Infants, young children, pregnant women, & the role of midwives in emergencies in New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Emergency Management at Massey University Wellington, New Zealand

Abstract

In 2023, New Zealand (NZ) experienced the North Island Severe Weather Events (NISWE) which began with the Auckland Anniversary flooding and culminated in Cyclone Gabrielle, the latter of which caused significant flooding in the Hawke’s Bay. While the NZ government commissioned several reports assessing the response to the NISWE, none of these reports assessed the emergency management response for infants, young children, and pregnant women (IYCP). IYCP have unique vulnerabilities during an event which need to be accounted for in emergency management planning and procedures. The aim of this research is to improve outcomes for IYCP in future events by learning from NZ's IYCP response to recent disasters.

Semi-structured interviews were held with emergency management professionals, midwives, and other responding organisations to determine:

1. How well did the emergency management response meet the needs of IYCP after NISWE? 2. Based on interviews with midwives, what were the experiences of their patients in recent events in NZ, including NISWE? 3. How might the needs of IYCP be better met during and after an event?

With the data gathered from the interviews, a focus group was held to discuss the research findings and discuss potential solutions in a collaborative environment. The interview and focus group questions were developed in response to the literature review findings and case studies.

The key findings from this research include the following:

● Lead maternity carer (LMC) midwives are not routinely included in emergency management planning and preparedness in NZ, and the needs of IYCP may not be met before, during, and after an event. It would be beneficial to include an LMC midwife in welfare group meetings. ● Emergency management would benefit from IYCP training to ensure international legislation and best practices are being followed. Midwives would benefit from training and tailored planning to ensure they can continue to provide care during and after an event. ● Existing emergency preparedness resources for IYCP in NZ do not align with international legislation and best practices and are often difficult to use. ● Evacuation centres are often unsafe for infants and very young children, and breastfeeding mothers may find it difficult to continue feeding. Emergency management should plan for evacuation centres to have a baby friendly space which includes a safe place for young children to play, supports safe infant sleep, private space for mothers to breastfeed, and allows for the distribution of infant formula and necessary supplies to those who need it.

The findings of this study are consistent with other research suggesting that NZ emergency management does not have appropriate planning to meet the needs of vulnerable populations in emergencies. If emergency management and LMC midwives can develop a collaborative relationship, IYCP vulnerability in future events could be significantly decreased.