Tuesday, 2 June 2009

Danger pregnant woman alert!

I was shocked to find out that immigration cancels temporary visas of women who get pregnant during their stay in New Zealand.

The women in question are students or the partners of businesspeople. Before anyone says 'what about the dollarz?', the women are paying their own healthcare costs and the children will not be New Zealand citizens as neither of their parents are New Zealand citizens or residents.

So in reality there is no cost to the taxpayer and no 'backdoor immigration' just pregnant women who apparently are are a fate worse than swine flu.

Shame on the Department of Labour for this despicable procedure.

44 comments:

cat said...

I had the impression that there is a fairly severe shortage of maternity care in NZ at the moment. So it's not about being able to pay, it's about having enough resources to care for them...

Anonymous said...

I do not agree with this policy but I know first hand of many women who simply could not pay for maternity care and so did not seek any care until labour which which is not optimal. Also in my rural area they often simply relied on the kindness of local midwives to look after them for free. These woman also avoided hospital because of fear of being charged.

Tui said...

Wait, children who are born here aren't citizens if their parents aren't? That doesn't sound right to me?

Tamara said...

Hi cat - yes, that's what the article says, and I have a feeling the print version I read over the weekend was stronger on that aspect. A question of being able to pay but there being nothing to pay for? A consequence of the underfunding of maternity services I suppose. A foreign friend of mine had her baby here a couple of years ago and her German health insurance paid. I suppose if she tried that now she's be asked to go home!

The ex-expat said...

children who are born here aren't citizens if their parents aren't? That doesn't sound right to me?Actually Tui it is. Recent changes were made that state that being born in New Zealand doesn't automatically mean you are a New Zealand citizen.

anna c said...

Tui - yes, it was changed a few years back - children are now only automatically citizens by virtue of birth in NZ if one of their parents is a citizen or permanent resident.

anna c said...

Snap!

Tui said...

Wow, that's... really lame. :-/

Dave said...

I bet you that if they were to have abortions they'd be allowed to stay.

And you are incorrect to claim that all the pregnant women are paying their own healthcare costs when just one was quoted as saying she is able to do so.

Tui said...

Actually, Dave, I believe they meant that people on temporary visas are not entitled to health care from the state, and so would be required to pay for things like maternity care whether they were able to or not.

So long as they could pay for an abortion I'm sure they would be allowed to stay - if pregnancy is the problem for some mysterious reason (lack of facilities, for example) then having an abortion would undeniably take care of the problem - that's just a consistency. I think that's really unfortunate as it borderline constitutes forcing women to have abortions, although I suppose they can choose to leave the country instead - but the situation that this law is clearly creating is one which forces women to make that choice. I'm really uncomfortable with that idea myself.

Psycho Milt said...

Wow, that's... really lame. :-/

Actually it makes a lot of sense. My son was born in Germany, 6 months before we came back to NZ. He's not entitled to German citizenship because his parents aren't German, but you could also say that he's not entitled because he has no connection with that country other than having been born there. It would be downright bizarre if he was entitled to citizenship.

Tui said...

I guess I'm pretty relaxed about citizenship.

Anita said...

To be contrary for a moment...

If New Zealand really doesn't have a sufficient quantity of maternity care, then some kind of rationing is the necessary outcome. Excluding people who have somewhere else to go and don't intend to raise their children in New Zealand seems like the least bad option when it comes to rationing until we have sufficient trained staff and resource.

All predicated, of course, on the concept that we have and insufficient quantity of maternity care. Which raises two important questions:
1) What are we doing about that?
2) Are pregnant mothers being excluded from adequate maternity care? If so, what mechanism is being used to make those decisions, and how are the risks being managed?

katy said...

Re: the citizenship thing, you are not entitled to citizenship by birth unless your parents are NZers. I understand, however, that the process for obtaining citizenship is simpler if you are born and raised here than if you are born here and raised somewhere else. Since there is not a great deal of difference between obtaining permanent residence and citizenship (from what I have seen) this would mainly be a problem for those on temporary visas, wouldn't it?

Tamara said...

Yes, Katy, I believe I read something about temporary residence, not permanent. Women or their partners on working visas etc.

Tui said...

I bet their male partners don't lose their visas. :-/

Alison said...

@ Anonymous;

I don't understand. Maternity care is free to NZ citizens and residents in NZ. All independent midwives provide free care by law (and are reimbursed by DHBs and Ministry of Health.

@ Anita;

Last week I tired of the double-speak around maternity funding from the government (more money, but not for actual midwives who provide most of our maternity care) and sent a long email asking a series of very specific and pointed questions. No reply yet, but if there is a reply with any actual, useful answers, I plan on sending in the direction of THM.

Julie said...

