Women’s Health Planning Day 2020

MARY BURR 

General Manager, Women’s Health

The Women’s Health division held a successful planning session in Ko Awatea on 21 October 2020. The session was attended by 80 participants, from across all women’s health professional groups, as well as eight consumers of our services.

The goals of the day were to progress a focus on equity of access to care, to design our future models of service delivery and review our facilities, our expectations and our culture. We sought the input of all the stakeholders present, giving us a great opportunity to design services that reflect the needs and expectations of all.

The session began with an update about inequity – how it has evolved, what it means and how it affects our women and whaanau. Keeping that conversation in mind, groups set about developing ideas and solutions to meet the challenges. Many ideas are exciting and innovative, some are relatively easy to deliver and some require wide-ranging system changes. We will now investigate all of the suggestions and ideas.

Gathering a consumer perspective on services

Great representation from consumers enabled us to gain the perspective of those using our services and we thank these women for taking the time to contribute. Their feedback was imperative to begin our co-design journey. Discussions centred on a number of questions facing newly pregnant women: Where should they have their baby? Where to find information? What to expect? What choices did they have and what were their expectations?

Our consumer participants told us information is gathered from many places – other women, word of mouth, family and midwives, who were often the main point of contact. They would be keen to have more opportunities for education throughout their pregnancy, to increase their knowledge and become more empowered through that knowledge. They also reported that the midwifery shortage had affected women in the community, especially those due to birth between December and January each year, when it was very difficult to engage a midwife. More assistance in this area would be welcomed.

With respect to primary birthing facilities, women nice facilities, good street appeal, a restful environment with single rooms, an ensuite, birthing pools, bigger beds, partners able to stay, home cooked meals and approachable staff. Access to free parking was important. Consumers felt strongly that it was a woman’s choice where to birth. They suggested that at Middlemore, birthing rooms should be on the ground floor with access to outside areas, such as gardens and open spaces, and should be away from the hustle and bustle of the hospital.

All participants thought a community hub with flexible clinic times, close to transport, with Whaanau Ora/Ola ‘home’ models would be excellent. Being handed over too soon after having their baby, especially for first-time mothers, was a concern for the group. More support postnatally would be helpful.

Reinforcing the need for top-class facilities

For other groups, there was a strong feeling that any new building at Middlemore Hospital must be purposed built and designed to cater for women and whaanau, with a well-designed layout for patient, whaanau and staff flow. There should be amenities that promote rest and relaxation, such as prayer and meditation rooms, music rooms, nature gardens, light and outdoor spaces. Perinatal loss and bereavement suites should also be protected and have appropriate support.

Because Middlemore is a secondary facility supporting complex obstetrics and gynaecology, it was important that first-class clinical spaces are designed, state-of-theart equipment is in place, and there is seamless access to theatres and neonatal units. There must be enough theatre access to allow all women with gynaecology issues to be

treated. These spaces must co-exist alongside more flexible spaces to promote physiological birthing, with a number of participants suggesting a primary unit on or close to the site.

Designing buildings and facilities with staff welfare in mind was also raised as a key focus. Wellness and recreation facilities, such as a swimming pool, yoga and pilates rooms, a pool table in the staff room, coffee machine, hot desks and private spaces at night would be the ideal. The need for adequate work spaces and break rooms was highlighted, as were added extras such as a rooftop terrace and walking track. Availability of free parking was a constant theme through all responses for all sites.

How can I find a midwife? Make contact with a midwife for every pregnancy as soon as you know you are pregnant. Ask for a Pregnancy Information Pack available from your family doctor.

Ask friends and family about a midwife

When discussing access to care, the need to design culturally they would recommend. appropriate models of service delivery once again came to the fore, not only in terms of the facilities provided, but also through the removal of any barriers to accessing services; Information about homebirth Go on line www.findyourmidwife.co.nz Visit or phone your local community birthing unit to help you find a midwife: this requires a complete redesign of our models of service Talk to your midwifeBotany - 292 Botany Rd, 09 259 5032

Papakura - 1 Clevedon Rd, 09 299 9102 homebirth.org.nz

delivery to ensure they are culturally envisioned, women and Auckland Homebirth CommunityPukekohe - 1 Tuakau Rd, 09 237 0629 whaanau-centred, and community led. ahbc.spaceIf your local birthing unit is Middlemore

Hospital or you have a more complex facebook.com/groups/

Looking at future options homebirthaotearoapregnancy, please call 09 276 0187. If you are still unable to find a midwife, ask

your family doctor to complete an electronic

As well as the rich feedback received above, comments were referral to Maternity Services. made that wider societal or funding changes, which promote For more information on maternity care: https://www.health.govt.nz/your-health/ health equity for all, are required. Relationships such as pregnancy-and-kids/pregnancy public, private and iwi partnership models for primary birthing could be explored.

A follow-up planning session will be held in April 2021 to ensure that all the suggestions and ideas form the first session are investigated and inform future planning.

Options for Maternity Care in Counties Manukau

 Options for Maternity Care, CM Health 2019