Two Cambridge midwives joined a protest of around 500 in Wellington recently, marching on Parliament to urge politicians to improve their pay and conditions. Jenny Baty-Myles and Yvonne Szabo donned purple garb and hoisted their banner, marching along to the rallying song of “We’re not going to take it” by Twisted Sister at the march on May 3. The midwives and their supporters took a book of desperate stories from the front lines of midwifery and a petition demanding urgent improvements to lead maternity carer (LMC) midwives’ pay and conditions to Minister of Health David Clark. The campaign, entitled Dear David, was started by a remote rural midwife after her accountant told her she was barely meeting her business costs. A petition organised by a consumer and signed by 13,000 people in just one month was also presented at the march, which was held 2 days before International Midwives’ Day.
At the heart of the issue is the grim economic reality of being an LMC or community midwife, which earns them $12 – $13 per hour in urban areas and just $7 – $8 per hour in rural areas once business costs have been deducted. Cambridge sits somewhere in the middle, classified as semi-rural. “Some days we can do between 250 – 300kms (driving) when they (mums) are early postnatal” Jenny explained. All which has to be paid for out of the four payment modules the midwives receive. The first payment does not come until the woman has reached 28 weeks of pregnancy, and midwives may have already seen them up to six times before that. This is particularly hard on new graduate midwives, Jenny said, because they have to somehow survive for 28 weeks (more than six months), without any income.
And the workload associated with the model is seeing burnt out midwives leaving the profession in droves. It’s not uncommon for midwives to put in up to 80 hours a week, on call 24 hours a day (for which there is no funding) Yvonne explained, so it’s hardly surprising many of them have had enough. Jenny said that in Waikato last year, between 30 and 40 lead maternity providers (LMCs) have left the profession, making finding a midwife an increasingly difficult task for expectant parents. It’s a nationwide problem that is only getting worse, as the remaining LMCs buckle under the strain. With around 55,000 – 60,000 births a year but just 1100 LMCs in the country and dropping, the current funding model is not sustainable Jenny and Yvonne said.
Fielding phone calls from increasingly desperate women is hard, Yvonne said, and often emotional. “When you’re turning women away, you get women crying who have rung numerous midwives and no one can take them.”.
There may be a light at the end of the tunnel in the form of the budget, and Jenny said that many midwives throughout the country would be watching the Budget on this week before deciding their next move. While David Clark has said there will be “some” money for midwives in the Budget, Jenny says it may be too little too late for many LMC’s.
If there is not a meaningful improvement in pay and conditions for LMCs, communities such as Cambridge could be affected. And nobody wants that, least of all these midwives who are passionate about their work.
Costs of being a midwife:
· Vehicle costs – petrol and maintenance
· Rent for premises
· Annual practicing certificate: $445
· Maternity software (required by Ministry of Health but funded by midwives): $1500/year
· Emergency skills day: $125
· Standards review every 2-3 years: $500
· Annual compulsory and elective education
· Admin/accountancy costs of running a business
· ACC and Taxes
· Midwifery consumables
Once these costs have been deducted, rural midwives average an income of between $7-$8, while their urban counterparts are bringing in around $12-$13 an hour. The adult minimum wage in New Zealand is $16.50 before tax. To become a midwife, you need to complete a Bachelor of Midwifery – a four-year equivalent degree programme combining theory and practice (2500 clinical hrs) that is completed over three years. Midwives are highly trained health professionals with increasing levels of responsibility expected of them and no extra funding.