NCWNZ stands with our organisational sisters – the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the New Zealand College of Midwives (NZCOM) – in urging caution ahead of the second reading of the 3-Day Postnatal Stay Bill in Parliament. 

Ahead of the Second Reading of the Pae Ora (Healthy Futures) (3-Day Postnatal Stay) Amendment Bill, three leading organisations in women’s health and maternity care — the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), the New Zealand College of Midwives (NZCOM), and the National Council of Women of New Zealand (NCWNZ) — have issued a joint statement calling for careful consideration of the Bill’s broader implications.

While the group supports the principle that all women should have access to appropriate care after giving birth, they caution that the Bill, despite its good intentions, could entrench existing inequities and place further strain on Aotearoa New Zealand’s overburdened maternity system.

Instead, the group recommends prioritising investment in other chronically underfunded aspects of maternity care, such as maternal mental health care services and pregnancy ultrasounds. To be successful in improving outcomes from maternity care, ideally a post-birth extended in-patient stay should be part of an integrated and flexible package of postnatal support including improved access to maternal mental health support, and wider aspects of homebased postnatal support as required.

We do not want to see a ‘postcode lottery’ determining who can access extended postnatal stays under the new legislation

The proposed Bill guarantees a minimum three-day postnatal stay for all mothers and babies. While this may seem like a positive step towards enhanced care, the groups warn that if implemented without adequate expansion of resourcing and facilities to deliver services, the Bill could have serious unintended consequences.

There is a risk that the policy could shift the provision of postnatal care from a model based on clinical need to one driven by entitlement. In such a scenario and under current capacity constraints, there is a risk that some women may be discharged before they are ready, to accommodate those who may not need an additional stay but are entitled to it.

“No woman or newborn should be discharged before they are ready. Yet in reality, some are currently being sent home due to a lack of available beds,” states Alison Eddy, CE of the New Zealand College of Midwives.

There is also a chronic shortage of midwives to support women, both in maternity units and in their homes. Extended postnatal stays will be available only in theory and not in practice if midwives are not available to support women and their newborns.

“We do not want to see a ‘postcode lottery’ determining who can access extended postnatal stays under the new legislation”, said Raewyn Stone, NCWNZ Health Action Hub Convenor. “We would like to see the Government invest in strengthening the maternity workforce as a matter of priority, to ensure that existing disparities are not deepened.”

With maternity units across Aotearoa already operating beyond capacity, introducing extended postnatal stays without expanding facilities and resources risks deepening disparities for those facing barriers to healthcare.

According to the Select Committee Report, implementing the Bill would require 175 additional postnatal beds, costing between $31.9 million and $38.3 million annually in operational expenses. Capital costs for expanding facilities would exceed $100 million. These figures raise serious questions about the Bill’s feasibility and return on investment, especially given there is limited evidence to support that longer in-patient stays lead to improved postnatal outcomes.

Dr Gibson concluded, "We welcome legislative reform that will genuinely improve postnatal outcomes. But to be effective within the current environment, it must be grounded in evidence and clinical need, and supported by the necessary investment and resources to ensure it can be delivered safely, equitably and sustainably."