Maternity Safety, Midwifery Workforce, COVID Vaccination Advice, Placenta Concerns, and Accountability Records 2020-2025

Official Information Act Request

Maternity Safety, Midwifery Workforce, COVID Vaccination Advice, Placenta Concerns, and Accountability Records 2020-2025

 

To: Ministry of Health; Health New Zealand / Te Whatu Ora; Midwifery Council; Medical Council; Nursing Council; Health and Disability Commissioner; ACC; Medsafe; Immigration New Zealand; and any other agency holding relevant records

From: Tracy

Date: 10 July 26

Subject: OIA request – maternity outcomes, midwifery workforce, COVID vaccination advice, placenta concerns, and accountability records, 2020-2025

 

This is a request under the Official Information Act 1982.

I request information for the period 1 January 2020 to 31 December 2025 concerning maternity outcomes, midwifery workforce changes, complaints, adverse events, overseas-trained midwives, loss of experienced New Zealand midwives, COVID vaccination requirements, informed-consent advice, placenta condition, pathology concerns, safety monitoring, and the treatment of experienced midwives who raised clinical concerns.

For clarity, this request is not based on nationality, ethnicity, or any claim that overseas-trained practitioners are inherently unsafe. It concerns maternity safety, professional competence, patient outcomes, informed consent, workforce loss, communication standards, complaint handling, and whether experienced practitioners were heard or silenced when they raised clinical concerns.

Experienced midwives have reported concerns that placental condition and maternity outcomes appeared different after 2020. This request seeks the records, adverse-event data, pathology findings, clinical reviews, safety monitoring, complaint records, and communications showing whether government agencies were notified of those concerns, what investigation occurred, and what action was taken.

1. Midwifery workforce

1. The number of practising midwives each year from 2020 to 2025, broken down by New Zealand-trained, overseas-trained, internationally recruited, New Zealand citizen, permanent resident, resident visa holder, work visa holder, other visa holder, and unknown or not recorded.

2. The number of midwives who left practice, resigned, retired, were suspended, were deregistered, were disciplined, or were placed under conditions each year.

3. Any records assessing why experienced midwives left practice, including burnout, disciplinary pressure, disagreement with Council policy, COVID-related policy, management pressure, lack of support, movement overseas, or inability to practise independently.

4. Any records assessing whether New Zealand became more reliant on overseas-trained or internationally recruited midwives between 2020 and 2025.

2. Maternity outcomes

5. Annual statistics from 2020 to 2025 for total births, live births, stillbirths, neonatal deaths, maternal deaths, birth injuries, emergency C-sections, delayed escalation incidents, shoulder dystocia incidents, postpartum haemorrhage, neonatal resuscitation events, ACC treatment injury claims related to maternity, HDC complaints related to maternity, and serious adverse events involving maternity care.

6. Any records comparing maternity outcomes by lead maternity carer model, hospital, district, midwife qualification pathway, overseas-trained versus New Zealand-trained where recorded, staffing levels, and continuity of care.

3. Complaints and competence

7. The number of complaints made about midwives each year from 2020 to 2025, broken down by complaint type, clinical issue, communication issue, informed-consent issue, failure to escalate, wrong advice, lack of empathy, poor bedside manner, and outcome.

8. The number of competence reviews, disciplinary referrals, suspensions, conditions, cancellations, or remedial training requirements involving midwives each year.

9. Any records showing whether complaints or adverse events are analysed by training background, overseas qualification, language competence, district, employer, or model of care.

4. Innovation, clinical techniques, and professional disagreement

10. Any policies, guidance, minutes, reports, or correspondence concerning how the Midwifery Council, Health New Zealand, Ministry of Health, or professional bodies assess innovative midwifery techniques, non-standard techniques, overseas techniques, traditional or experienced-practitioner techniques, emergency techniques, practitioner-developed techniques, evidence from successful outcomes, and disagreement between experienced practitioners and regulatory bodies.

11. Any records showing whether midwives have been disciplined, investigated, restricted, or criticised for using techniques that saved babies, avoided emergency escalation, improved birth outcomes, were not accepted by the Council, were not part of standard training, or were based on experience rather than Council-approved protocols.

12. Any records showing how the Council evaluates whether a non-standard or innovative technique should be studied, accepted, rejected, restricted, or incorporated into practice guidance.

13. Any records showing whether the Council has sought independent expert advice, international evidence, or practitioner evidence before rejecting or criticising a technique.

5. English-language competence and patient communication

14. All policies and audits concerning English-language competence, informed consent, clinical communication, emergency communication, handover, documentation, and patient understanding for midwives.

15. Any records of complaints involving patients unable to understand a midwife, midwife unable to understand a patient, poor explanation of risk, failure to obtain informed consent, failure to understand patient history, failure to communicate during labour, and failure to escalate.

6. Accountability and inter-agency referral

16. Any records showing how serious concerns about overseas-trained, internationally recruited, or visa-dependent midwives are referred to an employer, the Midwifery Council, Health New Zealand, HDC, ACC, Immigration New Zealand, or any other responsible agency.

17. Any memoranda of understanding, information-sharing agreements, referral protocols, or operational policies between the Midwifery Council, Health New Zealand, Ministry of Health, HDC, ACC, Immigration New Zealand, and employers concerning midwife competence, complaints, registration, discipline, patient safety, or visa status.

18. If any information is not held in the form requested, please provide the closest available information and identify which agency is likely to hold the missing information.

7. COVID vaccination orders, mandates, suspensions, and workforce loss

19. The number of midwives, nurses, maternity staff, LMCs, hospital maternity staff, neonatal staff, and related health workers who were suspended, stood down, dismissed, had contracts suspended, had access to facilities removed, had practising restrictions imposed, resigned, retired early, or otherwise stopped practising because of COVID vaccination requirements, COVID orders, employer vaccination policies, or professional-regulator expectations.

