Lakes District Health Board said last month it was struggling to recruit enough midwives to staff the Rotorua maternity unit. Photo / Andrew Warner
Five women were discharged home or transferred to other wards after Rotorua Hospital was left with one midwife on duty on Friday night.
The Lakes District Health Board says the duty midwife had the support of a team that included obstetrics professionals and a Lead Maternity Carer midwife who wasonsite.
It says that while midwife recruitment is an ongoing struggle amid a widespread shortage, pregnant women can be assured they will receive high-quality care.
A midwifery union says it happened due to two of the three rostered midwives calling in sick, and it is concerned about what will happen to the unit if Omicron affects staffing.
The union, Midwifery Employee Representation and Advisory Service (MERAS), has previously said New Zealand's maternal units have had a midwife shortage for the past three to four years and it was getting worse.
Another local maternal health professional said the shortage was concerning but women would still receive high-quality care.
At the time, Lakes District Health Board said the board tried to have five midwives or nurses on per shift in the Rotorua maternity unit, but it was often only able to have two to three.
MERAS union co-leader Caroline Conroy said she understood that on Friday night, the hospital had a "reasonable roster" with three midwives on duty, but two called in sick.
While it "got sorted", she said maternity services found it difficult to provide sufficient midwives on duty and sick calls were challenging to cover with staffing "so tight".
"We will see this happening through Omicron as people are suddenly off sick with Omicron. There will be a lot of units across hospital services struggling at times to keep the service going."
Conroy said Rotorua had an advantage of being "relatively close" to maternity units in Waikato and Tauranga, for example.
"There might be times when they need to perhaps send some women to a neighbouring unit just to keep the workload down."
Lakes DHB chief operating officer Alan Wilson said that a team was available on Friday night to support the midwife on duty.
It included: "... a registered nurse with obstetric background, an LMC midwife who was on-site overnight and another LMC on call for emergencies. An obstetric house officer was also in the birthing unit to assist."
He said when all options were exhausted to fill the shift with another midwife, three women were discharged home with their LMCs' support and two were transferred to the children's unit for care or transferred to the birthing unit.
He said the DHB was facing "ongoing issues" with the national and international shortage of midwives.
"Management of this shortage is a high priority and plans are put in place immediately there is a problem to ensure the safety of patients and staff.
"Pregnant women are assured their care and the care of their babies is of high quality. "The DHB is very appreciative of the collegial help from local Lead Maternity Carers and Lakes DHB's maternity staff."
He said that typically, midwives in the birthing unit support LMCs, who care for their own clients within their scope of practice. They also begin inductions of labour until the LMC takes over care when mum is in labour, and provide all maternity care to women who do not have an LMC and all other clients who require specialised care due to pregnancy risk factors.
Wilson said the maternity unit at Taupō Hospital was closed on Friday, meaning any woman who needed to birth was transferred to Rotorua Hospital.
Last month, Associate Health Minister Dr Ayesha Verrall said strengthening the maternity system, including addressing the shortage of midwives, was a priority for the health sector and Government.
Budget 2020 included the "largest-ever funding boost" for primary maternity services, with the Government investing $242 million over four years.
This would support a range of initiatives such as strengthening national and local maternity quality and safety programmes and supporting workforce sustainability, she said.
Finding a midwife in the Bay of Plenty
The midwife shortage is also affecting maternal services in the wider Bay of Plenty region.
First-time Tauranga mother Suzanne Barker found out she was pregnant in May and started contacting midwives straight away.
"We contacted over 20 midwives in the Bay of Plenty … and nobody was available for us," the 34-year-old said.
"It was actually a pretty stressful event because we [didn't] know what we were meant to do in that regard."
She ended up going through Tauranga Hospital after speaking to friends in Rotorua who told them this was an option.
"But of course, you don't have that sort of one-on-one with an actual midwife that you see through from day dot to when you have [the baby] and after with the post-natal."
Barker said not getting an independent midwife "takes away the opportunity where you would like to give birth".
But Barker said she had "excellent medical care" at the hospital even though she saw different midwives there.
In her view, midwives at the hospital were "under a lot of pressure" due to the shortage of independent midwives but they did "an amazing job".