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Our rural midwives – honouring mothers.

By Pauline Stewart.

Last Friday 5 May was International Midwives Day. The Informer decided to highlight the work of midwives in this region as part of honouring mothers everywhere and honouring motherhood, whatever shape it takes and whoever loves enough to be in that role.

The bulk of the information about the way Midwifery Works on the Coromandel is from my interview with Fiona Kington, a qualified Midwife who after twenty- nine years of practice is acting as a locum.

Not every one of the midwives was available but the informer was also able to speak with Tara Roberts and Sheryl Yates who shared their insights and some of their own particular experience. We are in awe and what they do. We thank Fiona, Tara and Sheryl for their valuable contribution to this issue but also for their work along with Jocelyn, Sally and Summer – with mothers across the years and across the Peninsula.

 

From Fiona:

Six midwives on the Coromandel Peninsula. Jocelyn Yates and Tara Roberts cover Mercury Bay, Kuaotunu, Tairua and Pauanui and Hot Water Beach, Hahei and Cooks Beach. Sheryl Wright covers Coromandel Township south to Manaia and all the way up to Port Jackson. Jocelyn and Tara also do some at Matarangi. Another midwife in this area is Summer O’Brien and she does home midwifery (homebirths) and is based in Tairua. I am a locum that is, I will step in when there isn’t anyone. The other locum apart from me is Sallie Turner. Sallie is predominantly the locum for Jocelyn and Tara.

I speak for the midwives on the Coromandel. They are amazingly dedicated. They give women confidence. They triage very carefully to give high risk women the help they need. There are a lot of health professionals we work with – physios, mental health services, secondary obstetric services at the hospital, local GP’s. The midwives are very knowledgeable and deal with most things within their scope of practice. “It is a great privilege and a great honour to walk alongside women and their families and try to give them confidence and choices especially confidence in their own ability to make the right decisions in their own journey of pregnancy, childbirth and mothering. With high risk, a woman often has to go beyond our care to the hospital, but I know that what we do offer them throughout is reassurance and it is comforting for them that in a remote location, there is always someone at the end of the phone. We try to give them confidence to have their birth at home in the primary unit.

We often meet women when they are newly pregnant. The women in this area are fortunate to have their own direct care; there are not many who have access to a Lead Maternity Carer (LMC). After us midwives discharge the mothers and babies after six weeks, they are then referred to Tamariki Ora (Plunket). But you can never underestimate that post-birth period of six weeks as a new mother. It’s a model that works. If we can sustain it, it is extremely valuable.

Including the Thames and Paeroa areas, there is not one LMC left so all the women in that area are being cared for by the Thames birthing unit staff who run clinics and who see them at the unit. Often woman in these areas go to Waikato to give birth because there are not enough staff to cover the shortage. There used to be LMC’s to give the kind of care we also offer; but they are all gone. The mandates with covid had something to do with that and as LMC’s retire, they are not being replaced in the remote rural towns. A lot have gone to Australia recently because the conditions and pay are far superior.

Personal journey: I think I have always wanted to be involved in nursing and nursing of this kind. I think the deeper and main reason why I am a midwife is that my birth mother was a midwife. She died when I was one year old. I think there is a part of me that connects with her and always did. I grew up being interested in her early midwifery career and her role as a nurse I started off n general nursing. Years ago, midwifery was tacked on to nursing as a diploma. I did the additional diploma. Now there is a degree in midwifery. It is a direct entry to a degree programme. Nursing and midwifery are both separate bachelor’s degrees.

New Zealand has been a world leader in providing primary care for women giving birth. Years ago, the GP’s used to do it but it was a great achievement when midwives got autonomy to practise alone.

 

From Tara

I have been a midwife for ten years and been working locally in the Coromandel for the last two years. The most important thing for me is to be present. “To be with” is what the word ‘midwife’ means. I am available 24/7 and that means from the time a woman knows she is pregnant to the six weeks after the baby is born. Pregnancy is a very stressful time and sometimes all the woman needs is a phone call.

