Whānuitanga o Te Mahi | Scope of Practice

Dr Hope Tupara 
Tangata Whenua Co-Chair 
Collaborative Reference Group

 Te Tiriti o Waitangi and Te Tatau o te Whare Kahu ki Hine Pae Ora - our journey

Drawing on Te Tiriti o Waitangi for this Project has been a journey. We are providing some narrative about the path we have travelled as a Project team, as co-chairs, and the Collaborative Reference Group (CRG), to describe the way Te Tiriti o Waitangi changed, challenged and shaped work of the CRG and the Scope of Practice of a midwife.

Dr Judith Mc-Ara Couper
Tangata Tiriti Co-Chair
Collaborative Reference Group

A word from the Board

Ngarangi Pritchard
Tangata Whenua Co-Chair
Te Tatau o Te Whare Kahu | Midwifery Council 

Kerry Adams
 Tangata Tiriti Co-Chair
Te Tatau o Te Whare Kahu | Midwifery Council 

We are thrilled to share the second draft revised Scope of Practice for Midwives in Aotearoa New Zealand with you all. We would like to thank the Project Working Group Co-chairs, Dr. Hope Tupara and Dr. Judith McAra-Couper for their expert leadership and the members of the Collaborative Reference Group and the Project Working Group for all the mahi they have put into developing this Scope statement.

We would also like to thank everyone who made a submission during the initial feedback process. It is great to see so many midwives participating and providing thoughtful contributions.

We believe the revised scope is whānau centred.  It upholds the mana of Te Ao Māori and Tangata Tiriti worldviews. It is inclusive and affirms and enables us to practice in ways that meet the needs of all whānau in Aotearoa. The revised scope will support our ability to address a detrimental imbalance of representation, understanding and appreciation of Māori knowledge, values and practice.

a. 

Te Tiriti o Waitangi is embedded in the practice of a kahu pōkai | midwife in Aotearoa New Zealand.

b. 

The kahu pōkai | midwife is responsible for providing culturally and clinically safe care, in any setting, for whānau who are planning a pregnancy, pregnant, birthing, and postnatal.

c. 

The kahu pōkai | midwife values mātauranga Māori and other worldviews to provide safe kahu pōkai | midwifery care that promotes whānau health and wellbeing.

d. 

The kahu pōkai | midwife draws upon cultural and clinical ways of knowing, with effective communication skills, to assess, diagnose, plan, provide and evaluate care. Where clinically indicated, and with the appropriate education, the kahu pōkai | midwife prescribes treatments and medicines.

e. 

Fundamental to a kahu pōkai | midwife’s tikanga, expertise and knowledge is the understanding, promotion, and facilitation of the physiological processes that support wellbeing and the recognition of complexity.

f. 

The kahu pōkai | midwife consults and collaborates effectively with whānau, other kahu pōkai | midwives and relevant health and social services, making timely referrals when appropriate and implementing emergency care when necessary.

g. 

The tikanga / quality and safety of midwifery care is supported through seeking whānau feedback, cultural safety, continuity of care, and effective interprofessional relationships, including tikanga ako / practice. It is also upheld through the kahu pōkai | midwife’s engagement with health care safe systems, evidence-based practice, reflective practice, ongoing education and professional development.

h. 

The kahu pōkai | midwife develops the knowledge, skills and cultural expertise to be responsive to meeting the varied health needs of whānau. The kahu pōkai | midwife may expand tikanga ako/midwifery practice by undertaking relevant education and gaining expertise, including in wider sexual and reproductive health and infant health care.

i. 

The kahu pōkai | midwife is involved in the advancement of midwifery from multiple perspectives through education, research, management, quality and safety, regulation and leadership.

A word from the Secretariat

Lesley Clarke
Chief Executive and Registrar

Te Tatau o te Whare Kahu ki Hine Pae Ora remains a key strategic focus for the Council and I am excited to share the next step on the journey as we progress this work together. This project is considering contemporary midwifery practice in Aotearoa and examining the cultural and clinical impact midwives have on all whānau.

Te Tatau o te Whare Kahu | Midwifery Council is responsible for ensuring that kahu pōkai |midwives are competent to practise and can be responsive to the contemporary needs of whānau. The work of this project is essential, and I look forward to seeing this mahi progress as we continue on this journey together.

Ki te kotahi te kākaho ka whati, ki te kāpuia, e kore e whati
When we stand alone we are vulnerable but together we are unbreakable
Nā Kingi Tawhiao

He āheinga nui, he haerenga roa kei mua i te aroaro kia whakatōngia tōtika ai te mana me te mauri o Te Tiriti o Waitangi hei tuāpapa mo ngā āhuatanga katoa o ēnei mahi. Ki te tū kotahi ai tātou ka kitea mārika ai te marea i ngā hua nui ka puāwai mai mo te katoa i te kaha ūnga ki ngā tikanga o Te Tiriti.

Ki te kāpuia te hāere me mārakerake ai te kite a te katoa i ngā taipitopito katoa o ēnei mahi,nā whai ano he tomokanga tēnei e whakaatu atu I ngā mahi kua tutuki, me ngā mahi kei mua tonu I te aroaro. Kāore ano kia oti ai tēnei haerenga, kātahi ano kē kia timata ai, kei te hāere tonu ngā mahi whakamāori a tuhi, ā wairua, ā whakapono nei, ko te manako nui kia hono tahi mai te katoa ki tē tautoko I te anga whakamua.

We have a great opportunity and challenge ahead to embed Te Tiriti o Waitangi as a solid foundation to support everything we do.

Tiriti-honouring practice will have benefits for all. A dedicated focus on working together to embody this will set a standard of excellence never before seen in the health sector. To stay united we must be open, honest and transparent and this portal of information has been created to share the journey traversed so far and what challenges lie ahead. It’s important to note this information will continue evolving as we move forward and nothing we are sharing at this stage of the process is set in stone.

As we continue to navigate our way forward the visibility of te reo me ōna tikanga will increase and become a part of what we do every single day. We invite and welcome your participation on this journey as we continue to create a future that represents and serves our people.

Feedback on the revised Scope of Practice statement closed on 21 November 2022

Te Tatau of te Whare Kahu | Midwifery Council sought feedback on the revised Scope of Practice statement in April 2022. Based on the feedback received, the Council made further adjustments to the Scope statement. The revised Scope of Practice statement was made available for comment again.

Feedback closed on 21 November 2022. The Council will make a few necessary adjustments to the Scope statement based on the received feedback and then communicate next steps once this is completed. Thank you to all those that submitted feedback.