Better funding is needed to improve the health workforce’s support of women after miscarriage, says midwife Cassie Kenney whose PhD looked at miscarriage.
Kenney is the first Māori to gain a PhD in midwifery and is currently based at the University of Alberta where she is a postdoctoral fellow in ethnicity and health, focusing on improving health care for minority and indigenous women.
With one in four confirmed pregnancies in New Zealand ending in miscarriage, Kenney said miscarriage was a significant issue for midwives and for child-bearing Māori women.
She says increased funding is needed to improve resourcing of miscarriage-related care – particularly to develop health workforce capacity so women have better access to information, counselling, support and follow-up visits.
Miscarriage support groups were available in some areas but in other areas there was little organised support for the “socially silenced topic”. “Silencing of women’s and families’ experiences denies women’s identities as mothers, the human identities of their unborn children and families’ experiences of loss and may be extremely detrimental to whanau ora.”
During her doctoral research Ms Kenney became aware of five women who committed suicide after having miscarriages. “Maternal mental health statistics indicate there may be a correlation between miscarriage and women’s experiences of mental ill health directly following miscarriage and in subsequent pregnancies.”
“The challenge for the health system will be addressing miscarriage-related issues in a timely manner rather than the current practice of funding the ambulance at the bottom of the cliff.”
The focus of Ms Kenney’s doctoral research was on developing a methodology, Te Whakamaramatanga (The Enlightenment), with the aim of addressing gaps in areas of midwifery, miscarriage-related care, health professional development, Māori health and health research literature.
Interweaving indigenous and European world views, theories and research, the methodology was also built on consultation with Māori and midwifery stakeholders plus the views and stories about miscarriage of 20 midwives and women from European, Māori and Pasifika backgrounds.
Kenney, who is a registered midwife and occupational therapist, also lectured at the Manawatu campus of Massey University’s school of health and social services.
Kenney (Ngati Toa Rangatira, Te Atiawa ki Whakarongotai, Ngai Tahu) says she has been aware of gaps in midwifery care, particularly for Māori since she was a student midwife. Her doctoral thesis, Me aro ki te ha o Hineahuone – Women, midwives and miscarriage stories: Towards a contextually relevant research methodology – also saw her the first Māori scholar at Massey to be awarded a place on the dean’s list of exceptional doctoral theses.