NZCOM chief executive Alison Eddy said the increased stay would create more pressure on the services and staff. Photo:
The New Zealand College of Midwives (NZCOM) says if the new three-day-stay bill is brought into New Zealand's current healthcare system, it will result in unintended consequences.
The Pae Ora (Healthy Futures) (3 Day Postnatal Stay) Amendment Bill proposes the 48 hours of funded inpatient post-natal care currently available, be upped to 72 hours.
NZCOM chief executive Alison Eddy said in the organisation's oral submission - heard by parliaments health committee - it did not support the bill.
"Midwifery strongly advocates for all women and their whānau to have access to the health services they need in the post-natal period. And we consider that no woman should be discharged from hospital after giving birth, before she is ready to do so," she said.
"In spite of this, we do not support the proposed bill for three reasons."
System capacity
Eddy said the organisations first reason for opposing the bill was that the system did not have capacity.
"We have a significant shortage of midwives, and the place that this shortage manifests the greatest in our hospital system is in the post-natal area.
"Our post-natal areas are busy and under-staffed, our system is overloaded, our hospital bed capacity is insufficient to universally accommodate a three day stay for every women - whether she needs it or not."
Eddy said bed grid-lock was a common issue in the post-natal area, and if the bill passed, that issue would get worse.
"There are no beds in the post-natal area for women to move to after they have given birth, and no space will become available until someone is discharged.
"This creates bed-block in the labour ward, which then leads to delays in necessary care."
She said the increased stay would create more pressure on the services and staff.
New Zealand College of Midwives chief executive Alison Eddy. Photo: Stuff / John Kirk-Anderson
Return on investment
Eddy said her second point - on behalf of NZCOM - was return on investment.
"There is a misconception that extra time in hospital will automatically result in positive outcomes," she said, clarifying it was often not the case.
"The post-natal period extends to six weeks after birth and consists of many, many aspects of health and social care, and cultural and emotional support."
She said "patient stays are costly" and "investment in the post-natal period could be better placed elsewhere".
Unintended consequence
The third point Eddy made on behalf of NZCOM was the possible unintended consequences.
"Introducing legislation which provides everyone with the entitlement of a three day post-natal stay - whether it is clinically needed or not - into a system which has inadequate capacity, will result in unintended consequences."
Labour MP Ayesha Verrall. Photo: VNP/Louis Collins
She said the solution was not to legislate a three night stay for every women, but rather ensure those who needed a longer stay were able to access the care needed.
When asked by Labour MP Ayesha Verrall whether the bill would help women, hurt women or make no difference, Eddy said it depended on the individual circumstance.
"There is potential for all of those scenarios, but I would think the potential risks of hurt would outweigh the potential benefits…"
Catherine Wedd - the National MP who brought the bill to parliament - said she was disappointed the NZCOM did not support the bill.
"I could not see how it could hurt women, but I'm interested to see how you see it could hurt women," she said.
Eddy responded, further explaining how women could be hurt by the bill using the "real" example of bed block.
National MP Catherine Wedd. Photo: RNZ / Angus Dreaver
"Inductions of labour, for example, they require a bed, they require midwifery staffing, and they require resource.
"If there are no beds in the labour ward, because a woman is waiting to be transferred up to the post-natal ward… her induction of labour will be delayed.
"That could cause unintended consequence and potential harm," she said.
Both Wedd and NZCOM have been approached for further comment.
The bill is due to be reported back in parliament on 17 June.
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