Little progress on recommended Hawke’s Bay Māori birthing unit

There appears to have been little or no progress on setting up a specialised Māori birthing unit in Hawke’s Bay, a key recommendation of a critical review into racial discrimination in the region’s maternity services.

A review into how Hawke’s Bay Hospital treats Māori whānau in maternity care was commissioned after concerns were raised over the hospital’s treatment of Māori, following a highly publicised uplift of a child in 2019.

The review was released publicly in June.

Some whānau said they were treated with cruelty and were fearful for their own privacy. These incidents created fear, uncertainty and frustration, leading to whānau mistrusting the service.

One of the key recommendations in the review suggested creating a Ngāti Kahungunu-centric birthing unit that could provide culturally safe care for all hapū māmā (pregnant mothers).

Local midwife Jean Te Huia is one of the advocates for this new unit.

“I believe it’s much-needed, because we’ve got evidence to show that the current Māori birthing population is not being served well by the current system,” she said.

She cited the recently released 15th annual report of the Perinatal and Maternal Mortality Review Committee, which found Māori and Pasifika experienced worse outcomes.

She visited the Toronto Birthing Centre in Canada, led by indigenous midwives, to get ideas.

“The birthing centre is open to everybody and they also provide a training centre for First Nation midwives. I believe that is an opportunity that we, here in New Zealand can do. It does culturally meet the needs of the women that birth there – it provides them with an individual service that caters to her need. It’s not a standardised midwifery service.”

However, Te Whatu Ora Hawke’s Bay said this kind of scheme was no longer under its remit in the new health reforms.

Te Aka Whai Ora (the Māori Health Authority) is now responsible for responding to the needs of whānau Māori.

In a statement, a spokesperson said its Kau Taurima (maternity and early years team) was looking to call for proposals in the new year for innovations, the likes of mātauranga Māori solutions which could provide opportunities for these kinds of ideas.

Te Huia said the change in structure at the hospital had left things “uncertain”, leading to staff turnover.

“There’s a heap of them that have taken flight and flown out of there, and there’s a desperate skeletal crew that have been left behind who are kind of a bit nervous about creating a future for themselves and for anybody else.”

But she said that was “not disheartening”.

“That’s just the way of the world at the moment. I think there’s a lot of indecision… especially because we’re right at the verge of a new election next year.”

She said she and other Māori midwives were having conversations with different community groups about where the centre could go and what it could look like.