20. Please provide this data broken down by profession, district/DHB/Health NZ region, employer or contracting arrangement, date, whether the person was employee, contractor, LMC, self-employed, or facility-access dependent, and whether the action was dismissal, suspension, contract suspension, facility-access restriction, resignation, or other.

21. Copies of all policies, instructions, guidance, emails, notices, board papers, legal advice, or operational directions concerning removing unvaccinated midwives or nurses from practice, suspending contracts or access rights, ending or restricting LMC practice, facility-access restrictions, replacement staffing plans, maternity-service continuity risks, and predicted or actual harm caused by loss of staff.

22. Any records confirming or refuting whether approximately 400 nurses, midwives, or maternity-related staff were removed, suspended, dismissed, or had contracts restricted on or around any single date or decision period because of COVID vaccination requirements.

8. What midwives were allowed to say about COVID vaccination

23. Copies of all guidance, instructions, professional standards, warnings, notices, emails, disciplinary guidance, or communications issued to midwives, nurses, doctors, maternity staff, or LMCs concerning what they were permitted or not permitted to say to pregnant women, birthing women, breastfeeding women, or families about COVID vaccination.

24. Any records concerning whether midwives or maternity staff were discouraged from raising concerns about COVID vaccination, restricted from discussing risks, uncertainty, adverse events, or informed consent, instructed to provide only Ministry of Health-approved messaging, warned against advising patients contrary to official guidance, or investigated, disciplined, referred, or complained about for discussing COVID vaccine concerns.

25. Any records explaining how informed consent was protected where midwives or maternity staff were required to follow government or Council messaging.

26. Any legal advice, clinical advice, ethical advice, or professional guidance about balancing informed consent, professional independence, patient rights, public-health messaging, freedom of expression, disciplinary risk, and midwives duties to pregnant women and babies.

9. Placenta condition, pathology, and reported changes after 2020

27. Any records, reports, emails, complaints, clinical reviews, adverse-event notifications, pathology reports, coronial records, HDC referrals, ACC treatment-injury records, maternity-quality reports, perinatal-mortality reviews, or internal correspondence concerning reported changes in placenta condition, placenta appearance, placenta pathology, placental insufficiency, placental damage, clotting, calcification, infarction, inflammation, maternal vascular malperfusion, fetal vascular malperfusion, growth restriction, stillbirth, neonatal compromise, or other placental concerns from 2020 to 2025.

28. Any records showing whether experienced midwives, obstetricians, pathologists, scientists, researchers, maternity staff, or families reported concerns that placentas appeared different, damaged, abnormal, or clinically concerning compared with pre-2020 practice.

29. Any records showing whether those reports were received, recorded, escalated, investigated, dismissed, referred to Medsafe, Ministry of Health, Health NZ, HDC, ACC, PMMRC, Coroner, universities, pathology services, or professional regulators, or not acted on.

30. Any records showing whether the Ministry of Health, Health NZ, Midwifery Council, Medical Council, HDC, ACC, Medsafe, or maternity-quality bodies compared placental pathology data or maternity outcomes before and after 2020.

31. Any records showing whether placental pathology, stillbirth, neonatal death, fetal growth restriction, miscarriage, preterm birth, birth injury, emergency C-section, postpartum haemorrhage, maternal clotting, or neonatal compromise were monitored as possible safety signals during or after the COVID vaccination rollout.

32. Any records showing whether COVID infection, COVID vaccination, lockdowns, stress, maternity-service disruption, staff shortages, delayed care, or other pandemic-related factors were assessed as possible contributors to changes in placenta condition or maternity outcomes.

10. Safety monitoring, adverse-event systems, and accountability

33. Any records showing how maternity-related adverse events following COVID vaccination were recorded, coded, assessed, followed up, or reported.

34. Any records showing whether Medsafe, CARM, Ministry of Health, Health NZ, HDC, ACC, PMMRC, the Midwifery Council, or maternity services had a specific process for reviewing adverse pregnancy, birth, neonatal, breastfeeding, or placental outcomes after COVID vaccination.

35. Any records showing whether reports by midwives or families were included in safety monitoring, or whether they were excluded because they were anecdotal, unverified, not clinically coded, or not reported through the correct channel.

36. Copies of any final or interim reports, reviews, dashboards, minutes, risk assessments, safety-signal assessments, or briefings about pregnancy, birth, placenta, fetal, neonatal, breastfeeding, or maternal outcomes following COVID vaccination.

37. If no such monitoring occurred, please provide the records explaining why no specific monitoring, audit, or review was considered necessary.

11. Innovation and suppression of experienced midwifery knowledge

38. Any records showing whether experienced midwives were prevented, discouraged, or disciplined for raising concerns about placenta condition, maternity outcomes, vaccine safety, informed consent, non-standard clinical observations, or changes observed through long-term practice.

39. Any records showing whether experienced midwives clinical observations were reviewed by independent experts or rejected without review.

40. Any records showing how the Crown ensures that long-practising midwives observational knowledge is captured, assessed, and escalated where they report emerging clinical changes.

Public interest and transfer request

This request is made in the public interest to understand maternity safety, midwifery workforce change, loss of experienced practitioners, informed consent, COVID-related professional restrictions, placenta-related clinical concerns, adverse-event monitoring, and whether reported safety signals were properly recorded, investigated, and acted on.

If any part of this request is more closely connected with another agency, please transfer that part under section 14 of the Official Information Act 1982 and advise accordingly.

Please provide the information electronically. If the full request is considered too broad, please contact me before refusing so the scope can be refined. I am willing to receive the information in stages, beginning with document indexes, titles, or data tables where that would assist processing.

Tracy