Early care in pregnancy

Early care in pregnancy is important to help keep hapū māmā (pregnant people) and unborn pēpi well. Pregnancy care and support ideally starts before 10 weeks of pregnancy with timely health screening (such as blood pressure and urine checks) that is crucial for good outcomes. Good care leads to timely birth, and lifelong health and wellbeing.

Whilst many women across Aotearoa experience great care, joyous pregnancies, and good outcomes – some don’t. The maternity workforce is stretched, pregnant people's care needs are growing, and it can be hard to navigate care pathways and be supported to make informed decisions, including accessing specialist care when needed.

Please take care when reading the following text.

Wellness through pregnancy

The changes that women go through during and following pregnancy can include physiological and psychological factors that contribute to a potentially challenging time for women (and pēpi). Research shows that between 30 and 60 per cent of cases of severe maternal morbidity (very unwell hapū māmā) are potentially preventable. These severely ill women have a higher risk of poor infant outcomes including increased rates of still birth, premature birth, low birth weight pēpi, and admission to Neonatal Intensive Care Units. Better care and systems can reduce these harms.

Post-birth, untreated conditions such as perineal tears, prolapse, or incontinence - or factors such as not being able to have a contraception plan met - can also impact negatively on overall health and wellbeing, including maternal mental health. It’s disturbing but important to acknowledge that in Aotearoa, suicide is the leading cause of death for women at this time.

This is heavy. But it’s even heavier to acknowledge and understand that the risk of poor outcomes described above is not the same for everyone – with systems continuing to fail Māori, Pacific and Indian peoples more than New Zealand Europeans. The maternity service is failing 42 per cent of the population giving birth who suffer increased unacceptable harm. 

The good thing is that we know there are opportunities to improve. The harm experienced is not due to factors related to the pregnant person or their family, they are factors related to the timely provision of care, and the health care pathways and wider systems overall. 

We can do things differently by modifying the current systems to prevent harm!

A lot of work is ongoing to address the need for improved maternity quality and safety in Aotearoa. Training more midwives is one aspect, but other supportive factors include access to quality ultrasounds, stable and safe housing, and affordable oral healthcare. 

Much more can be done to reduce preventable harm. Our team wholeheartedly support multi-disciplinary collaboration - midwives, nurses, sonographers, obstetricians, GPs working together (in community and in hospital) within an appropriately funded model of maternity care for Aotearoa that will ensure best outcomes for māmā, pēpi and whānau.

Accountability

Te Whatu Ora (Health NZ) is ultimately accountable for the preventable harm women and pēpi suffer. They must take action and resource change to reduce the unacceptable levels of harm and mortality. Transformative change is needed. 

Research as activism

We use research as activism. Research driven by wāhine toa, challenging inequitable systems, shining a light on system failings and barriers, and most importantly, introducing possible solutions. It’s women’s health research, to make a difference.

We pay our respects to all who have been impacted by pregnancy associated harm or loss 

Me aro kī te hā o Hine–ahu-one, pay heed to the dignity of women.