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Background: New Zealand midwives who are employed by District Health Boards and are based in hospitals and maternity units are known as core midwives. Half of New Zealand midwives are employed as core midwives, performing a variety of key roles and, as such, are central to the functioning of maternity services. The sustainability of core midwifery is therefore highly significant for the future of maternity services in New Zealand. Research on sustainable midwifery practice operates as a constructive counterpoint to the growing literature on burnout and stress amongst midwives. Aim: The question this study asked is: What sustains midwives who have been in hospital practice in New Zealand for more than eight years? The findings will inform workforce planners, managers and the midwifery profession about what may well contribute to the retention of midwives who are essential to the maternity services provided in hospital settings. Methods: A qualitative descriptive study was conducted in New Zealand, recruiting and interviewing 22 core midwives with between 8 and 40-plus years' experience. Interviews were transcribed and thematic analysis was undertaken by the research team. Analysis was done as a group in a reciprocal fashion between the individual interviews and the data as a whole. Themes were clustered into groups and excerpts from the data used to illustrate the agreed themes. Ethical approval was obtained from

This paper explores the current influences and expectations in relation to adverse events in New Zealand's maternity setting and the affect these have on midwives. Midwives, like other health professionals, have the potential to become the second victim, a term used to encompass the health professional's feelings of despair following an adverse event. Insights from international research and reports are related back to midwifery and a growing number of New Zealand qualitative studies that identify the effect of adverse effects on midwives are highlighted. The evidence indicates that the current tools or support measures that are implemented at the individual or group level may be limited in their effectiveness. Common principles emerge from the literature that could facilitate a midwife's safe journey through the emotional distress when there is an adverse event. These are: understanding the nature of midwifery practice, the midwife's own emotional well-being, providing safe environments, seeking and receiving professional reassurance, and a willingness to learn from the adverse advent. An action research study is planned by the primary author to work with midwives about their experiences of successfully navigating adverse events with the aim of facilitating accessible support to reduce the trauma of adverse events. For midwives to be able to support women and their families they too need to be supported.

These findings have been used to support introduction of an EWS to the maternity unit at ACH.

New Zealand’s response to COVID-19 was go hard and go early into Level 4 lockdown on 25th March 2020. This rapid response has resulted in low rates of infection and deaths. For New Zealand midwives, the sudden changes to how they work with women and families during pregnancy, birth and postnatally, especially in the community, required unprecedented innovation and adaptation. The volume of information coming from many different sources, and the speed with which it was changing and updating, added further stress to the delivery of a midwifery model of care underpinned by partnership, collaboration, informed choice, safety and relational continuity. Despite the uncertainties, midwives continued their care for women and their families across all settings. In the rapidly changing landscape of the pandemic, news media provided a real time account of midwives’ and families’ challenges and experiences. This article provides background and discussion of these events and reports on a content analysis of media reporting the impact on the maternity system in New Zealand during the initial surge of the COVID-19 pandemic. We found that the New Zealand midwife was a major influencer and initiator for relational care to occur uninterrupted at the frontline throughout the COVID-19 lockdown, despite the personal risk. The initial 5-week lockdown in March 2020 involved stringent restrictions requiring all New Zealanders, other than essential workers such as midwives, to remain at home. Midwives kept women, their families and communities central to the conversation throughout lockdown whilst juggling their concerns about keeping themselves and their own families safe. Insights gained from the media analysis suggest that despite the significant stress and upheaval experienced by midwives and wāhine/women, relational continuity facilitates quality and consistent care that honors women’s choices and cultural needs even during situations of national crisis.