A critical shortage of midwives in Dunedin has eased slightly, but expectant local parents are still struggling to find a midwife to visit their home.
In late 2019, the downward spiral in the number of local midwives resulted in the Southern District Health Board having to provide midwifery care through an inpatient clinic at the Queen Mary Maternity Centre.
By the end of 2019, about 90 women had enrolled with the Dunedin Hospital service.
What was meant to be a short-term fix using hospital midwives to provide cover during the holiday period has become a permanent outreach midwifery team which currently has 57 women enrolled.
SDHB director of midwifery Heather La Dell said a small number of women were still unable to find a non-hospital midwife in Dunedin, and the outreach service continued to provide care to them.
"It has been wonderful to see that six new [non-hospital] midwives have come to practise in Dunedin this year.
"Some are new graduate midwives who are part of the midwifery first year of practice programme, and others are midwives who have returned to the [non-hospital midwife] role."
College of Midwives Dunedin representative Charlie Ferris said she estimated 19 non-hospital midwives were now working in the city.
While that was an increase from just 14 in early 2020 , it was still well down from the 70 who practised in 2014.
"If there are any women in a primary clinic then the system is in crisis as it is an inferior way of looking after women compared to the community-based [non-hospital midwife] system, which is the gold standard," Ms Ferris said.
"Some of those midwives would take over 40 women a year, but some are part-time and take between 20 and 40, while some take less than 10 women a year.
"We are still in a crisis, just not quite so much of a crisis."
Dunedin had a four-year pregnancy average of almost 1600, a number far beyond what the current non-hospital midwife workforce could cope with Ms Ferris said.
"Graduate midwives average less than 10 years in the workforce, so these new graduates numbers practising may not be sustained."
The shortage of midwives was largely due to underfunding from central government, and the SDHB had had to find a stopgap measure, Ms Ferris said.
Ms La Dell said a user group made up of the SDHB and the public was contributing to the design of a new primary maternity unit inside the new Dunedin Hospital.
"Based on international evidence, having a primary maternity unit on site, but separate from secondary services, will mean that more healthy well women will feel confident to labour and birth in the primary maternity unit," she said.
"Anticipated benefits of this new purpose-built space for normal birth will include improved normal birth outcomes, improved birth experience for women and families, and a supportive environment for midwives focused on providing primary care."
