Kia Ora Supporters
Right now we have an opportunity to put in submissions for the ACC Maternal Birth Injury and Other Matters Amendment Bill.
This email is a guide to doing a submission and why it's important that we do one, there is still more that needs to be done. I highly recommend you tell you stories, and the effect that it has had on the quality of your life physically and mentally. We strongly encourage all that have been affected by Birth Injury to please put forward a submission, because our voices need to be heard.
We have until midnight Friday, 11 February 2022 go get our submissions in, so please do not delay.
Submission Guide - Accident Compensation (Maternal Birth Injury and Other Matters) Amendment Bill
INTRODUCTION
Thank you for taking the time to make a submission on the Accident Compensation Amendment Bill.
The amendments to the current Accident Compensation Corporation (ACC) legislation are welcome and we applaud the government for initiating change.
However, the amendments do not go far enough to support women and birth givers who suffer both physical and psychological injury related to child birth.
We need as many people as possible to make submissions on the proposed amendments to have the best chance of more birth givers, more birth injuries (both physical and psychological) and their babies being covered by the amended legislation.
Changes to the way these people are supported is critical if we are to see thriving parents, whānau and communities.
It is suggested that 85% of New Zealand women and birth givers suffer childbirth injury. We also know that 1 in 3 birth givers report their birth as traumatic (1; 2).
Many people consider physical and/or psychological injury to be “just a part of birthing” – this does not have to be the case and, when injury arises, everyone deserves treatment and support.
Many of us are consumers of maternity services in Aotearoa and are also birth trauma survivors – please go gently with yourself and gather support if you need it.
Please see the background to the bill as to why, what, and other amendments that are needed and the steps to make a submission
and points you may wish to include in your submission.
BACKGROUND AND ADDITIONAL INCLUSIONS
The main objectives of this bill are to provide more equitable coverage for injuries covered by the Accident Compensation Scheme, to provide greater clarity for claimants, and to better give effect to the policy intent of the Accident Compensation Act 2001.
To be covered under the current legislation an injury must occur due to an “external force” and a foetus is not considered external to the birth giver until they are born. This means that many injuries sustained during birth are not covered.
Also, injuries currently only receive ACC cover if they are found to have occurred due to treatment or lack of treatment during birth. This means if a birth injury “just happens” it won’t be covered by ACC. It also means that those injuries due to treatment (or lack of) need to be proven by the birth person and her health care staff. This process can be gruelling for parents who are injured, recovering from birth, caring for baby and possibly other family, and often in paid employment.
Further, ACC recently changed the way it interprets the existing legislation. This simple change to the interpretation of the law is resulting in fewer ACC claims being accepted.
FURTHER AMENDMENTS TO THE BILL ARE REQUIRED
In summary:
the proposed amendments to the bill include a list of birth injuries which would be covered.
- Many birth-related injuries are therefore excluded
all birth-related injuries - Both physical and psychological - must be included in the amended legislation
- The bill is not retrospective.
- The amendment bill includes an exhaustive list of birth injuries which would be covered under ACC, as opposed to cover for all birth injury. This decision was made due to the cost of covering all birth-related injuries.
All physical injuries related to birth should be covered under legislative change, no matter the cost. - Psychological injuries resulting from birth are not covered in the proposed legislation changes. While psychological injury relating to physical injury is mentioned in the legislation, psychological injury can occur independent of psychical injury. Psychological injury can be as debilitating as physical injury and those who suffer mental injury due to birth require coverage under the scheme.
- Injuries to baby are not specifically covered in the amendment bill. Injuries sustained by baby during birth can have life-long consequences for baby and parent. The baby, their parents and whānau need to know they have treatment, assistance and support for as long as needed following injury.
- The amendment bill will only cover injuries which have occurred following the October 1, 2022 date. Any injury sustained prior to this date will only receive cover under the existing legislation. This is incredibly frustrating and unfair for those who have already sustained a birth injury. Most of these injuries are not currently covered and timely, effective treatment often needs to be funded personally by the birth giver.
APPLICATION PROCESS CHANGE IS CRITICAL
At present, the application process by women/birth givers for injury cover is time and energy-consuming, convoluted and difficult. Struggling through this process comes at a time when parents are already exhausted, let alone physically and/or psychologically debilitated.
The application process for birth-related injury needs to change:
ACC must engage with consumers (claimants and their supporters, including support agencies) in the design of the system, end to end
claimant focused processes: procedures, documentation, communication, processing of compensation or entitlements and activities need to be focused on the experience and outcomes of the claimant collaboration with stakeholders: communication and collaboration with other key stakeholders, such as medical practitioners, must be proactive, to ensure there are consistent support measures in place for the claimant
the application process for coverage should be clear, transparent, supportive and must not re-traumatise the claimant
continuous improvement of the process through evaluation and feedback.
