Changes to Whakatāne Obstetrics and Gynaecology Service

From mid-January there will be no Obstetrics and Gynecology senior medical officers (SMOs) in the maternity service at Whakatāne Hospital. Several of our SMOs are leaving, and we have been unable to recruit qualified specialists to replace them at this time. As in many parts of New Zealand, especially in more rural areas, it can be challenging to recruit trained specialists.

No, this is unrelated to Health New Zealand’s reset, and we are working hard to recruit to these specialist roles and return to a full-service as soon as possible.

No, we expect this to be in place for up to 12 months and we will provide regular updates.

Yes, we are trying to source specialists from both the United States, United Kingdom and Australia. We have recruited two Obstetrician Gynecologists who are moving from overseas and expected to arrive in mid-2025.

Across the motu there is difficulty recruiting and retaining staff at smaller hospitals such as Whakatāne. It is a busy job requiring 24 hour on-call shifts, 72-hour weekend cover, and an unpredictable workload overnight. The service is dependent on overseas staff, but it is common that after a while they move on to larger hospitals, which have a less frequent on-call component, or return home.  A wider national discussion is underway about how to provide a sustainable model of care.

Tauranga is also experiencing staff shortages so moving staff across the district would affect the Tauranga service.  The Tauranga service is not only critical to provide care but is also essential as a training and supervision site for new specialist staff to help return to full service in Whakatāne.  It is therefore essential to preserve the 24/7 service and instead support Whakatāne remotely out of hours, plus visiting sessions during the day for clinics and day surgery.

International Medical Graduates (IMGs) require approval by the Medical Council of New Zealand, with oversight from the specialist college (RANZCOG), and then a period of supervision by a local specialist before they can gain full registration from the Medical Council and practice without supervision. This will require them to start at Tauranga Hospital and move to Whakatāne after several months.

Primary birthing services are provided by midwives and includes caring for low-risk pregnancies and conducting vaginal births.

Secondary birthing services are those which require obstetric consultation, or obstetric intervention such as instrumental birth, caesarean section, epidural access, induction of labour, management of major obstetric bleeding, and repair of complex perineal tears.

There is a national guideline around which conditions require secondary care consultation available here.

Women/pregnant people with low-risk pregnancies can birth at Whakatāne Hospital under midwife care. Women/pregnant people who have increased risk of needing intervention during birth will need to birth at Tauranga Hospital. While you are pregnant, your care will continue at Whakatāne Hospital with the support of Tauranga specialists. Clinical safety for women/pregnant people and babies is the key priority during this time.

There will be options for birthing at Bethlehem Birthing Centre for women/pregnant people who may have some risk of developing complications in labour, or who would prefer to birth in a primary unit with quicker access to specialist input at Tauranga Hospital.

In the first place, discuss your options with your midwife.  It may still be the right thing for you to birth with your midwife in Whakatāne Hospital.  They will assess any risk and make plans with the Tauranga Obstetric team if other arrangements are needed.  You will need to also discuss your wishes for birthing as they may require a different plan during this time. 

If you are pregnant and do not have a midwife, it is important that you book with one as soon as possible at www.findyourmidwife.co.nz. You can also call our dedicated phoneline on 0800 429 328 to speak to a midwife.

Clinical safety for women/pregnant people and babies is our priority.

This change in service is being put in place with the health and safety of women/pregnant people at its heart. It is to ensure those who need additional care are identified early and arrangements are made for the appropriate level of care. Those needing or likely to need secondary care for their birth will be identified during pregnancy and birthing will be arranged in Tauranga.

If lower risk women/pregnant people develop complications during labour or while birthing at Whakatāne, and emergency transfer will be arranged to Tauranga.  We will continue to offer full maternity care from conception to birth and beyond for low-risk pregnancies.

In Maternity and Obstetrics, we are unable to maintain a secondary birthing service, but primary birthing can continue. Women/pregnant people with risk factors for complications such as previous complex pregnancies or births, previous caesarean section, or risk factors for heavy bleeding, would need to travel to a hospital such as Tauranga Hospital who have the staff and facilities to safely care for them. Whakatāne Hospital will be unable to provide an induction of labour service, caesarean sections, or epidural service. If you suffer a complex perineal tear during birth at Whakatāne Hospital, you will also need to travel to Tauranga Hospital for repair.

Care during your pregnancy will continue at Whakatāne Hospital or with your midwife with ante-natal clinics.  Specialists from Tauranga Hospital will run clinics at Whakatāne Hospital for those that need specialist input.

If you are identified as needing secondary care for your birth you will need to come to Tauranga for this and you may need to stay there before you give birth to make sure you are in the right place.

If an emergency arises, or secondary care is needed during labour, or women/pregnant people come to the hospital late in their pregnancy with a high risk, these people will undergo an emergency transfer to Tauranga via road or air ambulance.

There will be help for financial support for transport and accommodation.  Transport assistance will also be available to return you to home after you have your baby, or back to Whakatāne Hospital if you still need some time in hospital.

Tauranga hospital is 90km (1hr 15) drive from Tauranga Hospital and has 24-hour secondary obstetric service cover, and 24-hour anesthetic service cover. Tauranga Hospital can provide epidural access, induction of labour and caesarean sections.

Most gynaecological care will be moved to Tauranga Hospital except for day case surgery and some outpatient clinics. Specialists will visit from Tauranga to Whakatāne to run some of the Gynae outpatient clinics and perform some day case surgery. More complex surgery or intervention will need to be carried out at Tauranga Hospital and transport and accommodation may be provided.

Local emergency, medical and surgical team will provide urgent care for emergency presentations and will stabilise a patient with a gynecology emergency prior to any transfer for specialist care.

The termination of pregnancy service will continue to be available. However, people will likely need to travel to Tauranga or Rotorua for this particularly for later terminations after 10 weeks of pregnancy.

Any surgery that requires an overnight stay in hospital, or procedures that are not currently performed in Whakatāne such as outpatient hysteroscopy.