By Kathleen Maki

In 2021 the Ministry of Health announced a new initiative which would provide targeted support for Māori and Pacific midwifery students. The initiative was gifted the names Te Ara ō Hine which represents Māori and, Tapu Ora to reflect Pacific. The purpose of the initiative is to address the critical under representation of Māori and Pacific midwives in the community and to increase a midwifery workforce that is diverse and better reflects the communities in which they service.

The initiative is being funded by the Ministry of Health over four years, enabling the implementation of multi-layered support in each of the five schools of midwifery. Te Ara ō Hine – Tapu Ora aligns with Whakamaua: Māori Health Action Plan (2020-2025) and ‘Ola Manuia: Pacific Health Action Plan (2020-2025).

In 2020, the five schools of midwifery came together and consulted with current and previous Māori and Pacific midwifery students at the time. The students shared the ongoing barriers they experienced and suggested various supports that may mitigate some of the ongoing challenges. Collectively the students, who were consulted, strongly supported the need for a dedicated liaison to support students while navigating the tertiary environment, and life’s competing demands. A contribution towards financial aid, professional membership fees and national hui fees were also included as critical components.

Te Ara ō Hine – Tapu Ora reinforces the need to have a New Zealand midwifery curriculum that honours Te Tiriti ō Waitangi and reminds us that Te Ao Māori and Pacific world views are unique and rich and worth investing in.

Bibliography

Deb Beatson, S. A., Patterson, J., & Griffiths, C. &. (2018). Pasifika student experience in a Bachelor of Midwifery . New Zealand College of Midwives Journal • Issue 54 , 44-50.

Ministry of Health . (2020). Whakamaua:Māori Health Action Plan 2020-2025. Wellington: Ministry of Health.

Ministry of Health. (2020). 'Ola Mauia:Pacific Health. Wellington: Ministry of Health.

Tupara, H. &. (2020). Te Aronga-a-Hine: Consolidated Summary of Evidence and recommendations. Wellington, NZ: Te Rau Ora.

At Ara, we have 27 tauira over all three years who identify as Māori and Pacifika (six of these are Pacifika and some identify as Māori too). This year is the largest intake of Māori and Pacifika tauira within the midwifery degree, and it is great to see the supports being implemented to support these tauira in their success. With the implementation of Te Ara ō Hine – Tapu Ora Kathleen Maki and Jay Beaumont have begun roles as Māori and Pacifika liaisons to provide wrap around support for these tauira, the feedback from tauira around this has been nothing but fantastic and it has made all tauira both in Ōtautahi and the Ara satellite areas feel extremely supported. We are also extremely lucky to have the opportunity to have 2 Māori and Pacifika student representatives, Tazmin Traynor and Kerianne Becks, to represent the collective of Māori and Pacifika tauira. Kathleen and Jay have both been of extreme value since their roles began and they are fantastic at making themselves available for both one on one support and group sessions, this has really helped with the connections within the group. Jay has also offered huge value in helping tauira connect to the roopu, Māori Midwives ki Tahu and they have all been extremely welcoming. This is all such an achievement for midwifery and the community, it is great to see the success of Māori and Pacifika tauira midwives being valued and supported in such ways. As a collective we are so thankful for the support from both the institution, Jay and Kathleen as well as Māori Midwives ki Tahu and we hope that these supports help future tauira to feel that midwifery is achievable and supportive.

By Tazmin - Second year student at the time.

I realised that I wanted to become a midwife during a whānau birth that I attended during lockdown in 2020. It was during this moment that i realised midwifery is where my heart was, and this was the path I had been looking for.

Beginning midwifery has given me the opportunity to reflect on my own birth experience and really strive to provide better experiences and journeys for the whānau I care for in my degree and going forward into the midwifery workforce. Empowering wāhine to achieve all they can in pregnancy, childbirth and beyond is my dream and I work every day to ensure that I am providing the best I can. I believe that all wāhine should leave their experience feeling empowered, no matter how they birth or what hand they are dealt there is always opportunity for them to leave feeling empowered and respected.

The degree has presented many challenges along the way while also providing moments I will treasure forever. I often feel like the universe of midwifery always knows what I need and when, I can be struggling to get through and then all of a sudden, I will be given an experience that reminds me why I am here and how much I want to be a midwife. Seeing wāhine and whānau transition into the new chapter with new life feels so empowering and I am so privileged to be welcomed into the space where this happens.

The greatest things about being a Māori midwifery student so far is the feelings of connection with the midwifery community that I have and feeling like I have been welcomed into that space with open arms. All the midwives I have encountered on my journey have welcomed me with open arms and make it a priority to teach me all they can which I am so grateful for.

One thing I would say to anyone considering becoming a midwife…..

While it is challenging and trying at times, there is no better feeling than supporting wāhine and whānau through the journey of bringing a new pēpi into the world. The firsts you gain through the degree are once in a lifetime opportunities that will build you up and stick with you forever. Follow you heart and you will be great!

