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Mothers and babies in good hands with Gina

Friday, 24 June 2011, 2:39 pm
Press Release: Waikato District Health Board

Midwife Gina Chaney loves her job

“It’s always different, you never know what you will get in a day,” says Gina, who works as a senior midwife and Delivery Suite coordinator at Waikato Hospital.

It’s a busy place day or night, with 3615 babies delivered at the hospital last year, a number that has increased steadily over the past five years (up from 2875 babies in 2005).

Waikato Hospital Delivery Suite services a wide catchment area and women with a variety of needs, including some emergencies, transferring from as far away as Gisborne, Whakatane and Tauranga, or from regional birth centres and rural hospitals. “We are talking life and death, women who are brought in by Westpac chopper or ‘priority one’ by road,” says Gina.

Women coming to Waikato Hospital to give birth are in good hands with Gina and her colleagues.

Gina has been a midwife for 18 years and recently graduated with a Masters degree in Health Practice (Midwifery) from Auckland University of Technology (AUT).

She says she has always wanted to be a midwife.

Gina began her career as a registered general and obstetrics nurse, graduating in 1989.

After spending six months working in theatre at Auckland Public Hospital, Gina moved to Waikato in 1990, spending a year in orthopaedics before transferring to the postnatal ward.

In 1992 Gina began her midwifery training, graduating at the end of 1993.

She didn’t initially intend to get her Masters. “I fell into it,” laughs Gina.

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While studying for her post-graduate Complex Care Programme in 2009, Gina was encouraged to continue her studies. “AUT said I have only two more papers to complete to get my Masters.”

It was lots of hard work – four years of part-time study in total - while working part-time as a midwife, and being Mum to her now teenage son, but Gina says it’s been worth it.

She graduated with distinction, getting A and B+ grades in all of her papers.

Gina is one of only three midwives at Waikato Hospital with a Masters qualification; the others are Lindsay Fergusson, with a Masters in Health Sciences (Midwifery) and Corli Roodt with a Masters of Philosophy (Midwifery).

Clinical Midwife Director for the Waikato District Health Board Corli Roodt says Gina is “a natural leader” who is “widely regarded as a valuable clinical resource by her peers”.

Gina’s Masters study has benefited the hospital team says Corli. “She brought back cutting-edge knowledge and critical thinking that stimulated debate over current practices, she instituted practice changes and introduced new practical ideas that assist the teams to more efficiently respond to clinical requirements,” says Corli.

Gina’s area of interest, and much of her Masters study, is focussed on caring for women with “complex needs” – those with multiple health issues during pregnancy (from preeclampsia to pre-existing heart conditions).

“I know a lot about those with complex situations, and those pregnancies can often have co morbidity (presence of one or more conditions),” says Gina. “Those pre-existing medical conditions can compound themselves with the added stress of pregnancy.”

Not surprisingly, Waikato Hospital, by the nature of the high level of medical care it can provide, has a higher number of inductions and births involving intervention.

Waikato Hospital midwives are well trained to deal with complex cases and emergencies, making it the safest place in the region for women to birth babies.

In 2010, 25.4 per cent of babies (916 of 3615 deliveries) at Waikato Hospital were induced.

Some 17.9 per cent (633) of women needed emergency caesareans, 10.7 per cent (380) were assisted with vacuum extraction and 4.2 per cent (147 women) with a forceps delivery. Just over half (56.9 per cent, or 2015 births) were spontaneous vaginal deliveries.

For Gina, women with preeclampsia in pregnancy is an area of special interest.

The potentially life-threatening condition is most often characterized by high blood pressure which can lead to seizures, strokes, organ failure and puts both mother and baby at risk.

In their first pregnancy, women have a five per cent risk of developing preeclampsia, and for those who have had it, a 10 to 20 per cent risk of developing preeclampsia in a subsequent pregnancy.

There is increased risk for women who are obese or have a close female relative who has had preeclampsia, and particularly for those who have been with their partner for less than three months.

