15 April 2026

Health NZ has recently released Tuituia te Kahu – the national Bereavement Care Pathway for Perinatal Loss. This 184-page “framework of nine national standards” is designed to guide “compassionate, consistent, high-quality care for whānau who experience perinatal loss and outline optimal perinatal bereavement care across the health system”.

Women’s Rights Party Co-leader Jill Ovens says of course it is a ‘care pathway’ and a ‘framework’ as this is the language ‘du jour’ in the public sector. “What the report is not full of, however, is mention of mothers. The word 'mother' can be found just 14 times in 184 pages, and then only where reference to mothers couldn’t be avoided as in what is contained on the death certificate.”

Women were only marginally better represented. The word "woman" was mentioned 17 times, and mostly extended to include "pregnant people". Although the report uses te reo extensively, the word “wāhine” gets only one mention and is not defined in the 16-page glossary.

Women’s Rights Party members note the centring of “whanau”, a word most often associated with the wider family, as disrespectful of mothers experiencing the loss of their baby.

Indeed, the report defines “whanau” even more widely than family members to include close friends, and all of those who are within the rainbow communities, and tāngata whaikaha (people with disabilities). See glossary examples below.

By broadening the scope of those involved in a bereavement involving loss of a baby, the report minimises the grief of mothers, as well as fathers or partners, including lesbian partners, Jill Ovens says.

One member, who is a midwife, reports that in her experience many men grieve the loss of a much wanted baby, “but they do this differently to the women, and most of them recognise that this loss is felt more profoundly by their wives or partners, so their role in the immediate aftermath is to support her”.

She acknowledges that grandparents and other family members can also be upset by a baby loss, but she says it is not the responsibility of health services to provide intimate loss care for the wider family.

Here’s what Health NZ had to say about their report (all emphasis here and further below is ours): “Developed by the Technical Advisory Group (TAG) with the voice of whānau who had experienced loss at the centre, Tuituia te Kahu brings together lived experience, expert advice, research, and international best practice to highlight where services are working well and where they can better support people during an incredibly difficult time.”

We are told “the pathway aims to ensure that every whānau receives safe, timely, and responsive care that honours their needs, circumstances and preferences”.

The voice of the ‘community’ on the TAG was represented by:

• Frankie Karetai Wood-Bodley, described as “a passionate advocate for LGBTQIA+ and disability rights who identifies as disabled, non-binary and gay, bringing vital perspectives on intersectional advocacy”;
• Poonam Rishi, an artist, and project coordinator at The Asian Network Incorporated (TANI) who “brought a deep understanding of the cultural, linguistic, and systemic barriers faced by Indian families navigating healthcare systems”;
• Rāwā Karetai (Waitaha, Kāti Māmoe, Kāi Tahu, Ngāti Maniapoto), described as “a respected advocate for Indigenous, Tāngata Whaikaha Māori, and LGBTQIA+ human rights with international leadership experience”.

Frankie was the bearded ‘pregnant person’ who with her husband Rāwā starred in the tax-payer funded documentary Trans and Pregnant: Couple share journey to parenthood.

Midwife members of the Women’s Rights Party point to examples where the report uses "pregnant women/people" inappropriately, as when the report talks about paediatric palliative care and a baby with a terminal or life limiting diagnosis. In these cases, the woman is clearly not pregnant any more. It should be the woman and they should also speak of the man, the father of the child who is also dealing with this in different ways.

What is clear is that the report writers don't seem to care that it is offensive and often inaccurate due to the unwieldy language used to avoid even talking about women, let alone men in the context of the report.

NOTES

Here are some examples extracted from the 16-page Glossary which opens with the following statement (again all emphasis below in bold is ours and our comments are highted in purple):

“Nau mai haere mai ki tēnei pātaka kupu. Kua whakatakoto ēnei kupu hei awhina i te marama me te manaaki o tēnei ao. Me āta pānui, āta marama ngā kupu, ngā reo whānui o tēnei ara hou – Tuituia Te Kahu | the National Bereavement Care Pathway for Perinatal Loss.

We welcome you to this glossary as an introduction and foundation of the language specific and integral to our new pathway, Tuituia Te Kahu, the National Bereavement Care Pathway for Perinatal Loss.

Each term and word hold definitions that honour the many communities impacted by perinatal bereavement in Aotearoa.

Antepartum Haemorrhage (APH): Any bleeding from or into the genital tract, occurring from 20 weeks of pregnancy and prior to birth. One of the leading causes of maternal/perinatal morbidity and mortality. Women/people who have an APH are at significant risk of a postpartum haemorrhage (PPH). APH complicates 2-5% of all pregnancies. [Only mothers experience antepartum or post-partum haemorrhage. That is a fact!]

Bereavement Midwife: A midwife who specialises in supporting families experiencing baby loss. [Once upon a time, the midwife’s role would have been to centre the mother!]

Bereavement Care Pathway for Perinatal Loss: A structured and compassionate approach to providing care andsupport for individuals, whānau and families experiencing pregnancy or baby loss. This pathway ensures thatbereaved individuals, whānau and families receive timely, equitable, and personalised support that aligns with their cultural, emotional, and spiritual needs. [Let’s name the mother and her partner!]

