In a submission to the Education and Workforce Parliamentary Committee the Society indicated support for changes to ACC legislation designed to broaden cover for maternal birth injuries.  These changes are contained in the Accident Compensation (Maternal Birth Injury and Other Matters) Amendment Bill.

The Bill would amend legislation to ensure women who sustain tears, uterine prolapse and some other physical trauma in labour and childbirth, can access funded treatment including surgeries and pelvic physiotherapy.

Currently birth injuries that are treatment injuries have ACC cover.  The bill amends legislation to ensure women who sustain tears, uterine prolapse and some other physical trauma in labour and childbirth, can access funded treatment including surgeries and pelvic physiotherapy.

Many of these injuries share characteristics with sprains or strains, but aren’t covered by the scheme despite 85 per cent of New Zealand women experiencing an injury when giving birth

The amendments relating to maternal birth injuries are supported and the proposed extension to birth injury coverage is welcomed.

The changes are supported for a number of reasons including:

·        Potentially improved and more equitable access to services, treatment, rehabilitation, and support for women suffering birth injuries.

·        More timely access to some treatment services for some women. This should not be necessary, as timely access should be available through the healthcare system as opposed to the ACC scheme.

·        Additional financial support and social support for women with severe birth injuries and/or those undergoing prolonged rehabilitation. 

·        There is coherent basis for the extension. 

·        Restricting ACC coverage to treatment for maternal birth injuries has always been anomalous, given that all maternal birth injuries involve common mechanisms and consequences.

·        It will avoid women having to establish that their birth injury meets the 'normal requirements of a treatment injury'. This has clearly been a problem in the past.

·        The costs involved are minimal and, to some extent, are limited to a cost transfer.

·        The list of maternal injuries in the proposed schedule 3A appears comprehensive and logical.  

·        The use of a specified list has clear merits, insofar as it will provide a high degree of certainty as to what has coverage.

While the proposed changes highlight the disparity between the ACC and healthcare systems, the Society position is that the changes still have merit. 

Moreover, they are unlikely to create a problematic precedent, in that, extending coverage more generally to birth injuries relates to a unique scenario or set of circumstances.

Injuries listed in the proposed schedule include:

·        Labial, vaginal, vulval, clitoral, cervical, rectal, and perineal tears

·        Levator avulsion

·        Obstetric fistula (including vesicovaginal, colovaginal, and ureterovaginal)

·        Obstetric haematoma of pelvis

·        Pudendal neuropathy

·        Ruptured uterus during labour

·        Uterine prolapse

Ideally that list should and may well be expanded when the bill is reported back to the house. 

Although the Society submission focused on the birth injury changes, various other changes on the Bill designed to improve access and support for injured persons and/or reverse some previous, ill-advised changes were also supported.

In a submission to the Education and Workforce Parliamentary Committee the Society indicated support for changes to ACC legislation designed to broaden cover for maternal birth injuries.  These changes are contained in the Accident Compensation (Maternal Birth Injury and Other Matters) Amendment Bill.

The Bill would amend legislation to ensure women who sustain tears, uterine prolapse and some other physical trauma in labour and childbirth, can access funded treatment including surgeries and pelvic physiotherapy.

Currently birth injuries that are treatment injuries have ACC cover.  The bill amends legislation to ensure women who sustain tears, uterine prolapse and some other physical trauma in labour and childbirth, can access funded treatment including surgeries and pelvic physiotherapy.

Many of these injuries share characteristics with sprains or strains, but aren’t covered by the scheme despite 85 per cent of New Zealand women experiencing an injury when giving birth

The amendments relating to maternal birth injuries are supported and the proposed extension to birth injury coverage is welcomed.

The changes are supported for a number of reasons including:

·        Potentially improved and more equitable access to services, treatment, rehabilitation, and support for women suffering birth injuries.

·        More timely access to some treatment services for some women. This should not be necessary, as timely access should be available through the healthcare system as opposed to the ACC scheme.

·        Additional financial support and social support for women with severe birth injuries and/or those undergoing prolonged rehabilitation. 

·        There is coherent basis for the extension. 

·        Restricting ACC coverage to treatment for maternal birth injuries has always been anomalous, given that all maternal birth injuries involve common mechanisms and consequences.

·        It will avoid women having to establish that their birth injury meets the 'normal requirements of a treatment injury'. This has clearly been a problem in the past.

·        The costs involved are minimal and, to some extent, are limited to a cost transfer.

·        The list of maternal injuries in the proposed schedule 3A appears comprehensive and logical.  

·        The use of a specified list has clear merits, insofar as it will provide a high degree of certainty as to what has coverage.

While the proposed changes highlight the disparity between the ACC and healthcare systems, the Society position is that the changes still have merit. 

Moreover, they are unlikely to create a problematic precedent, in that, extending coverage more generally to birth injuries relates to a unique scenario or set of circumstances.

Injuries listed in the proposed schedule include:

·        Labial, vaginal, vulval, clitoral, cervical, rectal, and perineal tears

·        Levator avulsion

·        Obstetric fistula (including vesicovaginal, colovaginal, and ureterovaginal)

·        Obstetric haematoma of pelvis

·        Pudendal neuropathy

·        Ruptured uterus during labour

·        Uterine prolapse

Ideally that list should and may well be expanded when the bill is reported back to the house. 

Although the Society submission focused on the birth injury changes, various other changes on the Bill designed to improve access and support for injured persons and/or reverse some previous, ill-advised changes were also supported.