The Three-Day Postnatal Stay Amendment Bill has been adopted, meaning in the future, mothers or people who have given birth will be legally entitled to stay for three days in hospital – an extra 24 hours than what is currently offered. Alice Hampson spoke to the MP behind the bill, Catherine Wedd, a young Kiwi mum who wishes the legislation was in place when she gave birth last year, as well as those who have serious concerns about the bill.
It was the first night Jane had ever spent as a mother.
Her daughter had entered the world that afternoon after a 26-hour labour and via c-section, which had all come as a bit of a shock, to say the least.
“My birth plan went right out the window,” says Jane. “I had all these plans of how I wanted it to go – all this time learning all these different pain management techniques, hypnotherapy and just, none of it happened. Things went from manageable, to being in hospital and it all going pear-shaped. The pain came on so suddenly and then her heart rate dropped and next thing it was chaos and I was in surgery. It was traumatic. I think I slept for about one hour total that first night.”
Jane felt in absolute shock in the aftermath, but there wasn’t much time to take stock – she now had an infant in her arms to take care of.
But Jane says her sense of shock was only further compounded when she felt she was being hurried out the hospital doors, just the next day after giving birth.
“We live quite rurally,” she says, “so there’s not a Birthcare in our area, but there is a birthing centre nearby that offers postnatal stays. We’d signed up for that, but it was entirely down to whether they had room or not.”
Unfortunately for Jane, the centre was completely full – she wouldn’t be getting in that night and they weren’t sure it would be possible by the next day.
“I was shocked that the midwives at the hospital were so quickly talking about getting us out of there,” says Jane. “They were very much like, ‘let’s get you going today!’ I’d only just had the catheter removed and had stood up for the first time – which was agony. The idea that I should go home and look after a baby felt completely overwhelming. We had no family around – my mum was coming, but the earliest she could get there was in two days”.
Luckily for Jane, one of the midwives saw her panic and took charge, saying they’d keep them in for another night. Thankfully, the next morning a space became available at the birthing centre, so she was able to transfer there for a further two nights, but she couldn’t help but wonder what might have happened if that wasn’t the case.
“The midwives at the birthing centre helped me learn to breastfeed, which certainly didn’t come naturally, like I thought it would, and helped me bond with my baby after a traumatic start,” she says. “I really needed them during those swings of hormones. The idea that my husband and I would have had to go home in that state – I could still barely stand – on our own… I mean, it would have made things a lot more traumatic.”
It’s a scenario National MP – and mother of four – Catherine Wedd says she can certainly relate to, after feeling pressured to leave following the birth of her first child.
“I personally had an experience where I felt I was asked to leave quite early after having a traumatic birth,” she says. “That always makes me emotional thinking about it.”
Her firsthand experience is what has drove the Tukituki MP forward in creating a new bill, that aims to ensure new mothers and birthing people greater support after birth.
The Three-Day Postnatal Stay Amendment Bill will ensure that people who have given birth will be legally entitled to stay for 72 hours in hospital, should they wish to. It was announced last week that the bill has been adopted and will pass through Parliament as part of the Government’s legislative programme.
Currently, women or birthing people are able to stay for a minimum of 48 hours – of course, in some situations, complications may mean that women may stay for longer periods. This Bill stretches that minimum stay out another 24 hours and legally requires lead maternity carers to inform their patients of their right to stay for three days.
“I feel that every mother should have the ability to have the support that they need, and especially if you’ve gone through a traumatic birth,” says Catherine.
Thinking back to her own traumatic birth with her first child, she can empathise with anyone who has been through a difficult experience birthing, and believes that support during this crucial time is key.
“The trauma you face if you go through a traumatic birth, and then the feelings you get after that – sometimes, you have this ideal in your mind, that I remember I had. I’d gone to my antenatal classes, I was going to have the music on, the lights dim and we were going to have this perfect birth. And then, of course, suddenly the baby gets stuck. Suddenly we’ve got specialists in the room and it’s all go. Then, afterwards you think you’re going to have this beautiful skin-to-skin with baby, but then suddenly they’re whisked away to the SCUBU and you feel emotionally empty, and you just can’t believe what happened.”
Catherine says that every birth is different and outcomes – and will likely require different needs. She believes this new bill will allow more support for those who need it.
“I mean, there’s so much to navigate when you’ve had a baby, from the breastfeeding, the nappy changing, the bonding, the bathing… and that can be quite overwhelming, particularly as a new mum,” she says. “And so, I think this bill will certainly go some way to providing more support for mums and families across New Zealand.”
