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Source: Health and Disability Commissioner

Deputy Health and Disability Commissioner, Rose Wall, has found a registered midwife breached the Code of Health and Disability Services Consumers’ Rights (the Code) for failing to adhere to Manatū Hauora/Ministry of Health and New Zealand College of Midwives standards when providing postnatal care to a woman.
The woman was admitted to a public hospital in 2020 with pre-eclampsia and underwent an emergency Caesarean section due to foetal distress and failure to progress in labour. She and her baby were discharged two days later and given medication for the woman’s high blood pressure, along with a plan for the midwife to monitor her blood pressure.
When she first booked the midwife, the woman received a letter stating the midwife would visit regularly for between four and six weeks after leaving hospital, and the first home visit would generally be the day after discharge.
However, the woman was not seen by the midwife until four days post-discharge and was only seen three times postnatally, instead of the minimum seven expected visits outlined in the Manatū Hauora/Ministry of Health guidelines.
After her third visit, the midwife told HDC she was planning to see the woman the following week, but the woman was out of town. The midwife made a referral to Plunket so care could continue, but she did not meet with the woman personally or contact her by telephone to discharge her from her care postnatally. The midwife did not reply to the woman’s text about whether she and her baby were still under the midwife’s care.
The New Zealand College of Midwives midwifery standards state the midwife should negotiate the completion of the midwifery partnership with the woman.
Ms Wall was critical of the time it took to visit the midwife to visit the woman once she was discharged, the number of times she visited and her failure to negotiate the completion of the midwifery partnership with the woman.
She found the midwife breached Right 4(2) of the Code for failing to adhere to the Ministry of Health and New Zealand College of Midwives standards when providing postnatal care. Right 4(2) states that every consumer has the right to have services provided that comply with legal, professional, ethical, and other relevant standards.
Ms Wall said the main goal of postnatal care is to maintain and promote the safety and wellbeing of mothers and their newborns.
“It also promotes continuity of care to ensure that mothers receive the ongoing support they require after birth. In my opinion, it was the responsibility of the midwife to ensure that safety-netting measures appropriate to the circumstances were followed.”
Ms Wall’s report recommended the midwife provide the woman and her family with a written apology for the breach of the Code and provide HDC with an audit of her clients to confirm she is currently providing postnatal care to the required standard.
Since these events, the midwife has worked in a partnership of four so that she can have a first and second midwife on call to assist, if required, over a weekend. She also told HDC that she now scrolls through her messages when she gets home each day to ensure no messages have been missed.