Here's Bomber's post on the matter too.

Anonymous said...

ALsion I was talking about providing care to women specified in the original post who are not eligible for funded maternity care in NZ and must pay their own way. Midwives are NOT funded for caring for these women.

Hugh said...

Re: the citizenship thing, you are not entitled to citizenship by birth unless your parents are NZers.Wrong. Anna is correct that the children of a permanent resident become citizens too.

I understand, however, that the process for obtaining citizenship is simpler if you are born and raised here than if you are born here and raised somewhere else.Even if this is the case, you need to pay the application fee, which is pretty significant.

Since there is not a great deal of difference between obtaining permanent residence and citizenship (from what I have seen)The main difference, other than the inability to pass residence on to your children, is that a citizen can't be deported.

I don't mean to derail the discussion, but to me the decision to make citizenship harder for children to obtain was probably in the top five things that the previous government did that made me unhappy.

Tui said...

Devil's advocate, Hugh: doesn't this almost eliminate that problem? it certainly seems icky that a child born and raised in NZ say, until the age of 5, by parents on a working visa (or parents who eventually become permanent residents) would have any difficulty (financial or otherwise) obtaining NZ citizenship. But this law actually makes that scenario impossible.

Hugh said...

Well Tui, given that there's nothing to prevent the child from returning to NZ after they're born (which seems not unlikely), I'm not sure that the law would achieve the desired effect - presuming that that is the desired effect.

But for me the issue is larger than that - I can't see any justification for shunting off people who require support overseas. So even if it's consistent with the existing laws, that's not a good argument for me, because I have a problem with the existing laws.

And this is before we begin to consider that it's possible a standard of maternal services equal to that provided in New Zealand may not be available in the country the mother and child end up in, which makes it even more unpleasant to my eyes.

Tui said...

Still arguing the devil's advocate here.

But for me the issue is larger than that - I can't see any justification for shunting off people who require support overseas. This is difficult for me too. On the other hand, the extension of your position on healthcare services would ultimately result in the rapid exhaustion of our resources (and hence our ability to help anyone.) I would hate to think of our infant mortality increasing because our midwives can't cope with an influx of people who can just about afford a flight to NZ but not good (possibly unobtainable) maternity care in their own country.

Yes, the solution is to increase funding to midwives (I think - not being devil's advocate for a second - at *minimum* people with temporary visas, which usually (unless student) include WORK which means TAX which is what we use to fund the health system should be entitled to benefit from that health system - what other medical conditions result in the revoking of the temporary visa?) But ultimately there are limited resources for all areas including maternity.

Hugh said...

Tui when you say that resources in the maternity area are limited, surely you don't mean that this limit is an absolute one, only that they're limited at any given time based on the ammount of resources the state chooses to put into healthcare. The concern you're raising doesn't seem to apply to population growth through any reason other than immigration, so I don't see why it would particularly apply to immigration.

But even if you are right, and it's necessary to turn some people away due to limited resources, shouldn't it be done on the basis of who will suffer least, not who isn't a citizen?

But really this is devil's advocacy for me too - as you know, I don't really see it as a matter of 'our' resources, or recognise the idea that a NZ citizen has greater claim on them than an immigrant, or indeed anybody else in the world. But I'm aware that this isn't really the place to discuss that kind of thing, so maybe I should be content to have said my piece.

Tui said...

Tui when you say that resources in the maternity area are limited, surely you don't mean that this limit is an absolute one, only that they're limited at any given time based on the ammount of resources the state chooses to put into healthcare.No. Resources are finite. There are not the resources in the world to sustain a whole planet of people like you and me. There are not the resources in this very wealthy but relatively small country to treat every person in this world who is suffering, and turning away people who suffer least is not sustainable or efficient long-term: small problems become big ones, especially when they are ignored en masse and especially in healthcare. This in turn leads to a gradual impoverishment of the country as we focus all our resources into healthcare, which leads to a net reduction in our ability to support new immigrants and give support to developing countries. Impoverishing ourselves is not a good way to help other people.

Free border ideals are all very well but, kind of like the free market, I don't see everything shaking out in a positive way.

Hugh said...

I'm guessing this is no longer devil's advocacy then?

I think this is something we're going to need to (and actually already have, elsewhere) agree to disagree on.

Tui said...

Yeah, not in that comment, you got through my affected neutrality! I think we agree on this specific issue (pregnant immigrants) but disagree on broader applications (and indeed on first principles: I want us to help more people, you don't believe in us.)

Hugh said...

Yea, that's pretty much where I'm at. Although it's not just that I don't believe in 'us' - I believe it's because we look at it as a matter of 'us' vs 'them' that so many people go un-helped.