Culturally Safe, Whānau-Led, and Spiritually Appropriate: An approach that ensures bereavement care and services are directed by the preferences and needs of individuals, whānau, āiga, kāiga, magafaoa, kōpū tangata, vuvale, fāmili - immediate/extended family, for example, rather than being assumed or dictated by healthcare professionals. This often means creating a space where pregnant women/people, whānau, and families determine the cultural, spiritual, and personal aspects of their care. It is also crucial that professional support is consistent, respectful, responsive, and adaptable to the individuals, whānau and families’ values, traditions and grieving processes. [‘Pregnant women/people’ – you mean mothers?]

Ethic of Restoration: As explained by Moana Jackson, an ethic of restoration recognises that, like colonisation, restoration is a process; a process that seeks to restore our tikanga (practices), which is a values-based system of what ought to be, to help sustain a balance of relationships. The ethic of restoration was an integral design principle of Tuituia Te Kahu.

Kaiwhakatere The lead perinatal bereavement coordinator is the kaiwhakatere: they navigate the whānau - āiga, kāiga, magafaoa, kōpū tangata, vuvale, fāmili - and family along the pathway. [But not the mother?]

Maternal Sepsis: A life-threatening condition that arises when the immune system of a woman or person who is pregnant or has recently given birth responds to a severe infection. It is the third most common cause for maternal admission to ICU/HDU. [You mean a pregnant woman or a mother who has recently given birth?]

Medical Certificate Cause of Death of Fetal and Neonatal Death HP4721: A medical practitioner or nurse practitioner can complete the HP4721 Form for a liveborn baby who dies within 28 days of birth and stillbirth, as set out in the Burial and Cremation Act 1964. If no medical practitioner was present at the birth of a stillborn baby, a midwife may complete this form instead. The certificate records information about the mother, pregnancy, and delivery. It also includes the baby's birth weight, gestation, and cause of death. [This is the first time the mother is mentioned.]

Paediatric Palliative Care: a system of care that focuses on comfort, improving quality of life and supporting the pregnant women/people, whānau and family when a baby has a terminal or life limiting diagnosis. For the National Bereavement Care Pathway for Perinatal Loss, a baby is a newborn or infant. [This is inaccurate as such care occurs after the birth so the woman/mother is no longer pregnant.]

Rainbow Baby: A baby born subsequent to a miscarriage, stillbirth, baby loss, termination, or the death of a newborn or infant. [That’s a new one on me! I have heard stillborn babies called “sleeping babies” or “angel babies”.]

System Signal: In the context of this perinatal bereavement pathway, a system signal refers to healthcare data that signals to healthcare providers that targeted grief and mourning, as well as bereavement services, may be needed by a particular pregnant woman/person and their whānau. [By a mother and her partner? Note that after the baby is born, the mother is no longer pregnant.]

Tāngata whaikaha: People who are determined to do well, and an active removal of using the term ‘disabled people’. Tāngata whaikaha are incredibly resilient and adaptable, particularly in systems that often marginalise them. Tuituia te Kahu is inclusive of our tāngata whaikaha whānau. [People with disabilities are also being erased.]

Threatened Miscarriage: Any bleeding in or from the genital tract of a pregnant person. [Doesn’t define precise terms like threatened miscarriage. It's minimising what a threatened miscarriage is, either medically or psychologically for the mother who may have experienced more than one miscarriage.]

Transmasculine Individual: People who were assigned as female at birth but identify more as male than female. Their anatomical birth sex does not match their inner sense of gender identity and can include non-binary and gender fluid individuals. [In other words, a woman in the context of pregnancy and childbirth.]

Whānau: Extended family and community, which may include close friends, is central to Māori culture and decision-making in bereavement. The connected “family” group includes physical, emotional, and spiritual relationships and is based on a Te Ao Māori worldview. Whānau is used throughout the report, and within that term we are inclusive of all of those who are within the rainbow communities, and tāngata whaikaha. Whānau is another kupu meaning birth. When we mention whānau in this report, we also note the Pasifika references to family and whānau as well - āiga, kāiga, magafaoa, kōpū tangata, vuvale, and fāmili.

Whānau-Led Care: Whānau-led decision-making and care, recognising cultural, social, and spiritual needs. A reminder that it is not culturally safe to try and impose one’s cultural norms on the whānau grief and journey. This is consistent with the midwifery standards of practice, including Turanga Kaupapa. Tuituia Te Kahu asserts the position of bereavement care being whānau-led care. Whānau have mana motuhake.

[This final statement that “whanau have mana motuhake” is particularly disturbing given the importance of centring mothers in midwifery and maternity care, especially when a baby has been lost. It is not her wider family that has self-determination, authority, sovereignty in this situation. She does!]

Post-script

Nelson MP Rachel Boyack today posted the sad news of her recent miscarriage on her fb page. The Women’s Rights Party extends our heartfelt sympathy to Rachel and her husband and we thank her for sharing her experience with so many women who have suffered the loss of their baby in silence.

“Many people who suffer from infertility, miscarriage and baby loss suffer in secret and in silence. Scott and I want you to know that we see you, and we truly understand,” Rachel said.

She thanked family and friends, staff and MP colleagues, and her husband’s work colleagues for their wonderful support. In particular, Rachel thanked the many, many staff at Nelson Hospital who looked after her with such amazing skill, compassion and care. And finally, to her midwife, “words can not express how much we appreciated your care and advocacy”.

© Scoop Media