REFLECTIONS

By Sian Hannagan
Sep 2015

On August 31 the New Zealand College of Midwives took a courageous move to sue our Ministry of Health for Pay Equality. Their case, led by Mai Chen argues that pay levels for midwives breach gender rules under the New Zealand Bill of Rights Act. This move is as gutsy as it is well past due.  Our midwives work in incredibly challenging environments.

There have been many nay-sayers to this course of action, including our very own honourable John Key who doesn’t feel that this could possibly be a case for sexist discrimination, right after pointing out that some female dominated industries pay less and some male dominated industries pay more. I feel like maybe he doesn’t understand what gender discrimination in the workplace looks like. People wanting to undermine midwives will try to have you believe this is a selfish act designed to pad midwives pockets at the expense of birthing families.  But the reality is, this move, if successful will be one of the key factors in improving birth experiences and birth outcomes for women.

That may seem like a long bow to draw, but the reality of midwifery practice in what is now a low income environment means we are slowly but surely losing a body of expertise that is vital to protecting birth care quality and choice.

Midwives fill a unique space in our healthcare, they work in the community providing a vital service in a wide range of environments including remote rural environments and wider urban areas where a lot of travel is required to reach women in their homes. None of their equipment, or even infrastructure is provided externally, which means they must provide everything – from indemnity insurance, to back–up support in cases of illness or for a holiday, to their clinic space and vital equipment. Hospital based staff will walk into a hospital environment where everything, even their scrubs are provided and laundered, self-employed midwives do not. So, when pay rates remain static and costs increase, this means that over time, midwives experience a decrease in income.

So let us imagine for a while a birth culture where the income of midwives remains static (as it has done for the best part of three decades). If the only way to increase your income is to take more clients, this leaves midwives with caseloads that may exceed their ability to provide best service. No midwife wants to work in this environment, but when your income does not even keep pace with cost of living, for many midwives it is about increasing caseloads or leaving midwifery altogether when financially it cannot support their family.

Where does this leave birthing women and their families? Working with overworked midwives or losing birth choice as experienced and skilled midwives leave the industry. Neither of these outcomes is good for families. Women who cannot find a skilled midwife that they trust are left birthing in less than ideal circumstances.  Many people have commented that if midwives don’t like the pay, they should just leave. This is fine for people who work in luxury industries, but when it comes down to essential health services, this is a dead end argument. Without midwives we lose an essential service, and we lose best practice in birth care.

So, when we say that midwives don’t deserve equal pay, we are condemning women to birth without choice.

Home Birth Aotearoa supports this case, and we are hoping for the very best outcome for kiwi families.


Sian Hannagan our Acting Editor

Home Birth Matters

Volume 2 Issue 3

Published continuously since 2013

ISSN 2422-9946

Editor: Sian Hannagan