We asked Tara about the different experiences of midwifery she had had, in the ten years. “I spent six years in Middlemore Hospital before coming here. Being a midwife in the hospital is incredibly different. There, you spend 12-hour shifts and the mother comes in to have the baby and then the baby and mother spend time in the birthing unit and then they go home. That is the way it works in the big city. In the Cook Islands where we were for two years, midwifery is so very different to New Zealand practice. There is less autonomy, and the GP is very involved in the decision-making during pregnancy. In New Zealand, there is a lot of autonomy for the midwife and the mother.

Here I get to know the mothers. I see them up to six weeks after the birth. But I also see them at the supermarket, and at the sports field This element of the small town is very nice, and I am sure the mothers think it’s nice too. You get to know the family here.

What I do is I give people lots of space. I go in and do all my checks. If a woman is birthing normally, really all the midwife does is sit in the corner and make sure. It’s not about me when it comes to the birth. I watch and I watch carefully. Sometimes, the mother catches her own baby, I don’t even do that. We let her do her own thing. My role is to be present; treat her with respect; listen to any concerns and protect her and her baby from any harm. That doesn’t mean I’m hovering, over the mother. I often just sit there, and I watch and I let nature happen and intervene only when need be. I work with Jocelyn who does the Whitianga area. In the area we cover, there would be 100 woman a year that we look after. I receive a lot of support professionally and we work together.

When I can’t be there, it’s all okay. Today (Saturday 6 May) was my daughter ‘s birthday and I am on call. I was hoping so much I wouldn’t get a call and it has worked out. The best part of my job I would say is that immediate two to three hours after a woman has given birth. She has done it! It’s where all the reward is. She has had her baby. She is holding the baby against her skin – so close. The Mother gets a bit of a rest and has something to eat. To be witness to that is so rewarding and it’s a privilege.”

 

From Sheryl:

Sheryl was on the National Board of Midwives for a couple of years. It was a two-year role. She took that on when living in the Waikato but then moved north of the Coromandel township mid-term. “It was a bit of a challenge living in Amedeo Bay and having to meet in Christchurch as a representative on the National Board.”

When I moved up here, I thought I might not carry on, but I could see there was a need. When you have skill and you get to know the people, you just start to ask yourself, why you can’t do this. It comes back to the fact that I’m working with families and I’m making a difference. There is a sense of responsibility to your community. The challenge is I know I am needed.

In my area we are very short of midwives, and we are so geographically separate. When I moved up here, we were in a crisis with 11 midwives across the Coromandel Peninsula. Now we have three not including our locum and our home birthing midwife. I have worked on my own without a backup in an area that’s bigger than the whole area of Auckland. Jocelyn and Tara will give me a hand if they can, but it’s an hour and a half. The reality is our maternity system is underfunded and it has been a slow steady decline. One good side is that we do get finding for travel. The road closures have significantly added to the stress of the mothers. When you are relying on roads that are not open the question for a pregnant mother soon to give birth is “What will we do if this happens?” “Will the midwife get to me?” I worry – “Will I get to the Mum?” Obviously, it doesn’t happen often, but you are always carrying the weight of the possibility. I am always conscious of travel distances. This area and that of my colleagues is regarded by the Ministry of Health as one the five most isolated areas for midwives That includes the Coromandel peninsula down to Tairua. if there is a warning sign, then we make a decision earlier then if we are in a suburb. We have to be more proactive. If things aren’t going well, we need to move early. I have been doing this for 20 years. When I began, I was the same age as many of my clients. Now I feel like I’m their mother or even grandmother. Mothering is not just what you need to do for your children. Mothering becomes a part of your life for everyone. Midwives understand chaotic lives.

One thing that can be sometime difficult is that women in my area don’t have a choice of a midwife. It’s now me or me.

The best thing about this job is watching women grow into their abilities. They already have the ability but with reassurance and encouragement they just grow in stature and confidence. I worked in the Waikato for 16 years in Huntley and I could never go anywhere without meeting Mums and their children. When I first came here, it was so strange not knowing anyone. But now, after three years people come up and know you. My husband sometimes gets, “Oh, you’re the midwifes husband.”

I could not do this without David’s his support. When I have to go in the helicopter, he comes to pick me up. He’s the one who has the dinner ready when I come home several hours late. That is how the whole society works – partnership. The whole of our lives is sustained (or falls apart) by those human relationships.

This is a great job – all of us midwives invite people to take up this as a vocation.

 

Caption: Fiona Kington.

