Description

Turbulence and change are key themes in the history of the maternity care system and the evolution of midwifery in Aotearoa New Zealand (Aotearoa) that is admired around the world. The midwifery profession has been heavily influenced by systems and structures that have pervaded Aotearoa society since the arrival of British migrants who were granted permission to live in harmony with Māori as a result of their signing of Te Tiriti o Waitangi (The Treaty of Waitangi [Te Tiriti; Tiriti]) in 1840. Despite the promises of self-determination that Māori chiefs understood Te Tiriti to stand for, Māori people soon became the minority and have since been subjected to assimilationist policies and structures that favour dominant cultural norms.

Today, the maternity sector, stands as an example of the results of colonisation that occur when one society dominates another. Midwives are the main providers of maternity care in Aotearoa, Pākehā midwives make up the majority of the midwifery workforce, and Māori women and babies are over-represented in health inequities and negative or sub-optimal maternity outcomes. In addition, Māori women and whānau continue to experience persistent inequities across socioeconomic determinants of health and risk factors that impact on their wellbeing throughout the maternity continuum.1Inequities for Māori women are also likely to be present amongst Māori midwives. Māori midwives are at risk of burnout and could leave the midwifery profession if it remains ill-equipped to properly support them.

Māori midwives are severely under-represented in the midwifery workforce across clinical, education and professional settings. Patterns of workforce movement by Māori midwives are different to non-Māori and there has been no research to identify the reasons for the differences. Overall, there is a general under-reporting of Māori midwifery workforce data.

Māori midwifery students are among the high attrition rates occurring in midwifery education and they are under-represented in completion rates. It was difficult to access current data about the progression of Māori midwifery students through the education pipeline and a variety of sources were accessed to enable some data to be presented in this literature review. Research has identified an unexplained gap in completion rates between Māori and non-Māori bachelor level students across universities in Aotearoa. The researchers suggest the unexplained gap may be attributed to cultural-specific factors, which could be relevant to Māori midwifery students.