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Construction on a new birthing unit at Waitākere Hospital will begin in the coming months. A ministerial briefing, obtained by the Herald, reveals the severe pressure on existing services - and the risk to mothers and babies.
Over-full maternity units caused “an increased risk that women will give birthin an unsuitable and unsafe environment”, a top-level briefing reveals.
Construction on a new primary birthing facility at Waitākere Hospital in Auckland will begin in March, pending building consent. It is expected to open in July 2025.
A ministerial briefing from Health NZ - Te Whatu Ora, written last July and released under the Official Information Act, outlined the urgent need for more capacity, and warned that “by 2024 there will be insufficient maternity beds to meet demand”.
“Maternity service in Waitematā is under significant pressure with both North Shore and Waitākere maternity units operating above acceptable occupancy levels,” stated the briefing, which was provided to Ayesha Verrall, who was Health Minister at the time.
“The lack of specialist maternity beds places significant pressure on staff to provide safe care. This is due to the constant reprioritisation to ensure the most at-risk mothers and babies are catered for, and results in an increased risk that women will give birth in an unsuitable and unsafe environment.”
Health officials estimated that by 2024 there would be insufficient maternity beds: “There is a high risk that a person in labour within the Waitākere catchment will present for care and a bed will not be available.”
Occupancy for birthing beds within the Waitematā service (covering West and North Auckland) had been as high as 146 per cent. The accepted benchmark for occupancy is 75 per cent, based on international guidelines.
The needed $12.3 million in funding was announced in September last year. Plans for a primary birthing unit were discussed by the former Waitematā DHB in 2017, but have been repeatedly delayed.
Construction of the 970 square metre, six birthing/postnatal suite facility will increase capacity by 500 births a year, increasing capacity by 7 per cent. It will aim to provide a more “culturally tailored” experience for women and families, particularly for Māori, Pasifika, teens and refugees.
“Delays to project delivery present a significant risk to the safety of mothers and babies,” the document stated. “The lack of bed availability is a prevalent issue with teaching rooms now being used to accommodate birthing assessments.”
How the Waitākere birthing facility could look. It is due to open in July 2025
Health NZ (Te Whatu Ora): Waitematā maternity “bed utilisation is high at present’
The Herald asked Te Whatu Ora questions including what the average bed utilisation for Waitematā maternity services is currently, whether maternity services have operated above acceptable levels recently, and if there is insufficient capacity to meet demand.
Those were not directly answered in a statement from Emma Farmer, the region’s director of midwifery.
“Bed utilisation is high at present due to construction work currently in progress to upgrade the existing maternity unit at Waitākere.
“The first phase of the upgrade project is the creation of a negative pressure room to allow expectant parents who present with Covid-19 or other infectious illnesses to give birth locally, as well as a redesign to ensure all labouring women have access to their own ensuite bathroom.
“We have a contingency plan in place to manage occupancy during this period of construction, which includes using maternity beds at North Shore Hospital and postnatal beds at Warkworth, Helensville and Birthcare Auckland.”
Support can also be given by Auckland Hospital and Counties Manukau services, Farmer said.
“The safety of mothers and babies is of the utmost importance to us. Women and their whānau can be assured that they will receive the highest standard of care and support, regardless of where they give birth.”
Other hospitals have struggled with the demand for maternity services, particularly because of a shortage of midwives and nurses, who are being targeted with better pay and conditions by overseas countries including Australia.
Leaders at Auckland City Hospital have put strict limits on new private obstetricians, over concern at the high number of caesarean sections performed, and wider capacity pressure on services.
Ahead of the election, National Party policy included covering student loan repayments of nurses and midwives for five years, if the person committed to working in New Zealand for at least five years after graduation.
