Heather Muriwai: Midwifery & COVID-19 At Counties Manukau Health

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‘Ākina tō ora, hei oranga mau roa.’
Look after yourself to preserve health and wellbeing

The whakatauki ‘Ākina tō ora…’ underpins the COVID-19 response across all Counties Manukau Health facilities, and the care provided to whānau. The COVID-19 pandemic and the subsequent wellbeing of our whānau has demanded a new and different approach to Tikanga.

The COVID-19 pandemic has been felt with our hapū, māmā me te whānau and the midwives caring for them.

The midwifery system in New Zealand is arguably one of the best in the world for the outcomes, and importantly the women and whānau centred approach. In Te Ao Māori translated as kanohi ki te kanohi –face to face engagement. COVID-19 has challenged this approach dramatically, with the majority of meetings taking place via phone or virtually. There is an entirely new midwifery skill set required. How do you ‘feel’ the wairua and hauora of the māmā and her pēpi via Facetime or Zoom?

Our Lead Maternity Carer (LMC), community midwives, Māori health providers and Non-government Organisation’s (NGO’s) are examples of the few health workforces that continued to visit homes. Midwives have continued to attend both planned and unplanned home births (which anecdotally have increased in Level 4 and Level 3 of the pandemic). I believe the midwives commitment and passion for the mahi (work) has been overlooked by communities, including the media.

Every policy and protocol within Women’s Health at Counties Manukau Health has needed to be reviewed, placing a COVID-19 lens on it. Who would have thought that time would need to be spent on how to ensure that a paper CTG (Cardio Toco Graph) print out from an māmā with COVID-19 symptoms is safely sterilised before it leaves the room?

A policy change that has caused much angst amongst our whānau at Counties Manukau Health has been the ‘Visitors Policy’. Both hospital and community-based midwives have had to bear much of the brunt of this angst. It is heart-breaking to have to tell an māmā that she can only have one support person with her during the birth of her pēpi. How does she choose between her partner or her kuia whose planned role previously was to karanga the new mokopuna into Te Ao Marama? Then to have to tell this new māmā that she cannot have any visitors postnatally. Au E! Au E! Au E!

I would like to acknowledge my colleagues at Counties Manukau Health, in particular Mahaki Albert, Tumu Tikanga (Tikanga Leader), for the learning of “ Ākina tō ora, hei oranga mau roa” with kindness and compassion.

At the time of writing, the Counties Manukau rohe has had the lowest number of positive Māori COVID-19 cases of the three Auckland Metro DHB’s. A testament to the resilience of our dynamic whānau and their acceptance of #RESPECT THE RAHUI

Heather Muriwai
Clinical Lead Advisor, Māori Midwifery
Counties Manukau Health.