By Amy Henderson - 2nd year at ARA at the time of writing

1. Self-reflection – To me, the world of Te Aō Māori is vastly different to the world of the tertiary hospital. However, birthing tikanga is still present for many Māori in the way we see our pepi being born. It’s a time when we honour tradition and whānau as we walk beside the realm of the spirits and honour our Tipuna. I personally have found it empowering and connecting to honour my Tipuna by assisting women who want, to bring tikanga birthing practices to their own experience.

2. Description – a Māori woman having her first baby was diagnosed as having a large for gestational age baby via a scan. She subsequently caught Covid -19 and ruptured her membranes at home. She was told she was required (the doctors’ words) to birth in the tertiary environment. The discussion by the Drs was to augment labour immediately due to the Covid-19 infection and risk of chorioamnionitis and that they would have “very little tolerance for her labouring”. The woman continued with her birth choices of no pain relief, despite labouring with an oxytocin drip to augment her labour and almost constant doctor’s recommendations that she get an epidural. Her LMC midwife was called in after a vaginal exam by core midwifery staff and I found that her cervix was 5 cm and fully effaced and she was contracting 4 in 10 min. I slowly watched as each choice this wahine had for her birth was lost, a tikanga-led home birth in the water that was drug and hospital free. I had discussions with her between her contractions about what was the most important thing to her, something she could control no matter what her birth looked like. She wanted Karakia, and her partner to cut the pito with her Kuia pounamu. In the end, the woman decided that she could handle no more intervention on her body after 24 hours of labouring and decided that a caesarean section was what needed to happen. She asked her LMC to perform Karakia, but she didn’t know one, she looked at me and I just nodded. Although the surgeon was unsure what I was doing I started the karakia at the beginning of the incision and spoke the works of my tipuna over this māma and her pepi. When her pepi was born I spoke the words “Tihei Mauriora”. We assisted the papa to cut the cord using the pounamu and ensuring the Whenua was kept for them to return to the earth.

3. Reflection (thoughts and feelings) – I feel that the incorporation of tikanga in birthing is essential for Māori who feel the call for it. I really want to be able to facilitate this for māma who feel this need and be someone who can provide this for whānau. I felt a great sense of mana in being the person who was able to facilitate comfort and a sense of reclaiming power to a māma at that time. It is a moment I will take forward with me from my second year. After I left that night, I did not get to see this woman again. However, her LMC contacted me to let me know that she had given her the feedback form and received one back on my behalf. I was so pleased to have made as much of an impact on the woman and her whānau as she had on me.

4. Influences (knowing) – Simmonds (2017) speaks to the use of Māori birthing tikanga and the reclaiming and decolonising of it by māma, and birth practitioners using tikanga in our western medical institutions. He discusses that when Māori looking to their Ancestors way of birthing as a way to connect to Tipuna, it’s a way of handing down traditions to their pepi that have being previously lost. Lewis (2022) speaks about “Generativity” in the passing of cultural knowledge to younger members/children of the tribe/whānau/culture. In doing this you improve the sense of self of the ones learning about their people. By immersing herself in cultural birthing practices that were important to her, the birthing woman passes these on to her pēpi in the story of their birth, and increases a greater level of understand of wairua for herself and her pēpi.

Compentencies 1.4 and 1.5 of the Competencies for entry to the Register of Midwives (New Zealand College of Midwives, 2015) states that not only do midwives need to honour Tangata Whenua and the articles of Te Tiriti o Waitangi but that we respect her personal ethnic, cultural and social context. The Midwifery Council of New Zealand in the Statement on Cultural competence for Midwives states that a culturally competent midwife recognises and respects each woman’s culture, aware that different areas of that culture are more important to individuals or groups at different times.

5. Evaluation (analysis) conclusions – I feel that my actions had a profound effect on me and my connection to the woman, her whānau, my Tipuna and to midwifery. I will continue to do these things when they are appropriate to the situation and when asked for, with Mana and without fear.

6. Learning (synthesis) action – I will continue to learn more about tikanga birthing practices and incorporate these further into more facets of women’s experiences when this is requested. I also want to further my knowledge of my Tongan heritage and extend myself to understand better my own culture through continued relationships with Pasifika Midwives Aotearoa, and try to incorporate some of these learnings into the way I practice.

By Kalese Phillips - 2nd year at time of writing

My name is Kalese and as well as my involvement in Hākui and its operations I am also a midwifery student. I grew up in a large family and loved the surroundings of midwifery. I knew being a midwife was what I wanted. After having my first child at 17 this was confirmed for me and I didn’t want anything more than to be a midwife. After 2 more children I decided I couldn’t wait anymore and next thing I knew I had applied to start the degree and was beginning per-health to meet the entry requirements for the midwifery degree. Although it has been a challenge while welcoming my fourth baby in my first year and juggling life and midwifery it is such a joy and I wouldn't change any of it. Midwifery has so many joys to offer and the people I have met along the way are so special and just amazing! The Maōri midwifery community has been so welcoming and really just takes Tauira under their wing to support them in any way.

Now having had my 4th baby I could not imagine myself doing anything else. I am so thankful to the midwives and wāhine for the opportunities they have all given me and all the other tauira.