Midwifery Scope of Practice - SUFW Feedback
- May 6
- 4 min read
May 6th 2025
We sent our feedback to the Midwifery Council on May 5th, it appears that the Midwifery Council has taken almost nothing on board when proposing to amend the Scope of Practice, so it was simple feedback to provide, as it more or less echoed the complaint that we made to the Regulations Review Committee in April last year, you can read that complaint here. An addition of note is the reference to the directive issued by the Associate Minister for Health, Hon Casey Costello on women centred language.
This is from the Midwifery Council feedback website:
Te Tatau o te Whare Kahu | the Midwifery Council (the Council) is proposing to amend the wording of the revised Midwifery Scope of Practice, that came into effect on 1 October 2024, in order to provide greater clarity for kahu pōkai | midwives and the public.
Following advice from the Regulations Review Committee, the Council is of the view that these proposed amendments help clarify the role of kahu pōkai | midwives, while continuing to uphold the mana of Te Ao Māori and other worldviews. The proposed amendments retain inclusivity and affirm and enable kahu pōkai | midwives to practise in ways that meet the needs of all whānau in Aotearoa.
The area of the concern is the single page below.
Our feedback focuses on the the highlighted phrases, we were asked whether we disagreed or agreed with each paragraph on a scale. Rather than answer each question individually we created an issues paper (based on our original complaint) and submitted it to the Council, the main body of that submission is below.
Issues paper to accompany our written submission on the “Proposal for Feedback - Midwifery Scope of Practice”
Speak Up for Women (SUFW) is an advocacy group focused on the protection of women and girls' rights, language, and spaces. We host a discussion group where around 250 women participate, including mothers and midwives.
SUFW strongly oppose these fundamental changes to the SOP because they are in direct conflict to the pregnant woman’s rights under the New Zealand Code of Health and Disability Services Consumers’ Rights. The changes create conflicting priorities for midwives, decentering women from their practice, and resulting in worse health outcomes for pregnant and birthing women and their babies.
Our concerns
1. Conflicting priorities: the New Zealand Code of Health and Disability Services Consumers’ Rights (The Code).
The Code contains ten rights that are available to each person as an individual to ensure the protection of their privacy and autonomy to make decisions related to their health care.
The Code gives a woman, and only her, the right to make decisions concerning her pregnancy and birth. The changes to the SOP are effectively removing the rights of an individual woman to make decisions about her pregnancy, birthing experience, and breastfeeding, to prioritise the preferences of her family or whānau.
There are numerous situations where it is vital that the midwife’s working relationship and focus is with the mother, the woman giving birth:
Confidentiality: how much information can/should the midwife share with the whānau?According to The Code, nothing can be shared without the express permission of the individual.
Hostile environment: without the support of a midwife how can a woman stand up to her whānau to achieve the kind of birthing experience that she wishes and/or needs?
Cultural differences: a woman may have vastly different ideas regarding her birthing experience and pregnancy than her whānau - whose views will be prioritised and supported? Who defines who is part of the whānau when the woman is not Māori?
Domestic violence: how can a midwife screen for safety issues when she may not even be able to visit with her client alone?
2. Lack of support for the proposed changes
During the consultation phase, the Midwifery Council (MC) received four hundred submissions.
The MC reported that 90% of these submissions were negative (this includes 10% negative submissions from midwives); 5.2% were positive but raised concerns about the changes, and only 3.7% of the submissions were positive.
The Midwifery Council’s report identified common themes in the submissions that have not been addressed and cannot be ignored:
The changes lacked clarity and failed to clearly describe the procedures, actions and processes that are permitted to be undertaken in terms of the midwifery profession.
Why was the word whānau introduced in the SOP?
Confusion regarding the use of te reo and the lack of reasoning behind the usage of two languages.
Lack of description regarding education and outcomes.
3. Implications of using the word whānau in the Scope of Practice
While we understand that introducing the word whānau to the SOP is presented as a move towards a more inclusive approach to midwifery, this change in the language and scope of practice devalues the importance of protecting the mother-child dyad. Pregnant and birthing women and their babies are particularly vulnerable and require adequate protection.
The change of language in the SOP fails to acknowledge that “women have unique experiences, needs and rights in relation to pregnancy, birth, and breastfeeding that are not shared with others” (Gribble Karleen D., 2022). This is particularly important in situations of family and sexual violence and when the health of the mother and/or baby are at risk.
Introducing the word whānau to the SOP creates a barrier for the midwife to adequately support and advocate for the wellbeing of a woman, and to support her in making autonomous decisions during her pregnancy, birth and breastfeeding periods.
4. Women centred language as per the directive issued by the associate Minister for Health, Hon Casey Costello
We believe that the language in the SOP should reflect the women-centred approach / directive requested by Minister Costello. “Individuals (however they may identify) who are capable of child-bearing…” is an excellent example of the language that Minister Costello has directed should not be used. Changing the word Individuals to Women would solve this problem.
5. Our request
We request that the Midwifery Council design a new SOP based on ensuring a pregnant woman’s rights under the New Zealand Code of Health and Disability Services Consumers’ Rights are protected. We request that the SOP respects the bodily and reproductive autonomy - and the privacy - that a woman deserves and is entitled to under law.
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