Lifestyles burden on midwives' workload

Latest ministry figures show more than half the women giving birth in 2012 were identified as being overweight, including 28.1 per cent of mothers being classified as obese. Photo / iStock

New Zealanders' bulging waistlines, would-be mums who smoke, and the trend of modern Kiwi women having babies later in life have been cited as factors in a worrying rise in pregnancy complications.

While complicated births can still result in perfectly healthy babies being born, it means more care and monitoring by already over-worked midwives.

The issue has formed part of historic gender pay discrimination legal action lodged by the New Zealand College of Midwives at the High Court in Wellington this week.

The midwives claim that round-the-clock hours - made longer by complicated pregnancies - mean they often earn less than the minimum wage.

A range of reasons for more complications - including obesity, smoking, and age - have been cited by the midwives, and the Ministry of Health, which is also aware of the issue.

Latest ministry figures show more than half the women giving birth in 2012 were identified as being overweight, including 28.1 per cent of mothers being classified as obese.

In the same year, 15.2 per cent of pregnant women were smoking cigarettes when they engaged a midwife.

The age of women having babies in New Zealand, meanwhile, has jumped from a 1975 average age of 25.4 years to 29.6 years in 2009, according to Statistics New Zealand.

Alison Eddy, midwifery adviser for the New Zealand College of Midwives, said while older women could have "normal, healthy pregnancies", it did increase the possibility of complications.

The fact that New Zealanders were now among the fattest in the world also brought pregnancy risks.

Complications, including diabetes and high blood pressure, meant more work for midwives, or lead maternity carers (LMC).LMCs, who are on call 24/7, now look after 90 per cent of women, Ms Eddy said, regardless of their "levels of complexity" or pre-existing health issues.

They are paid set fees for first and second trimester care, third trimester care, labour and birth care, and post-natal care up to six weeks after the birth.

"Regardless of how many visits, how many hours, there is a minimum expectation set and no matter what happens during the pregnancy, the midwives get paid the same amount," Ms Eddy said.

"It's a swings and roundabouts model that was funded originally with a sense that it would all even out.

"But what we've seen is a change in the population and the nature of work over time, and it has become imbalanced."

The Ministry of Health's principal advisor for maternity, Bronwen Pelvin, agreed that a range of factors were behind the "increasing complexity of women's health status", including obesity, diabetes, and the increasing maternal age.

The ministry said 65 per cent of women experienced normal births.

For those women with complicated pregnancies, with appropriate care and supervision, many went on to have their babies normally, the ministry said.

But Ms Pelvin accepted that complicated pregnancies and births put an extra strain on midwives and the health system.