A patient receiving medical care. Photo: UnSplash/ Stephen Andrews
A young Ōpōtiki couple feel "lucky" that an obstetrician happened to be on duty at Whakatāne Hospital last month when they needed an emergency caesarean to save their baby's life.
But they fear other whānau may not be so fortunate, now that there is no specialist obstetric service in the district, which has about 650 babies born every year.
Stefanie Kaiser and Hori Barsdell were planning to have a home birth - but 36 weeks into the pregnancy, things went a bit sideways.
During a routine examination, their midwife discovered the baby was lying in the transverse position, with the head sticking out the side.
"And she was like, 'Oh, the head should be down'. And that's when everything changed," Barsdell said.
The midwife phoned Whakatāne Hospital, but there was no obstetrician on duty, so she called a specialist at Tauranga Hospital.
"And she pretty much just said on the phone, 'Stefi's got to come in now, she's got to come to Tauranga now'."
The doctor explained there was a risk that if Stefi went into labour, the cord could "prolapse" or come out first.
"'Baby could die', those were her words."
The couple frantically began making arrangements to go to Tauranga the next day, including finding care for their two-year-old son, Mātai-Nuku.
But early in the morning Kaiser got a call from an unknown midwife at Tauranga Hospital, telling her not to come after all.
"I was like 'okay, it's not that dramatic after all?'," the young mum remembers.
"I was really confused. And she said 'Well, they can't do anything before 37 weeks anyway, so there's no point staying in hospital'. It was really confusing."
Fortunately, before they had to go, baby turned and they looked back on track for a home birth.
Unfortunately, it was not to be.
During labour, Kaiser began bleeding and the worried midwife moved them to the local medical centre.
With the baby's heart-rate dropping and labour not progressing, it was time to go to Whakatāne Hospital - 44km away.
"We were basically flying to Whakatane, the ambulance was going so fast the trees were just flying past, and went straight into the emergency department," said the young mother.
Their son was immediately delivered by caesarean section by the sole obstetrician on duty.
The father asked him what would have happened if they had been forced to travel to Tauranga.
"He said 'I don't even want to think about it', that was his response."
It was 5 January. If the baby had not "decided" to come two weeks' early, there would have been no obstetrician left Whakatāne Hospital.
With the resignations of all four obstetricians on staff, Whakatāne Hospital has been reduced to a primary birthing unit since 15 January.
All complex cases - an estimated one in five births in the district - are now transferred to Tauranga.
Health NZ responds
Health NZ said it was trying to recruit more doctors.
Bay of Plenty's chief medical officer Dr Kate Grimwade said in Stefanie Kaiser's case, the initial advice to travel to Tauranga was based on a discussion between an obstetrician and the midwife.
"Another senior obstetrician also reviewed this plan and felt the risk of pre-term labour was low, which is why remaining in Whakatāne was deemed clinically appropriate.
"We recognise that the change of plan may have caused confusion, however the intent was to avoid an unnecessary trip to Tauranga for this whānau.
"This whānau wanted to birth to be at home, which was acknowledged and our team continued to provide clinical advice to support them as required."
If Stefanie Kaiser had needed an emergency caesarean after 14 January, there would have been "contingencies in place", she said.
"A dedicated ambulance is in place for emergency transfers to Tauranga Hospital 24/7 and air transfers are also available when circumstances require.
"We are very pleased that, despite some challenges, the outcomes for this whānau were positive, and we are reaching out to them directly to understand what they feel could have improved their overall experience."
Family fears for others
Baby Momo-Āio - his name means "a type of peace" - is living up to his name and the whole family is doing well, his mother said.
"We were just really lucky, but maybe another woman isn't that lucky. It is really scary."
Her partner said his heart went out to those in more isolated settlements.
"We're just over a couple of hours from Tauranga, but there are those places down the coast. You're talking three, four, even five hours to drive to Tauranga."
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