Safe Deliveries?: a Review of New Zealand's Midwifery Regulation through the Lens of the Health and Disability Commissioner

Abstract

Although birth is a fundamental part of the life process, competing factions within the health profession struggle to agree on the best way to deliver maternity services. Despite this long-standing tension, the midwifery-led model has dominated New Zealand’s maternity system for more than two decades with the majority of consumers expressing satisfaction with the care provided. Unfortunately for a small number of mothers and babies the pregnancy and birth experience is not a positive one and families are left suffering life-long, and often tragic, consequences. As one of the main consumer watchdogs in New Zealand, the Health and Disability Commissioner is charged with investigating claims of poor quality healthcare. This paper examines the central themes in the Commissioner’s reports on substandard midwifery practice and proposes a number of regulatory solutions to the issues involved. Working in unison, these amendments have the potential to ease the pressure placed on midwives; enhance interprofessional relationships; improve practitioner competence; and increase overall compliance with the Code of Health and Disability Services Consumers’ Rights. By implementing these changes, the New Zealand Government could safeguard valuable midwifery-based principles whilst still ensuring that high quality maternity care is provided to all of the country’s mothers and babies.