CONCLUSION
The access of support following (physical and psychological) birth injury benefits not only the birthing parent but also their baby, their whānau and our wider communities – when parents receive the support they need, the parents themselves, their baby, and their whānau thrive and this positive effect ripples through our communities.
Birth injury is not something women and parents just need to endure – appropriate treatment, care and support is available and women and birth givers are deserving of it.
Having the support and treatment of birth injury, in all its forms, covered by legislation should result in improved care and accountability by health care professionals.
Supporting mothers and birth people who are injured following birth is preventative healthcare. If we manage health challenges early on, they are less likely to become significant, and costly, health challenges in the future.
MAKING YOUR SUBMISSION
Visit this web page
https://www.parliament.nz/en/pb/sc/make-a-submission/document/53SCEW_SCF_BILL_118133/accident-compensation-maternal-birth-injury-and-other
2) Click on the button “I am ready to make my submission”
3) Follow the prompts and then either upload your submission or type it in to the box.
Here’s an easy format to follow; below are points you may wish to include:
Start with whether you support or oppose this bill. E.g. “I oppose the bill in it’s current form because...”
Use simple, clear language and avoid jargon; use bullet points – list what you do/don’t like about the bill and why?
If you feel comfortable, share your personal experience as this is one of the most valuable things a submission can offer. (Please do see the notes below if you are sharing your story).
Make recommendations – what are the things you believe could make the bill better?
Give a summary – what are the main points you want to the select committee to remember?
4) Done!
POINTS YOU MAY WISH TO INCLUDE IN YOUR SUBMISSION
The following points are those that Birth Trauma Aotearoa has identifed and has included in their submission.
You may want to include any that you agree with, as well as any other points you feel are important.
The bill does not include psychological trauma or injury – support services for this injury related to birth are severely lacking and challenging to access.
Recommendation: Extended cover to include psychological injury relating to childbirth.
The list of injuries covered by the bill is exhaustive. This exhaustive list excludes many injuries that occur during birth. Further, what was the process involved in creating this list? Was a range of health professionals consulted? Were consumers consulted?
Recommendation: For ACC legislation to be drafted to ensure that all birth-related injuries are covered.
The Bill does not provide retrospective cover – those who are already injured, or who sustain an injury prior to October 1st, 2022, are excluded from this cover.
Recommendation: Include cover for those who have/do sustain an injury prior to the October 1st date.
The Bill does not currently include cover for injuries to a baby sustained during birth.
Recommendation: That injury to mother/birth giver AND their baby which is sustained during birth be covered by legislation.
At present, the process women and birth givers need to go through in order to even apply for injury cover is time and energy-consuming, convoluted and difficult. Struggling through this process comes at a time when parents are already exhausted, let alone physically debilitated. Recommendation: Streamline the application and support process; make these processes consumer focused.
Recommendation: Birth-related injury to be diagnosed by a midwife, obstetrician/gynaecologist, GP or physiotherapist. This will ensure a faster, more streamlined application and support/treatment process.
Recommendation: Considering we understand the impacts of both physical and psychological ill health related to child birth, Birth Trauma Aotearoa recommends that every birth giver in Aotearoa is offered at least 3 physical and 3 psychological support sessions post-birth, as part of standard care, with the option to extend this support out to further sessions if needed.
PLEASE NOTE
Your name and submission will be published and therefore publicly available – please remember this if you are sharing your story or personal details. If you are sharing your personal experience, you may wish to be mindful of any details of your story that may identify others.
On that note, writing your story can be a big, sometimes hard and triggering process – please go gently with yourself, reach out for support if you need it and do what you need to, to keep yourself safe and supported.
When you follow the prompts, you will be asked if you would like to make an oral submission (in person in Wellington, or via ZOOM) – this is entirely up to you. Your written submission will still be considered if you do not submit orally.
The most effective way to make a submission is to make it your own. Try to avoid cut & pasting as the select committee (the group of people who read through and hear submissions) won’t take as much notice of submissions that sound very similar.
Use your own words, share your voice.
Ngā mihi nui - thank you so much for speaking up for women, birthing people, their babies and whānau.
For birth trauma support visit My Birth Story: https://www.mybirthstory.org.nz
For updates on birth trauma advocacy, education, research and support in Aotearoa visit Birth Trauma Aotearoa: https://www.facebook.com/birthtraumaaotearoa
References:
1) Soet, J., Brack, G., Dilorio, C. (2003). Prevalence and Predictors of Women's Experience of Psychological Trauma During Childbirth.
2) Creedy, D., Shochet, I., Horsfall, J. (2001). Childbirth and the Development of Acute Trauma Symptoms: Incidence and Contributing Factors.