The New Zealand maternity system is often regarded as one of the best in the world because women can choose their Lead Maternity Provider, being a GP, Obstetrician or Midwife, and maternity care in NZ is free. Women who book with midwives are able to choose between hospital, birth centre and home birth, and midwives are able to admit their clients to hospitals and birth centres. Midwives are the most commonly-chosen care providers for pregnancy and birth care. The care is provided free to women, which is fantastic, however, much like the Medicare benefits that health professionals receive in Australia, the fee paid to the midwife is not commensurate with the level of care provided. To adjust for the shortfall, NZ midwives often take on caseloads of around 60 women per annum. To put this into perspective, Australian hospital-employed caseload midwives take on 35 - 45 women per year, and private midwives take on anywhere from 5 - 30 women per year, with many private midwives attending 2 - 3 births a month. The results of NZ's stretched system are explained below:
The newly released Health Ministry Maternity Services Consumer Satisfaction Surveys contain several concerning results:
There has been a dramatic drop in the satisfaction levels of women with their care during pregnancy ...
There is a much higher rate of women forced to leave hospital before they feel ready to following birth. In 2007 one woman in seven was discharged before she felt ready to go home. In this survey, one woman in five has to leave hospital before feeling ready to go home.
Once home, the care for women remains substandard for more than a quarter of all women. More than one woman in four receives less than her minimum entitlement of postnatal visits.
... up to one-third of women in some areas had difficulty finding a midwife to care for them ...
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