A Bay of Plenty midwife fears a pregnant woman or baby will die due to Whakatāne Hospital “downgrading” to a primary birthing service.

NZME reported last month Health NZ made the change because of a shortage of specialists. It took effect on January 15.

It meant low-risk births could still take place at Whakatāne Hospital with the assistance of midwives. Any patient requiring intervention – such as an emergency caesarean – would have to go to Tauranga Hospital. A dedicated ambulance was available for these transfers.

Health NZ has acknowledged the “deep concern” from the community about the change and committed to returning secondary birthing services to the hospital “as soon as it is safe to do so”.

It will hold a community hui in Whakatāne on Thursday to discuss the changes.

About 650 babies are born at Whakatāne Hospital each year. It is the only hospital in eastern Bay of Plenty, which has a population of about 55,000 and is just over 50% Māori according to the 2023 Census.

‘This is going to kill someone’

The midwife - who spoke on the condition of anonymity - said in her view the hospital was now “the equivalent of a birthing centre”.

Pregnant women with risk factors including but not limited to a high bBody Mass Index, pre-existing medical conditions that could impact a pregnancy, and any current or previous pregnancy complications would be recommended to birth at Tauranga Hospital, she said.

Low-risk women who experienced a complication requiring intervention would also have to go to Tauranga.

Of the 650 births, she estimated more than half would have existing risk factors. The remainder still had the potential to develop complications, such as a baby going into fetal distress during labour.

“While we’re on that ambulance transferring to Tauranga, there is absolutely nothing that we can do … we can’t do an emergency caesarean in the back of an ambulance, so we’re basically crossing our fingers and toes that that baby has enough reserves to make it there.”

Pregnant women will need to travel from Whakatāne Hospital to Tauranga Hospital if they require secondary maternity care. Photo / Mead Norton

Babies who survived may still face long-term effects of the delay, such as brain damage.

“It’s not good enough. We’re a low socio-economic area with a high-risk demographic - we have rural māmā, we have a high rate of Māori that we already know have ... inequities in health ... "

The midwife said it could take up to two hours to get from Whakatāne to Tauranga if traffic was bad.

“Some women, they haven’t got two hours.”

She said mothers not having their first baby could deliver in less than an hour.

In her view: “This is going to kill someone.”

‘Appalling’

On one occasion, the midwife remembered ringing an on-call obstetrician for an emergency caesarean at the hospital to save a baby in fetal distress.

The obstetrician arrived quickly, the mother had a caesarean, and the baby survived.

“I can absolutely hand on heart say there is no f***ing way that baby was going to make it to Tauranga. The difference between this woman having a live baby and a dead baby was luck that there was a doctor on the day that she delivered, which is unacceptable.

“For luck to even be a factor … is actually appalling.”

'Not staying here to watch my mums and babies die’

The midwife said there had not been enough obstetricians to cover a full on-call roster since August following resignations.

Initially, the unit would temporarily downgrade to primary care one or two days per fortnight when there was no obstetrician.

“[But] it got to a point where there were more days in a week without cover than there was with cover.”

Local midwives met with a New Zealand College of Midwives representative to discuss their concerns as communication from Health NZ management was “horrendous” and they did not know how staffing issues would be addressed.

At a December 12 meeting with management they learned Health NZ was “downgrading” Whakātane Hospital to “a primary unit”.

A midwife fears someone will die as a result of Whakatāne Hospital changing to a primary birthing service. Photo / Alex Cairns

She said the biggest issue was retaining specialists. She believed there were obstetricians prepared to work in Whakatāne, but not until systematic issues were addressed.

In her view, Health NZ management needed to “take a long hard look in the mirror and actually ask themselves why these doctors are leaving”.

The midwife said she loved working in her community and would stay until secondary services resumed, but would look at relocating if services were “permanently downgraded”.

“I’m not staying here to watch my mums and babies die.”

Health NZ responds

In a statement, Health NZ Te Manawa Taki deputy chief executive Cath Cronin said the safety of pregnant people and their babies was its top priority.

“We acknowledge the deep concern from the community about the decision to move to a primary birthing model at Whakatāne Hospital while specialist doctors are recruited.

“We are committed to returning secondary birthing services to Whakatāne Hospital as soon as it is safe to do so.”

Cronin said Health NZ would continue engaging with its Iwi Māori Partnership Boards partners to listen to their views on how services were redesigned to support sustainable clinical services.

Asked about obstetrician resignations in the past six months and whether Whakatāne had any left, Cronin said three obstetricians had resigned and it was recruiting locally and internationally to help return to full-service provision.

She said Health NZ contracted Hato Hone St John for patient transfers in the eastern Bay, including Whakatāne.

A “dedicated” ambulance provided 24/7 coverage for all obstetric and emergency gynaecological transfers to Tauranga Hospital, in addition to other ambulance services.

As of Thursday, two patients had been transferred by the dedicated service since it started on January 13.

A Hato Hone St John spokesman said during emergency transfers from Whakatāne to Tauranga, the patient remained under the care of a hospital clinician.

“For urgent hospital transfers or where there is an immediate threat to life, the hospital may decide to call for an emergency ambulance or an air ambulance to transport the patient [instead].”

Health NZ community hui

When: Thursday, 5pm to 6pm.

Where: Acacia House, Louvain St, Whakatāne.

What: To discuss maternity service changes at Whakatāne Hospital.