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Choice Of Care Provider The Number One Issue

Choice Of Care Provider The Number One Issue For Woman In Maternity Care

Seventy people representing consumers and providers of maternity services gathered in South Auckland today for the final major consultation exercise in the National Health Committee's review of maternity care.

National Health Committee member and chair of the review Maggie Barry opened proceedings saying she saw the day-long forum as an opportunity for those present to help create a new vision for maternity care services in New Zealand.

"The overall goal we're aiming for is to ensure that all woman and their babies have fair access to quality maternity services of their choice," Maggie Barry said.

"We want to move the debate from the past into the future," she said acknowledging the many changes the maternity system has seen in the past decade and the huge range of experience and opinion held about maternity services.

Being able to choose the kind of care that most suits their needs is what woman attending the forum told the Committee is the number one issue for them in maternity care. This mirrors the findings of a telephone survey the NHC has just completed among 1000 New Zealand woman which shows that being able to have their first choice of 'lead maternity carer' is important for 88% of woman.

The same survey showed that 44% of woman had an independent midwife as their lead maternity carer, 12% had a hospital midwife, 10% an obstetric specialist, 10% an arrangement where their care was shared between a GP and a midwife and 9% had their own doctor as their lead maternity carer.

However this was not always their first choice. 35% of woman wanted an independent midwife as their lead maternity carer, 20% wanted their own family doctor and 16% wanted shared care between a GP and a midwife.

Besides preferred choice of lead maternity carer, post natal care, maternal mental health, services in rural areas, services that are culturally appropriate for Maori, Pacific Islands and woman from other cultures were all significant issues. Information about how the lead maternity carer system works and the choices woman have of providers, their training and experience in different areas of the country was also clearly called for. As well there were numerous calls for a comprehensive perinatal database to collect better information on clinical outcomes of care. Such information would provide a tool for comprehensively monitoring of the effects of changes in maternity care service arrangements and tracking trends in practice.

Where dissatisfaction with maternity services exists many of the groups represented at the forum felt that the funding arrangements for maternity services are the root cause.

Since the terms of reference for the review were issued by the Minister of Health, Wyatt Creech, in March, the NHC has received a wide variety of views on the future of maternity services from organisations and individuals, providers and consumers of services. The Committee has also gathered extensive information on the provision of maternity services in New Zealand and internationally from surveys, analysis of service data and a literature review.

"While it was an ambitious undertaking to bring so many people together to discuss the multitude of issues that exist in maternity care the forum was an extremely valuable event from the Committee's point of view.

"There was certainly heat but there was also light cast on some of the more divisive issues in maternity care," says Maggie Barry. The forum ended the four month information gathering process the NHC has undertaken for the review. It now has two months to formulate its advice on the future of maternity services in New Zealand which is due with the Minister of Health on 31 August 1999.



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