Māori midwifery practice reintegrates traditions

Tapuhi Kura midwives (from left) are Anahera King, Charlene Eparaima, Crissy Coromandel-Timu and Kiley Clark.

The dream to provide marae-based midwifery is one step closer with the opening of Tapuhi Kura, a Hawke's Bay midwifery practice reintegrating Māori cultural practices into daily care.

Self-employed midwives Anahera King, Charlene Eparaima, Crissy Coromandel-Timu and Kiley Clark started the practice in March after an 'aha' moment.

"We'd been trying for ages to get collective teams to work in. Some done by the DHB and a private health provider aren't sustainable," says Hawke's Bay lead maternity carer (LMC) Kiley Clark, who last year was covering a maternity leave placement at Hawke's Bay District Health Board as a Māori midwifery consultant.

"The DHB leadership role enabled me to build the rapport and networks with other Māori midwives. Our main priority at Tapuhi Kura is caring for our whānau Māori, and trying to re-adjust some of the statistics and inequities that exist. Through colonisation and the loss of food, our land and language, we have a disconnection to who we are."

Kiley says the team wants to stand alone, with clients accessing all four midwives during their pregnancy and birth.

"We have a rotating roster. The midwifery scope in New Zealand is based around continuity. It's unsustainable for one person to be everything to that one client."

She says whānau support them to work together.

"We need that on a collegial level. There's nothing new about the way we work, it's just that we are very collective. We have to hui and wānganga together so it works. We all get to know that wahine."

Tapuhi Kura covers hospital and home births, working out of clinics in Flaxmere and Napier, with another one starting at the Tuki Tuki Medical Centre in Waipukurau.

"It's good to keep establishing ourselves and fine-tuning our practices and mahi — what works well," Crissy says.

She believes the present system is failing whānau.

"The system doesn't fit. Rightfully or wrongfully, Māori are trying to work in a system that wasn't designed for us. One of our goals is to reclaim traditional practices during pregnancy and labour."

The wahine use mirimiri, karakia and rongoa and actively work hard to legitimise their use. Kiley believes an acceptance of Māori traditional ways of medicine, whether spiritual or physical, is evolving.

"We're trying to figure out where the kaupapa practices fit for whānau and for us. How do we grow together with the knowledge? Whether we learnt it from other Māori midwives or whānau, those are practices that we know about and engage in, but are not in every LMC's practice here."

The team uses fibres extracted from harakeke, which has medicinal properties.

"We teach them to make their own clamp for the pito. This is rongoa Māori — Māori medicine which is plant-based. We also use pounamu adze to cut the umbilical. If whānau ask us to karakia we do. We give them the option. They know they have the support."

Kylie says the best thing is they learn.

"That's the rongoā we go away with. It makes you feel good — like a big bunch of flowers. People migrate towards it. It's all about healing."

Although Tapuhi Kura hasn't reached their capacity of 24-28 clients a month, they have a steady clientele.

"We hope by next year to consistently hit 18 to 20 a month."

Kiley is hoping they might attract funding to support some of their initiatives.

"One is running a quarterly noho where we can include our clients and whanau and build on whakawhanaunga. It's more than just teaching about being pregnant. We're trying to establish a trust in us and network with our community."

■ For more information about Tapuhi Kura contact 0800 524278.