Te Ao Marama Midwife Anahera Ngatai. Photo: RNZ / Samuel Rillstone
- Whooping cough epidemic clocks up 3227 cases since October 2024
- Of the 289 babies under 12 months, more than half (51.7 percent) hospitalised
- One baby has died
- Midwives now funded to vaccinate women in their care
- Nearly 60 trained since August
Some midwives are no longer recommending pregnant mothers in their care go and get vaccinated against whooping cough, flu and Covid - they are doing the immunisations themselves.
The Lead Maternity Carer antenatal immunisation programme, which launched in August, is a key part of the government's response to the whooping cough epidemic, which has hit 3200 cases in the last year and caused one death.
Porirua midwife Cherie Parai from Te Ao Marama Midwifery said six of her team had completed vaccinator training.
"We're trying to improve access and improve the vaccination status in Porirua. We have the opportunity, it's come into our scope, so we've taken the opportunity for our whānau here."
Te Ao Marama is based at the Hapū Māmā Hub Te Puna Wairua in Cannons Creek, which was set up by Ngāti Toa as a one-stop shop for for maternity, antenatal and postnatal care.
Increasing access for Māori and Pacific women in particular was its kaupapa/founding principle, so as soon as funding became available for midwives to offer immunisations to pregnant women, Te Ao Marama jumped on board, Parai said.
"Hapū māmā are not sick, so sending them to the GP where they are sitting in a waiting room with sick people is something we want to avoid. So this [immunisation] is something we wanted to offer to our whānau here. It was a no brainer."
The Te Ao Marama waiting room. Photo: RNZ / Samuel Rillstone
Her colleague Anahera Ngatai said it was making lives easier for clients.
"Most wāhine are really receptive, especially because we can do it at the start of the appointment, they don't need to come in another day, they don't need to find childcare, they don't need to make extra time.
"You already have so many appointments when you're pregnant.
"So being able to do it at the one-stop shop is really helpful for whānau."
About 80 percent of women took up the chance to get vaccinated immediately, while others needed time to think, Parai said.
"Some of them are not keen on vaccinations, some have needle phobia - there are a whole heap of reasons why they don't get it. But we do give them the information so that they can make an informed decision."
Midwives were in a position of trust, she said.
"When you've got a relationship, you can have that conversation, people are a bit more open."
For her, the issue was also personal.
Her son, who was born prematurely, had whooping cough and spent three months in Starship Hospital, some of that in an induced coma.
"So that was very scary. It was horrendous because there was another baby next to him the same age with whooping cough, and he didn't make it. So yeah, it was something we really wanted to promote to other whānau, so they don't have to go through that."
Her son is now 21.
"And he gets sick the least of all my children!"
Mothers are babies' best defence
Babies are immunised against whooping cough at six weeks, three months and five months, then again at ages four and 11 years.
Before six weeks, their only protection came from maternal antibodies - and from all those around them being vaccinated to stop them coming into contact with whooping cough.
Since the current epidemic began in October 2024, there have been 3227 cases nationwide, with just over 9 percent hospitalised.
Of the 289 babies under 12 months, 51.7 percent were hospitalised, and tragically, one died.
Hawke's Bay midwife Sarah Nation from Kōwhai Midwives Collective, who was a nurse before doing midwifery training, has also seen whooping cough in an infant.
"I'll never forget it, it's pretty confronting. Because immunisation works, generally, people don't see it, they don't see people with symptoms because of the immunisation programme. So when you do see it, it's like, wow."
She immediately saw the sense in being part of the midwives' antenatal immunisation programme.
"If GPs, nurses and pharmacists can vaccinate pregnant women, then gosh, it's about time midwives can do it too, because we're the ones who see them the most."
Antenatal immunisation protected unborn babies, newborns and women themselves, who had naturally lowered immunity during pregnancy and increased cardiovascular workload, she said.
"And then clearly you've got a baby growing in there, your lung capacity is reduced, particularly in the third trimester. So those women who are exposed to influenza, they can become really, really unwell."
Increasing uptake by midwives - Health NZ
The National Public Health Service's director of prevention, Nikki Canter-Burgoyne, said 57 midwives have done the training so far, and there had been 83 "expressions of interest" in offering vaccines lodged by independent midwives and practices.
"This is in addition to the existing ability for midwives to prescribe and give vaccines as part of their registered skills up to six weeks post-delivery.
"The Midwifery Council has also approved 'colleague to colleague' vaccinations, allowing midwives and LMCs to vaccinate their co-workers in maternity care to protect women and whānau."
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