There are about 2800 practising midwives in New Zealand (according to the 2011/12 practising certificate numbers from the Midwifery Council of New Zealand) and the Waikato District Health Board employs about 120 midwives throughout the region. A further 122 Lead Maternity Carers have access to various Waikato District Health Board facilities to birth clients.

Midwives are a special breed. “As a midwife you need to have drive, and the flame to want to be involved with women and birthing and helping new mothers,” says Gina.

For midwives in the community (Lead Maternity Carers), it is a 24/7 job, being on-call for clients who may go into labour at any time.

Hospital midwives also walk alongside women, caring for those in the Delivery Suite at an important time in their and their family’s life, bringing a baby into the world.

The night shifts never get easier, says Gina, who works two-thirds of her shifts at night. “I’ve had 13 years of working after-hours,” she says. “You have limited resources at night and have to deal with whatever situation you’ve got.”

As a Delivery Suite Coordinator, a phone call can alert her to an incoming emergency, or she may be required to support a colleague in the community, offering a second opinion about a woman in labour.

“We offer support to midwives and GPs or nurses in rural facilities, and you get a call and help them decide if the woman should be transferred and how to manage that situation, or just reassure them that they don’t need to come in to the hospital,” says Gina. “Midwifery is about keeping birth natural. It’s also about how to support LMC colleagues to birth in the community, and for that LMC at 1am in Taumarunui, she might just need to hear a second opinion, for someone to look at her situation from the outside with fresh eyes.”

The Waikato District Health Board is struggling to recruit and retain midwives at the hospital.

Being short-staffed is putting pressure on existing midwives.

“Currently there are not enough midwives, I’ve no idea why,” says Gina. “Here, you get guaranteed shifts and your pay rate is guaranteed, and the hospital organises your educational needs and pays for your practising certificate.”

Gina enjoys working in the modern, upgraded Delivery Suite at Waikato Hospital, which was refurbished in 2008. The area is secure and there are private rooms for women to labour in, all containing an ensuite bathroom with a shower.

Historically, there has been tension between doctors and midwives says Gina, but she believes things are changing. “I think we are being accorded more respect (in professional circles), but I’m not sure if the public has come around to appreciating midwives,” says Gina.

“Some people are very mistrusting of midwives as a profession.”

She believes midwives need to be appreciated for their skill and expertise.

There is an emphasis on ongoing professional training at the hospital, and Gina often finds herself educating midwives, nurses and medical staffs about what goes on in the Delivery Suite, including emergency scenarios and the care and treatment of pregnant women with complex needs.

She is proud that she has helped make a difference in women’s lives. “A few years ago I stopped a caesarean section; a young girl was on the operating table about to commence her anaesthesia.”

After advising the doctor it wasn’t necessary, and explaining the reasons why, the expectant young mother went on to have a vaginal delivery – a result Gina is proud of. “I kept that birth natural, which made a big difference to her recovery and will make a big difference to any future births she has,” says Gina.

There are tough moments too, when things go wrong. Recent media attention has been critical of midwives. “It’s really tough when things flare up and there is negative publicity, and dealing with the public’s reaction.”

Hospital staff are often not allowed to comment due to patient privacy, and what is reported in the media is not always truthful, or the whole picture.

Outside the hospital, Gina keeps busy as a mum to her 13-year-old son and is involved in the school PTA.

She is also a Brownie leader, running a Brownie pack of 30 girls, and is involved in the organisation of the next Girl Guiding New Zealand Jamboree in Rotorua in January.

From the encouraging the next generation of young women as a Brown Owl, to supporting Waikato’s newest mums in their hour of need, Gina is a real asset to the region.

And, that might not be the end of the study – if she’s got time to fit it in.

“I haven’t ruled out going on and doing my doctoral thesis,” says Gina.

ENDS

Waikato District Health Board

Healthy People. Excellent Care

Waikato District Health Board (DHB) employs over 6500 people and plans, funds and provides hospital and health services to more than 391,770 people in a region covering eight per cent of New Zealand.