In our Māori and Pacific communities, there is still prevalent inequity in maternity support services available from the moment our young mums test positive for pregnancy, through to the early years of their child’s development. According to Oranga Tamariki,
“Teen birth rates in Aotearoa New Zealand are declining but remain high compared to other countries. The teen birth rate is particularly high amongst Māori and Pacific teens compared to all other ethnicities.”
Despite this, the 2021 Bula Sautu report shows that less than half of pregnant Pacific women are enrolled with a midwife for crucial screening and health care in their first trimester.
It’s this important gap that Tāmaki Health Director & Founder Ranjna Patel with funding from Total Healthcare PHO, sought to bridge back in 2019 through the Mana 4 Mums service.
We spoke with Maternity Services Coordinator, Bijal Soni, about how the Mana 4 Mums program she runs goes the extra mile to understand the key differences in the cultural systems of whānau, hapū, and iwi, and how taking an empathetic approach to complex individual circumstances can make a huge difference in a family.
Access to maternity services starts with education
For many young Mums, their ability to access maternity services in New Zealand starts with education. As identified in the Bula Sautu report, many do not understand how the health system road map for pregnancy, why it’s so important to engage early on, or even what support services they are entitled to.
Bijal says that often we assume that these conversations are had at home and that people ‘just know’ what to do, when often that’s not the case.
“People always think that young mums and families will be talking about pregnancy and maternity services, but sometimes there’s is not much communication going on in the family. That means there can be a lot of barriers and a lot of pressure that you either should or should not have the baby.”
Bijal also notes that this doesn’t necessarily mean that whānau aren’t supportive and empathetic – just that pregnancy at a young age can come with more barriers between a young mum and maternity care.
“A lot of times there are a few things going on at once. Sometimes it’s family violence, conflict, societal pressure, worrying that they’re too young and what their friends will say when they’re back at school, peer pressure.”
“Give young mums time and space after explaining their options and give them the room to absorb”
One of the key differences that sets Mana 4 Mums apart and makes a huge impact on young people’s lives during the early stages of pregnancy, is not only taking an empathetic approach, but giving young Māori and Pacific women agency to make their own, educated decisions.
“For a lot of mums, it will be a bit of a shock and they won’t know what to do. Some of the young mums ask me things like “if I want to go for an abortion what would the procedure be like?”, or, “if I want to continue, what kind of support can I get”. They just want to know what their options are before making the decision, even if they have a whānau around them or not”
Bijal adds that this unique approach of letting mums lead their own journey through the maternity services process is having some noticeable positive outcomes.
“[Empowerment] was the whole foundation I wanted to have for the program – it actually helps to get a proper outcome. So many mums, I would say more than 80% of mums in the program, have engaged with a midwife within the first or early second trimester which is a basic need.”
The key to success is enabling independence, she adds.
“They want to do everything independently – that’s what I have noticed so far. They want to feel that they’ve organised the whole pregnancy, and you know, welcomed the baby and all that stuff on their own, with our support. Independent and empowered, but supported.”
Culture plays a significant role in supporting our young mums, from whānau support to having a Māori or Pacific midwife
Understanding the place of whakapapa, whānau and tamariki from a Māori perspective also plays an important role in the way that Mana 4 Mums approaches maternity support. Bijal says that keeping an open mind and asking the right questions is at the centre of what she does.
“I always try to keep my mind open and be positive because you don’t know the whole story, you can’t judge someone just because they’re pregnant at a young age. It might be that in the family it’s okay to have a baby at 16 or 18, often they have a lot of siblings at a young age, and sometimes their whānau are really supportive as well – it’s not always negative.
Every culture has their own perspective on having pēpē, you have to be open and understand the whole process.”
Mana 4 Mums also seeks to pair young mothers with a Māori or Pacific midwife if that’s their preference, however, given that figures show 25 percent of Aotearoa's birthing population in 2018 identified as Māori, and 10 percent as Pacific, and less than 10 percent of midwives identify as Māori and less than 3 percent as Pacific, it can sometimes prove to be challenging.
Mana 4 Mums is a piece of a puzzle, working with other community services to make a difference
Bijal modestly credits some of her success stories to the collaborative effort of community support services, making the right connections and everyone offering a helping hand where needed. She describes a time where a young, solo mum whose family at the time were back in the islands, was grateful for the support of Mana 4 Mums and wider services.
“I engaged her with other social services as well for support such as housing and registering with Work and Income because she had just moved from the islands. One day she went to stay with her extended family and she called me on a Friday night and had been involved in family violence.
I immediately called social support services who went to her place, took her out of the situation and placed her in emergency housing, so at least she had a safe place for the weekend. From Monday, we were able to place her in private renting.”
Services like Plunket also helped to provide necessities like a car seat donated by another whānau.
“We went to her place after she had the baby before the 6-week mark. We were able to give her the car seat and warm clothes and that was quite overwhelming.
Her Mum was there at the time as well and said “thank you so much for looking after my girl while I wasn’t around”, and that she felt like she had another family. I started crying, it meant a lot.”
With over 800 women enrolled in the program, the statistics speak for themselves
Mana 4 Mums is currently working with 802 Māori and Pacific young expectant mothers, under 22 years old who live in South Auckland. Of these, 794 have had follow up’s or interventions after first contact, and 504 have an assigned midwife to assist them through their journey.