 

 |  The Informer  | 

By Pauline Stewart.

Last Friday 5 May was International Midwives Day. The Informer decided to highlight the work of midwives in this region as part of honouring mothers everywhere and honouring motherhood, whatever shape it takes and whoever loves enough to be in that role.

The bulk of the information about the way Midwifery Works on the Coromandel is from my interview with Fiona Kington, a qualified Midwife who after twenty- nine years of practice is acting as a locum.

Not every one of the midwives was available but the informer was also able to speak with Tara Roberts and Sheryl Yates who shared their insights and some of their own particular experience. We are in awe and what they do. We thank Fiona, Tara and Sheryl for their valuable contribution to this issue but also for their work along with Jocelyn, Sally and Summer – with mothers across the years and across the Peninsula.

 

From Fiona:

Six midwives on the Coromandel Peninsula. Jocelyn Yates and Tara Roberts cover Mercury Bay, Kuaotunu, Tairua and Pauanui and Hot Water Beach, Hahei and Cooks Beach. Sheryl Wright covers Coromandel Township south to Manaia and all the way up to Port Jackson. Jocelyn and Tara also do some at Matarangi. Another midwife in this area is Summer O’Brien and she does home midwifery (homebirths) and is based in Tairua. I am a locum that is, I will step in when there isn’t anyone. The other locum apart from me is Sallie Turner. Sallie is predominantly the locum for Jocelyn and Tara.

I speak for the midwives on the Coromandel. They are amazingly dedicated. They give women confidence. They triage very carefully to give high risk women the help they need. There are a lot of health professionals we work with – physios, mental health services, secondary obstetric services at the hospital, local GP’s. The midwives are very knowledgeable and deal with most things within their scope of practice. “It is a great privilege and a great honour to walk alongside women and their families and try to give them confidence and choices especially confidence in their own ability to make the right decisions in their own journey of pregnancy, childbirth and mothering. With high risk, a woman often has to go beyond our care to the hospital, but I know that what we do offer them throughout is reassurance and it is comforting for them that in a remote location, there is always someone at the end of the phone. We try to give them confidence to have their birth at home in the primary unit.

We often meet women when they are newly pregnant. The women in this area are fortunate to have their own direct care; there are not many who have access to a Lead Maternity Carer (LMC). After us midwives discharge the mothers and babies after six weeks, they are then referred to Tamariki Ora (Plunket). But you can never underestimate that post-birth period of six weeks as a new mother. It’s a model that works. If we can sustain it, it is extremely valuable.

Including the Thames and Paeroa areas, there is not one LMC left so all the women in that area are being cared for by the Thames birthing unit staff who run clinics and who see them at the unit. Often woman in these areas go to Waikato to give birth because there are not enough staff to cover the shortage. There used to be LMC’s to give the kind of care we also offer; but they are all gone. The mandates with covid had something to do with that and as LMC’s retire, they are not being replaced in the remote rural towns. A lot have gone to Australia recently because the conditions and pay are far superior.

Personal journey: I think I have always wanted to be involved in nursing and nursing of this kind. I think the deeper and main reason why I am a midwife is that my birth mother was a midwife. She died when I was one year old. I think there is a part of me that connects with her and always did. I grew up being interested in her early midwifery career and her role as a nurse I started off n general nursing. Years ago, midwifery was tacked on to nursing as a diploma. I did the additional diploma. Now there is a degree in midwifery. It is a direct entry to a degree programme. Nursing and midwifery are both separate bachelor’s degrees.

New Zealand has been a world leader in providing primary care for women giving birth. Years ago, the GP’s used to do it but it was a great achievement when midwives got autonomy to practise alone.

 

From Tara

I have been a midwife for ten years and been working locally in the Coromandel for the last two years. The most important thing for me is to be present. “To be with” is what the word ‘midwife’ means. I am available 24/7 and that means from the time a woman knows she is pregnant to the six weeks after the baby is born. Pregnancy is a very stressful time and sometimes all the woman needs is a phone call.

