can’t be ignored.
