An Open Letter in Support of Our Midwives

I am writing in support of the New Zealand College of Midwives' efforts to improve midwifery pay rates. Yes, midwifery as a career is largely a labour of love (pun absolutely intended). Without the requisite passion for supporting the emotional, spiritual, cultural, psychological and physical needs of pregnant and birthing women and new mothers, midwives would fail miserably the families in their care. We are incredibly fortunate to have so many capable, compassionate and competent midwives to support women at this special time in their lives. But just because so many midwives willingly care for our nation’s birthing population for minimal pay, does not render the situation appropriate, ethical nor sustainable. It potentially creates an unsafe system of care for the women who access it and the midwives who serve it.

Whether a midwife spends one hour or twenty minutes at an antenatal appointment, she receives the same remuneration; whether she sees a woman fifteen times postnatally or the minimal seven, she gets paid the same fee; whether she spends time talking with women outside of appointments, about the woman’s fears, about residual trauma from a previous birth, about how the woman is coping following a devastating miscarriage, about scan results that have left the woman feeling worried (…you get the idea), she gets no additional pay for this vital support that she provides.

As a first-hand example, I had terrible trouble breastfeeding my new daughter. My midwife drove to my rural home, twenty minutes from town, three times in one day to offer me some much needed breastfeeding (and emotional) support and encouragement. I struggle to imagine what path my baby and I would have headed down without her support. My midwife was under no obligation to make those visits, she wasn’t paid extra as a result; the money she spent on petrol and the time she spent with me that she could have been spent with her own child, were not costs that she would ever have recovered.

For many midwives such care is unsustainable. Given the poor hourly pay packet they end up receiving, they are forced to make changes to their practice, changes that make the midwife’s work less satisfying and safe, and changes that negatively impact the care women receive. With their own families to support, some midwives are forced to either increase their caseload, therefore decreasing the amount of time spent with each woman both antenatally and postnatally, or leave independent practice to at least have the regular hours that shift work affords them.

Society asks a hell of a lot from our midwives. We require them to be on-call 24-7, to attend to women’s needs at the drop of a hat, to compassionately and professionally attend all of their clients’ pregnancy, birth and new motherhood needs, no matter the struggles they (the midwives) may be facing in their own lives, and to ensure the safety of new mothers and babies at a critical and vulnerable time in their lives.

To take advantage of a midwife’s passion for the life-changing work that she does by paying her such a minimal wage demonstrates an appalling lack of respect and, quite frankly, is reflective of the archaic patriarchal and misogynistic culture in which we live. Shame on those who place such little value on the childbearing experiences of women and the midwives who protect them. And shame on the media and journalists who, over the years, have unapologetically encouraged a damaging public perception of our midwives, making it all the harder for them to gain the respect and recognition (including reasonable remuneration) that they deserve.

We have a world class maternity care system, one which is the envy of many midwives and childbearing women across the globe. If we are to keep it that way, we need to honour the women who are at the heart of maternity care - our wonderful midwives.