We asked Tara about the different experiences of midwifery she had had, in the ten years. “I spent six years in Middlemore Hospital before coming here. Being a midwife in the hospital is incredibly different. There, you spend 12-hour shifts and the mother comes in to have the baby and then the baby and mother spend time in the birthing unit and then they go home. That is the way it works in the big city. In the Cook Islands where we were for two years, midwifery is so very different to New Zealand practice. There is less autonomy, and the GP is very involved in the decision-making during pregnancy. In New Zealand, there is a lot of autonomy for the midwife and the mother.

Here I get to know the mothers. I see them up to six weeks after the birth. But I also see them at the supermarket, and at the sports field This element of the small town is very nice, and I am sure the mothers think it’s nice too. You get to know the family here.

What I do is I give people lots of space. I go in and do all my checks. If a woman is birthing normally, really all the midwife does is sit in the corner and make sure. It’s not about me when it comes to the birth. I watch and I watch carefully. Sometimes, the mother catches her own baby, I don’t even do that. We let her do her own thing. My role is to be present; treat her with respect; listen to any concerns and protect her and her baby from any harm. That doesn’t mean I’m hovering, over the mother. I often just sit there, and I watch and I let nature happen and intervene only when need be. I work with Jocelyn who does the Whitianga area. In the area we cover, there would be 100 woman a year that we look after. I receive a lot of support professionally and we work together.

When I can’t be there, it’s all okay. Today (Saturday 6 May) was my daughter ‘s birthday and I am on call. I was hoping so much I wouldn’t get a call and it has worked out. The best part of my job I would say is that immediate two to three hours after a woman has given birth. She has done it! It’s where all the reward is. She has had her baby. She is holding the baby against her skin – so close. The Mother gets a bit of a rest and has something to eat. To be witness to that is so rewarding and it’s a privilege.”

 

From Sheryl:

Sheryl was on the National Board of Midwives for a couple of years. It was a two-year role. She took that on when living in the Waikato but then moved north of the Coromandel township mid-term. “It was a bit of a challenge living in Amedeo Bay and having to meet in Christchurch as a representative on the National Board.”

When I moved up here, I thought I might not carry on, but I could see there was a need. When you have skill and you get to know the people, you just start to ask yourself, why you can’t do this. It comes back to the fact that I’m working with families and I’m making a difference. There is a sense of responsibility to your community. The challenge is I know I am needed.

In my area we are very short of midwives, and we are so geographically separate. When I moved up here, we were in a crisis with 11 midwives across the Coromandel Peninsula. Now we have three not including our locum and our home birthing midwife. I have worked on my own without a backup in an area that’s bigger than the whole area of Auckland. Jocelyn and Tara will give me a hand if they can, but it’s an hour and a half. The reality is our maternity system is underfunded and it has been a slow steady decline. One good side is that we do get finding for travel. The road closures have significantly added to the stress of the mothers. When you are relying on roads that are not open the question for a pregnant mother soon to give birth is “What will we do if this happens?” “Will the midwife get to me?” I worry – “Will I get to the Mum?” Obviously, it doesn’t happen often, but you are always carrying the weight of the possibility. I am always conscious of travel distances. This area and that of my colleagues is regarded by the Ministry of Health as one the five most isolated areas for midwives That includes the Coromandel peninsula down to Tairua. if there is a warning sign, then we make a decision earlier then if we are in a suburb. We have to be more proactive. If things aren’t going well, we need to move early. I have been doing this for 20 years. When I began, I was the same age as many of my clients. Now I feel like I’m their mother or even grandmother. Mothering is not just what you need to do for your children. Mothering becomes a part of your life for everyone. Midwives understand chaotic lives.

One thing that can be sometime difficult is that women in my area don’t have a choice of a midwife. It’s now me or me.

The best thing about this job is watching women grow into their abilities. They already have the ability but with reassurance and encouragement they just grow in stature and confidence. I worked in the Waikato for 16 years in Huntley and I could never go anywhere without meeting Mums and their children. When I first came here, it was so strange not knowing anyone. But now, after three years people come up and know you. My husband sometimes gets, “Oh, you’re the midwifes husband.”

I could not do this without David’s his support. When I have to go in the helicopter, he comes to pick me up. He’s the one who has the dinner ready when I come home several hours late. That is how the whole society works – partnership. The whole of our lives is sustained (or falls apart) by those human relationships.

This is a great job – all of us midwives invite people to take up this as a vocation.

 

Caption: Fiona Kington.