Life as a nurse and midwife on the remote Great Barrier Island

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Adele Robertson has been helping women give birth on Aotea Great Barrier Island since 1994.
Photo: Shepherdess / Michelle Marshall

Position – Midwife and rural nurse Adele Robertson, 70, has spent most of her working life enabling women in the isolated communities of Aotea Great Barrier Island to have children at home. But now that she’s retired, the way babies are born on the island may need to change.

As told to Sionainen Mentor-King.

I have been on Great Barrier Island for 37 years. I did my nursing training at Auckland Hospital and then went to Australia for eight years. While I was there I started working with women and children and I realized quite a lot happens before and during birth. So I came back to New Zealand to do my midwifery training at what was then St Helen’s in Auckland. After that I spent two years consolidating my education. My partner Shannon and I are both country people and we originally planned to return to Australia but decided to try rural New Zealand first – the track on Great Barrier Island was very similar to what I had done in Australia.

In 1994 I came to see the general practitioner of the island and his wife [Ivan and Leonie Howie] and we founded a company, Aotea Health. We took over all the health services and merged the public health aspect and general practice – before that he was private and I was half public health and half district nursing, and obstetrics was thrown somewhere in the middle. Ivan and I were both new to home births when we came to Great Barrier, and once we had a few deliveries we couldn’t believe how amazing it was.

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When I first started attending births, hardly anyone here had alternative power. People worked on 12-volt systems, or they just used candles. Ivan’s job was often to hold the torch so we could see what we were doing. Then water births came into fashion and the realization that you didn’t really have to see, you could really feel what was happening. Some women wanted a water birth, but the logistics of it were terrible. Most people on the island had small hot water cylinders that were heated by a fire, so trying to fill a birthing pool was quite difficult.

Being an island and with the weather, planes don’t always fly and helicopters don’t always come, especially at night. So what you have is what you have, and that’s what you have to make do with. It’s always the middle of the night, and it’s always when there’s a big storm. There’s a risk involved with home births here, and the women always know that. There are, of course, daytime births, but probably only 20 percent, compared to 80 percent at night. Dawn births are beautiful; I’ve had many babies while the sun was rising, and it’s such a spiritual moment, but it does mean you haven’t slept.

The nice thing about this location is that I don’t stop seeing these babies after they are born. After six to eight weeks, I put on another hat and become a pediatric nurse. And then I’ll put on another hat and become a school nurse. And then they go away and get professions and partners, and now they’re all back and I help deliver their babies.

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I’m still caring for women right now, prenatally, but it’s just too hard [now] do the deliveries alone. I’ve always done many of the deliveries alone, but if I needed help there was always someone in the background to help. It’s only gotten harder – and many of the births take place on the other side of the island. It’s an hour there and an hour back, and then there’s all that time at birth. I’m just not recovering as quickly as I used to, and there comes a time when you feel like it could be dangerous. I had three deliveries on my own at the beginning of the year, and two were at night. Both were quite long and tiring and I thought “It’s time, I have to stop”. My husband asks, “How long have you been doing this?” and I say, “Well, the Queen worked until she was almost 100”. He says “I think she had a bit more support than you”.

Some time ago a midwife came to replace me, but in the end she said there was too little obstetrics and too much nursing. As a nurse, I have a car and all the emergency equipment and all that stuff, which makes it easier, and basically primary health care subsidizes the midwife. There is not enough money to do obstetrics alone. I’m exploring other options, and things are happening for women, but right now they’re going off the island before birth. We will always have antenatal care available, but it may not be possible to give birth at home.

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With childbirth, every intervention has a consequence. One of the first and most common interventions is to remove women from their own safe environment – their home. What hinders birth, what slows everything down, is fear and pain and not knowing the people you are with. When you go to the hospital, even me as a midwife, I feel very vulnerable and out of my depth. That’s what the women feel, and their partners feel it even more.

When you step into the hospital, no matter how welcoming they are, you find yourself in a strange environment. You feel more pain when you’re tense, and that makes you more tense, and that slows down the whole procedure. When women are working at home, they are relaxed. They didn’t have to pack or go anywhere. They are in their own environment. They have their own music, they often have their friends around them. So everything seems to be going smoothly. You can be very detached and just let the women do what their bodies tell them to do. And that’s really powerful. I didn’t do it for them, they did it themselves. It is very liberating and there is a lot of laughter. For me, it’s about empowering women and their partners through a positive birth experience.

*This story was originally published on The Shepherdess and is republished with permission.

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