“Of course, there’s many mothers out there that just want to get out of the hospital and they want to get home, so this really is about providing choice and the ability to do so, if they want to. Because, I remember after number four, I was certainly ready to get home and get myself organized, but then, of course, some that do have more children may like to stay longer, because it gives them the ability to have some more of that precious one-on-one time with baby as well.”
Jane, who we spoke to earlier in this story, says she is thrilled to hear of the amendment.
“I didn’t know that I could push back and ask to stay a second night, if I had of known that I would have just said no, I’m staying. But having the option of a third night would have taken the pressure off – I wouldn’t have been so scared, in an already traumatised state.”
A System Under Pressure
While the Three-Day Maternity Care Bill certainly sounds like a step in the right direction, after the announcement that it has been adopted, we at Capsule quickly heard from women working in the maternity sector who have concerns.
Speaking to us under the proviso of anonymity, one woman who works in maternity care at a large Auckland hospital said, “We do not have the facilities or staff to manage this. If the government wants this to be possible, they need to fix the current system first.”
A midwife at another hospital in Auckland said, “we can’t keep women in for two nights after birth as it is. Nowhere near it. If you’ve had a vaginal birth, you’re often out the same day. One night if you’ve had a c-section. That’s not because we think it’s the right thing to do, or we want to send new mums home so quickly, but because there is literally no staff to cover much more than that. We’re already short-staffed and having to work additional hours to cover shortages as it is.”
A third maternity care worker from the greater Wellington region said, “In theory, this is brilliant. In reality, it’s just virtue-signalling by the government. From what I see in our maternity wards every day, this is nowhere near possible. We don’t have the staffing or resourcing to make good on promising two nights, let alone three.”
When I posed these concerns to Catherine Wedd, her response was:
“I think that it is positive now that we have dedicated officials at Health New Zealand looking into how we can better resource this, and how we can implement it. I think we’ve got to look at that positively.”
She said she understands that we have challenges on the health system and, of course, our maternity area as well, but pointed to the positives she is seeing in this sector.
“We are seeing increased midwife numbers, which I think is positive,” she says. “We’re seeing birthing units across the country that were previously not resourced because they didn’t have the staff to resource them, and we’re seeing a lot of those birthing units now being resourced. These are the things that we can look at, but of course, ultimately what we want to provide is better postnatal care for women, babies and families across New Zealand and I think that this bill goes towards doing that.”
Money well Spent?
Another group expressing their concerns over the new bill is the College of Midwives, with their head, Alison Eddy, telling RNZ the current system doesn’t have the capacity to meet the demands of the changes.
Alison cited the Select Committee report which estimates an additional 175 beds are needed for the amendement bill. She says those changes would require $140 million of investment – something she’s not convinced would provide a return on investment.
“There are plenty of other really worthwhile things that could potentially make more of a difference in the post-natal period, you know, better support for breastfeeding in the community, better support for maternal mental health for example, are things we would consider could lead to better outcomes rather than an extra night in hospital”
As we previously reported at Capsule, our maternal mental health statistics are dire. For a short recap, the current leading cause of maternal deaths in NZ is suicide and our rate is five times higher per capita than that of the UK.
Serious gaps in education, screening/assessment and funded therapeutic treatment have been found in our system, with a large 2022 survey finding 54% of respondents had never been given information about antenatal (the time during pregnancy) depression and anxiety, and 13% never received information about postpartum depression and anxiety (PPDA). Postpartum, 36% were never even assessed for PPDA, leading to delays in diagnosis and treatments.
GPs – and patients – report how near-impossible it is to be seen by Maternal Mental Health in NZ, and how few Mother-Baby Units there are in NZ to keep up with demand (these units allow mothers and babies to stay together during a mental health crisis, which is shown to have more positive outcomes for both). International guidelines recommend NZ have four of these units – we currently have half that number with just one in Auckland and one in Christchurch.
Catherine Wedd maintains the Three-Day Postnatal Stay Amendment Bill is a positive step for all families across New Zealand.
“I think that this bill, now that it’s been adopted as a government bill, we’ve got the resourcing behind it, we are looking seriously at the implementation and that will be officials from Health New Zealand, looking at all areas of postnatal care, looking at the funding, looking at the resourcing and looking at the implementation. And I think that’s got to be a positive outcome for all families across New Zealand that we’re taking this seriously. We’re wanting more mums to have the support they need, and looking at the resourcing and funding that goes with that.”
Now that the Bill will become part of the legislative programme, the Ministry of Health has been directed to work with Health New Zealand to progress this work. At Capsule, we’ll be following this progress.
