A baby is born in a car on the roadside near Cromwell; another is born in an ambulance near Lawrence; a labouring woman takes three consecutive ambulances from Wanaka to Dunedin, and her baby is born in the ambulance at Waihola. 

These aren’t recent examples; they all happened between nine and 20 years ago, and these examples are taken just from friends of mine.

There’s nothing new about babies arriving in less-than-ideal places and circumstances, such as the more recent examples in Wanaka. What has changed, though, is there are fewer midwives prepared to carry the responsibility of managing births in these circumstances. As one former Wanaka midwife told me, she left the job precisely because nothing had changed in the past 15 years.

The issues around our maternity services are complex: our distance from a base hospital will continue to be a challenge for the whole population, not just pregnant women; and we need well supported and resourced midwives - which is also a national challenge.

However, one thing is clear: our community needs a primary birthing unit.

Related: A chance to help shape local health services

A primary birthing unit is equipped for supporting healthy women with no medical complications through labour, birth, and inpatient postnatal care. Primary maternity facilities have on-site or on-call midwifery support in addition to the woman’s chosen midwife. Our nearest primary birthing unit is Charlotte Jean Maternity Hospital in Alexandra.

While most New Zealand women (around 87 per cent) give birth in a hospital setting, most of them could have (and arguably should have) given birth in either a primary birthing unit or at home, according to Women’s Health Action general manager Isis McKay.

To make primary birthing work in rural areas, we need sustainable and reliable fit-for-purpose primary birthing facilities, she says, and the best outcomes come when midwives and women are involved in the design, evaluation, and implementation of such services.

Despite that, the Southern District Health Board (SDHB) didn’t ask Wanaka midwives or the local lobby group Save Our Wanaka Midwives for input into what we need in our community. Instead, they gave us a ‘maternal and child hub’ - essentially a larger office space for midwives with a space set aside for ‘emergency births’. It’s a facility which Wanaka midwife Deb Harvey says won’t improve services for Wanaka women.

But SDHB chief executive Chris Fleming says a discussion still needs to be had about the “location or establishment of a primary maternity facility for the Wanaka/Central Otago region”. 

Midwives at Charlotte Jean may feel uneasy about that statement, as it suggests there can only be one such unit.

If that’s the case, such a policy is based on money, not the desire for better maternity outcomes. Even the hour’s drive through to Charlotte Jean while in labour is memorably intense (I know this from experience). Ideally, Alexandra and Queenstown keep their primary birthing units and we get one here in Wanaka - as soon as possible.

Chris said the discussion will be referred to the Locality Network, an advisory group being established to advise on health services required in the Central Lakes area, but he added the issue was so important the work will begin while the advisory group is still being established.

We’re still in the dark about who is representing our community on the Locality Network, what form that discussion will take, and who will be consulted. 

Back in the day there were maternity hospitals (last century’s equivalent of a primary birthing unit) in every small rural town. I was born in one, and I remember my community marching in protest in the 1980s when the Department of Health threatened to close those maternity hospitals. 

I have a sense of déjà vu.

I sincerely hope the SDHB will provide us with a primary birthing unit without depriving neighbouring regions of theirs. In the 1980s, the government’s health service provider didn’t listen to rural communities. Will it listen to us now?