Getting back to the matter at hand, and focusing on the narrow over the specific, isn't it odd that for all the rhetoric we hear about promoting family-based solutions to child welfare, this policy has the potential to split families up, since the father's visa is unaffected?

Tui said...

nd focusing on the narrow over the specific, isn't it odd that for all the rhetoric we hear about promoting family-based solutions to child welfare, this policy has the potential to split families up, since the father's visa is unaffected?Ask me what I think about revoking a pregnant woman's visa, but not that of the other person (if also on a visa) who is responsible for the pregnancy. We need to stop making pregnancy something that makes women's life harder, and we need to stop treating it as if it's a woman's problem alone.

Hugh said...

OK wait a moment.

I know we need to agree to disagree but I'm really confused.

You've said that we need to avoid a situation where healthcare spending spirals out of control due to unlimited entitlements.

But you've also said we need to prevent a pregnancy from making a woman's life harder. A major part of that would have to supplying healthcare and other resources (education, food, accomodation, training etc) based on need.

I can't see how you can square these two statements.

Tui said...

For the record, I think the reason I keep returning to this disagreement is because I really would like to agree with you and I want you to convince me.

You've said that we need to avoid a situation where healthcare spending spirals out of control due to unlimited entitlements.

But you've also said we need to prevent a pregnancy from making a woman's life harder. A major part of that would have to supplying healthcare and other resources (education, food, accomodation, training etc) based on need.
It's not a contradiction because I'm not limiting the amount of resources given, I'm limiting the number of people who are "entitled" to these resources on a practical level. (Of course everyone in the world is entitled to good health care, good health outcomes, a good standard of living. But I don't think it's possible to go out and provide everyone with that right now.) It will not break the bank to ensure that every pregnant woman in New Zealand Aotearoa, including those on temporary visas*, has access to a good level of maternity care, and then following birth to paid leave, good follow-up health care, education, food, etc.

*I possibly would go so far as to restrict holidayers, but probably not. It's not really safe for women to fly towards the very end of her pregnancy when she might conceivably accidentally or "accidentally" go into labour so I would assume anyone taking this risk is desperate enough that they really need our care: probably my restriction would be "can get into New Zealand legally", which is - yes - a very arbitrary restriction indeed. I would hope that that would include relatively high numbers of refugees.

Of course I'm not comfortable drawing an arbitrary line in the sand and saying "I'll use my luck of being born in this country to (through taxes, etc) help you and you, but not you and you and you"; and I would hope my line in the sand is a lot more generous than the average righty. But my feeling is that the line has to be drawn somewhere, and we are obliged to take responsibility for drawing that line and preserving our own luck by committing - with money and resources - to supporting developing countries.

Hugh said...

For the record, I think the reason I keep returning to this disagreement is because I really would like to agree with you and I want you to convince me.

Really? That's kind of reassuring, I thought it was because I was just like a dog with a bone on this issue and not very good at agreeing to disagree. Anyway...

Obviously I am not arguing that the New Zealand government alone could turn the world around by having a free border and healthcare entitlement policy (although I am sceptical about the idea that there is a risk of being overwhelmed if local policies are too generous - for reasons that I may need to go into later, but I'll leave them as an aside for now).

But there's very little that the New Zealand state alone can do for most global problems. To take another popular global cause, it's unquestionably true that even if New Zealand were to transform its economy into one that was absolutely environmentally unimpeachable, this alone would have no noticeable effect on the world's atmosphere. That's not a reason for us to not demand that the state that claims to represent us adopt the most moral policy possible. I'd argue it's the same for immigration.

If we're going to accept that policy is going to be made by states and states (particularly small ones) have limited resources, I suppose a line does have to be drawn, but my problem with the use of this particular arbitrary line is that it prioritises those who are already, in global terms, at the top of the heap. I know it's kind of perverse to be talking about women denied maternal care as privileged, but in a global context, I'd argue that that's still the case.

You've mentioned foreign aid as a way of fulfilling our moral obligation to assist our fellow human beings with whom we don't share citizenship. Obviously the % of state spending that even the most generous western nations spend on foreign aid is miniscule when compared to what they spend on even relatively stingily funded social services. This seems to me a clear statement that people outside the country just aren't that important. Distributing resources on the basis of citizenship just seems to me to ensure that people who are already relatively privileged recieve the majority of assistance - an all too common phenomenon in any such system, whether state-directed or private.

If an arbitrary line absolutely must be drawn, why not make it explicitly arbitrary and just hold a lottery, rather than use the citizenship system?

katy said...

"Re: the citizenship thing, you are not entitled to citizenship by birth unless your parents are NZers.Wrong. Anna is correct that the children of a permanent resident become citizens too."

