NZ College of Midwives Media Statement Re: Ms Casey Nathan and baby Kymani

The following can be attributed to the NZ College of Midwives Chief Executive, Karen Guilliland.

Members of the New Zealand College of Midwives extend their sincere and heartfelt condolences to the family of Ms Nathan and her baby Kymani. Ms Nathan experienced a rare and serious obstetric emergency in 2012 which resulted in the traumatic and tragic death of both her and her baby. It is difficult to imagine a more distressing outcome.

An Amniotic Fluid Embolism is a rare and catastrophic condition that very few women experience and as a result most midwives or doctors would never see this combination of circumstances in their working lifetimes, despite being trained in the rare possibility of such a circumstance arising.

The College wishes to reassure the public that over the last several years, collaboration between the Midwifery Council (the regulatory body) and the New Zealand College of Midwives (the professional membership organisation), with the support of Health Workforce New Zealand (Ministry of Health) has resulted in significant changes in the way midwifery is supported educationally. The first year of practice for new graduates in particular has undergone significant change over the last seven years.

Therefore the recommendations in the Coroner’s report relating to midwifery education have already been considered and appropriate changes made and implemented, something confirmed by the Minister of Health in his media release on Wednesday which noted “The Midwifery Council and the New Zealand College of Midwives, with the support of Health Workforce New Zealand (HWNZ), have developed an enhanced mentoring programme as part of the Midwifery First Year of Practice Programme.”

The College members are very supportive of these changes and strengthening of the first year of practice, and a recent national research study shows the effectiveness of the first year of practice programme (Dixon, Pairman, et al., 2014).

It must be pointed out that New Zealand and International evidence demonstrates that we have had safe and effective maternity services over the last twenty years, as we also have under the current model; providing excellent outcomes for mothers and babies. (Dixon, Prileszky, Guilliland, Miller, & Anderson, 2014; Perinatal and Maternal Mortality Review Committee, 2014; Page, 2014; Rowland, McLeod, & Forese-Burns, 2012).

We consider this case provided the Coroner with the opportunity to raise and explore other serious issues including gang related violence in the community and hospital workplace, and its impact on health service delivery, particularly in light of the zero tolerance on violence in New Zealand. We are disappointed that this opportunity seems to have been lost.

The College is still considering a more detailed response to the Coroner’s report, with particular reference to the criticisms of the College’s submissions, as we believe criticism of professional bodies who engage in judicial processes in good faith, is not in the public interest and in this case, not in the best interests of the wellbeing and safety of women and their babies.

Ends

Additional:

Midwifery students are assigned clinical placements in each year of their four year equivalent degree programme.

The final year is a full year of clinical practice under supervision and then once they have graduated, they have a mentor for their first year with emergency education workshops which reinforce their learning constantly.

The Midwifery First Year of Practice (MFYP) Programme has been in place for 8 years with almost a 1000 graduates having now been through it. Over the past three years the College has been working closely with the Council and Health Workforce NZ (HWNZ) to strengthen it further which is a normal process when reviewing programmes as they evolve.

NZCOM research into the programme shows that the entire profession supports graduates and as a result we retain them in the profession as confident midwives. The recently announced additional support from Government reflects that for graduates it is compulsory to enrol in the programme, there is extra assistance to support mentors and others who provide clinical assistance to the graduates.

Midwifery education was reviewed by the Midwifery Council and the degree hours were increased 1200 hours with 900 being clinical including working in maternity hospitals where women with complications in their pregnancy go. The College has worked hard with the Council and the health Workforce NZ and are pleased with the Ministers support of our graduate midwives and the wider profession and maternity service that supports them.

www.midwife.org.nz

References

Dixon, L., Pairman, S., Tumilty, E., Campbell, N., Gray, E., Lennox, S., . . . Kensington, M. (2014). Stepping forward into life as a midwife in New Zealand/Aotearoa: An analysis of the Midwifery First Year of Practice programme 2007 to 2010 Christchurch: New Zealand College of Midwives.
Dixon, L., Prileszky, G., Guilliland, K., Miller, S., & Anderson, J. (2014). Place of birth and outcomes for a cohort of low risk women in New Zealand: A comparison with Birthplace England. New Zealand College of Midwives Journal, 50, 11-18.
Page, L. (2014). What can midwives learn from New Zealand. British Journal of Midwifery, 22(10), 690.
Perinatal and Maternal Mortality Review Committee. (2014). Eighth annual Report of the Perinatal and Maternal Mortality Reveiw Committee: Repoorting mortality 2012. Wellington: Health Quality and Safety Commission New Zealand.
Rowland, T., McLeod, D., & Forese-Burns, N. (2012). Comparative study of maternity systems Ministry of Health (Ed.) Retrieved from http://www.health.govt.nz/publication/comparative-study-maternity-systems