They preside over some of the most intimate situations in a family's life and their privacy seems to sometimes extend to comment about their very profession.
Only several Central Otago midwives contacted about recent maternity issues in the district responded to Otago Daily Times' requests for comment, and those who did preferred not to be named.
Several others did not respond, but at least one of those had been sleeping at the time, having just delivered somebody's baby.
The reality of being on the clock 24/7 as a rural midwife is that when you can sleep, you should. You never know when you will be called on to bring another person into the world.
Twice this month, the primary birthing unit - the only birthing unit in Central Otago - had insufficient staff to provide back up to lead maternity carer (LMC) midwives using the unit, affecting post-natal service and requiring LMC midwives to provide their own back up, although the facility remained open for deliveries in both instances.
But the definition of "open" has been up for debate, partly thanks to a series of public statements from Waitaki MP Jacqui Dean.
Mrs Dean has issued three statements this month - two press releases and one newsletter - that all said Charlotte Jean had been closed and unable to accept birthing mothers twice this month.
But Charlotte Jean manager Roger O'Brien said that was incorrect. In fact, Charlotte Jean's support staff were unavailable for post-natal care during an 11-hour period on July 9, but the facility was still available for LMC midwives to use during that period.
Subsequently, during the weekend of July 13-14, because the Charlotte Jean staff member was a registered nurse, not a midwife, LMC midwives were again asked to supply their own back up midwife for any deliveries, but the facility was again still open for deliveries.
Mrs Dean had not contacted Charlotte Jean "to verify the facts or to get more information to understand the situation" after either episode, Mr O'Brien said.
She defended her public statements, saying a Central Otago midwife had made a recent Facebook post saying Charlotte Jean had been closed.
Mrs Dean said she did not now want to go into "what's incorrect or correct", but it was true the facility had been closed for a period for post-natal admissions, and only available for deliveries if midwives provided their own back up, "which rendered it [Charlotte Jean] effectively closed".
Central Otago Mayor Tim Cadogan has weighed in on the issue, posting on Facebook to clarify the reality of the reduction of services and saying "I am satisfied that the situation ... was not as bad as it may have been portrayed ... by some seeking to gain a political point or two from it".
He this week said he was "disappointed" Mrs Dean continued to distribute comments he called "factually incorrect".
"People in positions such as those Jacqui and I are privileged to hold have an absolute responsibility to truth and accuracy. While Jacqui and I will fight the same fight to ensure rural health services get the funding they need, using emotive and incorrect language to make a point is not something I would do."
The three midwives who spoke to the Otago Daily Times said they were used to backing each other up in a rural setting, but having to provide additional back up was causing midwives additional strain.
They acknowledged Charlotte Jean had officially remained open during the two staff shortages, although one midwife said if a midwife was unable to provide back up for birthing then the facility would "effectively" be closed to that midwife.
But all the midwives, as well as Mrs Dean, agreed on one thing: it was the health board's refusal to acknowledge growth in the Central Otago and Queenstown Lakes district, and provide sufficient additional funding and services, that was the problem. They all agreed the spotlight should be on the health board's lack of support to Charlotte Jean and Central Otago mothers.
Mrs Dean said "shifting services around" different districts, rather than keeping what existed and adding new services, was not good enough and not the solution.
Some have told the Otago Daily Times it is easy for Mrs Dean as an opposition MP to now criticise the Labour-led Government, and that National also did little to improve maternity services in Central Otago.
But Mrs Dean said her government had been working with the College of Midwives in 2017 and was going to introduce a new model of care and extra funding for midwives, but none of that had been picked up by the Labour-led Government.
Health board executive director strategy, primary and community, Lisa Gestro, said the growth in the Central Otago and Queenstown Lakes district was "one of the key reasons we needed to relook at the provision of maternity services across the district".
"There were significant inequities, with three primary birthing units within 40 minutes of each other in Southland (Gore, Winton and Lumsden), some with very low numbers of births, while there was no formal maternity infrastructure in Wanaka, and the LMC midwifery in the area was under extreme pressure.
"This is why we are utilising our maternity resources differently, establishing maternal and child hubs in Lumsden, Te Anau and Wanaka, and redirecting resources to provide additional payments to LMC midwives (who receive their income from the Ministry of Health), paying for relief midwives to enable time off, and supporting their business costs.
"Altogether we are investing more in primary maternity services across the district. We are establishing a more sustainable service that reaches more women and is better matched to the population and needs across the whole district."
The health board had also increased its funding to Charlotte Jean by 13% over the last 10 months, recognising the need for Charlotte Jean to offer competitive salaries to its staff following increases to the salaries of nurses and midwives employed under collective agreements after industrial action last year, Ms Gestro said.
More broadly, additional payments being made by the health board to all southern LMCs had resulted in an extra $250,000 being paid out to about 21 LMC midwives over the last 12 months, she said.
Mrs Dean issued a post-script to the issue on Thursday this week, now saying progress was being made at Charlotte Jean maternity because of negotiations between the health board and Charlotte Jean Maternity management which would hopefully mean greater staffing stability for Central Otago.
Her Thursday statement also said "I have also spoken with Charlotte Jean management and offered them my support in these negotiations, should they need it".
"I can say that I am reassured that the health and safety of Central Otago mothers and their babies is their top priority and that this facility is a real asset to the local community.
"Many local midwives have been ready to support each other during recent staffing issues, but I think their patience is running thin. The Southern DHB should not take advantage of their goodwill, but must step up to address the issues affecting maternity services in rural areas."
• Lead maternity care (LMC) midwives are self-employed, and paid by the Ministry of Health. They can access both Charlotte Jean Maternity Hospital and Lakes District Hospital any time, and provide care from these facilities, supported by the core midwives who are employed there.