Not "citizenship by birth" though, which was my point. Or am I wrong? I try to keep up with NZ immigration law but it is a frustrating activity.

Alison said...

@ Anonymous

Thanks, I understand now. I must have been a bit slow of brain when I read your reply!

Brenda said...

I'm 12 wks pregnant and this "maternity care is free" stuff is pissing me off. It's 100% booked out. It's free but you can't have any.

This is my first (and definitely last) kid. I have no idea what I'm doing, and only getting emergency care when I collapsed from dehydration (nausea, can't even keep down water)

Instead of sending people home, we need more midwives and obs. There aren't enough for kiwis. But were all needing care regardless of nationality.

Anonymous said...

Brenda - thats terrible. Certainly there are huge maternity shortages in NZ (Wgtn is very bad) but in other pockets they are "over run" with LMCs.

Hospitals usually provide a primary service for women who can't find a midwife but its not optimal

Tamara said...

Hi Brenda
I'm sorry to hear you're struggling so much, that's not fair! I was under the impression that if you can't get an independent midwife a hospital team has to take you for your antenatal care. Have you tried getting help from Mama Maternity Services? They know all about these things. Where are you located?

Hugh said...

Hi Katy

My understanding is that there are two types of citizenship:

Citizenship by descent, which is somebody born overseas who is the child of one or more NZ citizens.

Citizenship other than by descent. This covers people who are granted their citizenship after going through a citizenship ceremony (after a lengthy application process), and also people born in NZ as the child of an NZ citizen or resident.

The only difference between the two is that a Citizen by descent can't pass their citizenship on to children unless those children are born in NZ.

So, in a legal sense, there's no such thing as Citizenship by birth.

Alison said...

Oh Brenda, soory you're having trouble finding a midwife. You're right that there just aren't enough, and nothing is really being done to provide more.

It is correct that you should get in touch with the hospital though; they will provide your care if you can't find an independent. I'd also suggest continuing to ring around midwives, or asking some to put you on a waiting list, as women may move out of the area during pregnancy, or change or leave midwives for other reasons.

barvasfiend said...

I'm surprised the Department of Labour is drawing attention to this - basically it just shows up the gaping holes in the NZ healthcare system.

Here in Australia, New Zealand is often held up as a shining example of maternity care, especially in terms of the LMC model. Here, the debate centres on the "turf war" between doctors and midwives. In NZ it seems the system has 'devolved' from doctors but without any long term planning in terms of the maternity care required.

It is something that is often overlooked I think, but in Australia, having a lot of maternity care provided by your GP means that you are less likely to be relegated to missing out on care. For instance, retaining GPs in rural areas is a huge political issue and I think pregnant women gain from having their voices and needs lumped in with the needs of the rest of the community.

As tragic as it may seem, I think if maternity care was separated out from general practitioning it would be easier to marginalise it. I wonder if this is what happened in NZ. Brenda's story is staggering to me, and incredibly sad.

katy said...

Hi Hugh

That term is used in Immigration NZ materials but given how random so much of their information often turns out to be I wouldn't be surprised if it had no basis in legality :)

Hugh said...

That's interesting Katy... my info comes from my time in Internal Affairs, which is responsible for granting citizenship. But we always had a pretty dim view of Immigration's attempts to understand the law around citizenship. I'm a bit shocked that that confusion is being promoted to the public, though.

Tui said...

@barvasfiend, I'm not sure there's any need to throw the baby out with the bathwater (as it were.) When maternity is seen as a GP issue then, yeah, it can gain some traction in terms of banding together with everyone else in rural areas to get care, but ultimately lumping the needs of pregnant women in with the needs of everyone else will result in substandard care, because maternity does have different needs (especially, for example, antenatal care.)

Alison said...

Barvasfiend, it's important to understand that midwife autonomy was in part a reaction to the fact that GPs were already leaving maternity care because it didn't fit in with the requirements of providing GP care. That was forcing women into obstetric care, which wasn't want a lot of them wanted. Despite what is portrayed by the media, only a few GPs were still providing maternity care by the time midwives gained autonomy in 1990.

Now, the shortage of LMCs is self-perpetuating. The workload on independent midwives is unsustainable (especially since they provide round the clock continuity of care, and get little leave or downtime), and many end up leaving the profession after a few years.

The LMC model is excellent in many ways, but needs financial support from the government. For some reason that hasn't been forthcoming in the amounts it is needed, even though midwifery care is more affordable than a medical model for pregnancy. There is inadequate funding for training, so many potential midwives aren't accepted for courses, insufficient numbers are trained. That means there aren't enough to replace the current workforce with an average age over 40. The problem isn't the LMC model per se, or the midwifery model of care. It's the lack of funding provided for maternity care, because it's seen as low priority compared to other healthcare issues.