BULLETIN

release of Te Pae Tata Interim New Zealand Health Plan 2022

This document, which replaces the previous 20 district annual plans, outlines the first two years of operation for Te Whatu Ora and Te Aka Whai Ora.

The plan notes six key priority actions: • Place whānau at the heart of the system to improve equity and outcomes • Embed Te Tiriti o Waitangi across the health sector

• Develop an inclusive health workforce • Keep people well in their communities • Develop greater use of digital services to provide more care in homes and communities

• Establish Te Whatu Ora and Te Aka

Whai Ora to support a financially sustainable system. Of significance for midwifery, Te Pae Tata also identifies Kahu Taurima | Maternity and early years, as an area for service change and innovation (see pg. 5 for further details). square

report from Āhurutia Te Rito roundtable

Mahi a Rongo | the Helen Clark Foundation hosted a workshop style meeting in September to inform their ongoing work on Āhurutia Te Rito | It takes a village. This report - released in April 2022 - analyses what contributes to perinatal distress in Aotearoa and identifies opportunities to better support new parents and their babies. The workshop participants (which included College representation) provided direction to Mahi a Rongo on how the aims and vision of the report can be achieved. The importance of well-resourced and accessible health care services, as well as the need to centre and value the role of new parents and whānau at a wider societal level were key areas of consensus for participants. square

National guidelines update

Updated Diagnosis and Treatment of Hypertension and Pre-eclampsia in Pregnancy in Aotearoa New Zealand guideline Now published, this guideline includes the latest evidence to guide clinical practice for treatment of hypertensive disorders in pregnancy (HDP). The aim is to support a consistent approach to management and treatment, as well as recognising the health professional’s clinical judgement, expertise and knowledge. The guideline and evidence statements can be found on Te Whatu Ora website.

Guidelines for Consultation with Obstetric and Related Medical Services (Referral Guidelines) The publication of the Referral Guidelines has been delayed due to the need to ensure that all IT systems are updated so they support the guidelines. These changes are being urgently implemented and publication is expected in early 2023.

Diabetes in Pregnancy The first meeting of the multidisciplinary group to review the evidence and update the Diabetes in Pregnancy guideline will take place in December. College representatives are midwifery advisors Claire MacDonald and Brigid Beehan. square

Perinatal and Maternal Mortality Review Committee (PMMRC) report publication

The 15th PMMRC report is published online on 6 December, reporting mortality and morbidity data for 2019 and 2020. Information about outcomes in the first year of the Covid-19 pandemic has been anticipated across the sector, and reassuringly the report found no statistically significant differences detected in perinatal and maternal mortality outcomes in 2020. However, as the Chair notes, Covid-19 infection became much more widespread in the community from 2021 and continued monitoring is imperative.

The overarching emphasis of the 15th report is on achieving equity. Urgent priority has been given to recommendations that focus directly on promoting equitable outcomes for whānau Māori, Pacific peoples and Indian families and whānau, mothers under 20 years old, and those living in high areas of deprivation.

Midwives and all health workers in maternity services are encouraged to read the report and do what they can within their roles to put the recommendations into practice. A PMMRC webinar about the report is planned for early 2023. square

National abortion telehealth service rolled out for Aotearoa

The National Abortion Telehealth Service project decide.org.nz was introduced by the Ministry of Health in 2022. This service has been staggered in three phases: offering referrals and information about abortion services since April; follow-up care and counselling since July; and now telemedicine has been the additional service offered from 1 November.

The new telehealth early medical abortion service is free to pregnant women eligible for publicly funded healthcare in Aotearoa and will improve access to early abortion services, enabling women to access the health care and support they need in the first 10 weeks of pregnancy, when their choice is to have an abortion. This telehealth service will provide clinical consultations for early medical abortion requests, send out medications and link those over 10 weeks or with additional risk factors to other services.

The service, accessed via the 24/7 hotline 0800DECIDE, provides clinical care, support, advice and counselling for women undergoing abortions as well as offering consults for new patients during work hours. The telehealth service will be hugely beneficial in improving equitable access to abortion care, especially for those in rural areas and those who are financially disadvantaged. square

Christmas hours at the College

The College’s national office will close on Friday, 23 December at 12 noon, reopening on Wednesday, 4 January. There will be arrangements in place for any midwife who needs urgent legal advice during this period. Phone the office on (03) 377 2732 and a recorded message will have the relevant contact information. Staff at the national office wish all members a happy and safe Christmas and New Year. square