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The Baby Business - What's happened to maternity care in New Zealand?

Lynda Exton - 05/11/08

Review by Dorothy and Press Release by Glasstower Communications

The Baby Business Dr Lynda Exton
The Baby Business
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Dr Lynda Exton
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I began reading The Baby Business - What's happened to maternity care in New Zealand? wondering whether it would hold much interest for me as I have no medical background, but I am a mother and a grandmother and I was completely absorbed by it from the first pages. The care of mothers and babies is an issue relevant for most people in most countries.

Why did I find the book so absorbing?
Lynda Exton is a skilled writer as she showed in her first book, Healthy Start - A New Zealand Guide to Common Childhood Problems". She has the special skill which results from extensive experience and knowledge of the topic the ability to present the essential aspects in an easily grasped form uncluttered by technical detail which can put the material beyond the understanding of the lay reader.

At each stage in the development of maternity care she includes the key details and highlights the changes and their impact. The use of paragraph headings to clarify the development of the arguments and figures, to make graphic the statistics, assists the readers' comprehension.

I have been reading this book during the time when we are bombarded with electioneering material in the US and at home. After hearing numerous vague generalizations unsupported by evidence and wavering opinions I especially appreciated Lynda Exton's clear arguments supported by facts and consistent development of ideas towards firm conclusions.

She is constantly aware of the wishes of mothers and the way in which economic factors rather than women's choices seem to have influenced politicians making the decisions for change in 1990, led by the Minister of Health, Helen Clark, who has never experienced pregnancy and motherhood. She notes too that the Minister mentions statistics which cannot be backed up by evidence.

The reforms in 1990 resulted in maternity care being given to midwives while GP Obstetricians were excluded from funding arrangements although most women's preference would be for the family GP to be involved in their antenatal and postnatal care.

Glasstower Communications published the following Press Release when Dr Exton's book was released.

The mother of all failings

How the failings of our maternity system are putting the health and lives of New Zealand mothers and babies at risk is the focus of an explosive new book by Christchurch GP and author Dr Lynda Exton.

The Baby Business, what's happened to maternity care in New Zealand? Dr Exton's second book exposes the real story about how unsafe our maternity system has become over the past 18 years and how this happened.

Dr Exton says she was motivated to write this extensively researched book after a disquieting increase in the number of stories she was hearing from women of near misses, tragedies and unnecessarily complicated pregnancies and births.

When Dr Exton first started looking for the facts behind the stories, it soon became apparent that frighteningly little official information was actually available about the impacts of the 1990 Maternity Reforms.

From the data that was available, she uncovered some sobering facts about the decline of our maternity system since the reforms, including:

  • New Zealand's infant mortality rate ranking getting steadily worse compared to other countries
  • Annual maternal mortality recently moving from single to double figures
  • Women struggling to even find a midwife to care for them
  • Dramatic rises in hospital admissions for pregnancy complications and caesarean rates
  • Falling breastfeeding rates since the reforms began
  • Coroners' calls for a comprehensive review of the maternity system falling on deaf ears.

In delving deep into the history and background of maternity care in New Zealand and analysing the dramatic changes since 1990, Dr Exton concluded that major changes to this key health service have been made without adequate monitoring or independent audit. Even more concerning, she uncovered a clear link between these worrying trends and government policies that have forced family doctors out of maternity care.

Dr Exton hopes the book which has been two years in the writing - will be a wake up call to health planners and those who care for pregnant and birthing women, but also provide advice to expectant parents about ways mothers can be better informed about the maternity system to keep themselves and their babies safe.

"The bottom line is, if you are an expectant parent the maternity system isn't necessarily set up with your needs first and foremost as you might think it should be.

"I hope the book will empower parents to ask more questions, demand more answers and ensure they don't miss out on the things that can mean all the difference in their care.

"There is a way forward to a system which puts the health of mother and baby first. But we must not make any more major changes to our maternity system in the 'dark'. Women need better information to obtain a clearer picture of the service."

About the Author
Dr LYNDA EXTON MB ChB FRNZCGP Dip Obst has been a doctor for 25 years, 20 of those years in her family practice in suburban Christchurch. She has a particular interest in the wellbeing of children and in assisting parents, and has spoken at many parent support and education seminars. Lynda is the author of 'Healthy Start', a health and parenting resource for young New Zealand families. Lynda is a Fellow of the Royal New Zealand College of General Practitioners and has a postgraduate Diploma of Obstetrics. She and her husband John have a teenage son and daughter.

End of Press Release

Who would want to read this book?
This book discusses issues important for anyone expecting a baby, or planning parenthood or anyone who cares about someone in such a situation.

It is of paramount importance for anyone who is in a position to influence decisions regarding health care and administration or who is involved in training health workers.

Anyone interested in the history of health care in New Zealand would be interested in this book and would appreciate the quality of the in-depth research.

Is the future of maternity care in New Zealand bleak and beyond hope?
Professor Les Toop who has written the foreword for The Baby Business - What's happened to maternity care in New Zealand? offers some hope.
"An acceptance of the policy mistakes of the past, the introduction of a realistic funding structure that removes barriers to shared maternity care and a new spirit of inter-professional collaboration could see a return to general practitioner involvement in antenatal and postnatal care, to the benefit of all."

The Baby Business What's happened to maternity care in New Zealand? is published by Craig Potton Publishing, and is available at bookstores around the country with a RRP of $29.95.

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