A landmark High Court ruling has found the Crown breached its obligations to midwives and engaged in unlawful sex-based discrimination, in a decision set to reshape the future of maternity care in Aotearoa.
The judgment stems from a class action brought by the New Zealand College of Midwives, which argued the government failed to honour a 2018 settlement and continued to underfund Lead Maternity Carer midwives despite clear commitments to reform.
The Court found the Crown did not implement a national midwifery agreement as promised, failed to act in good faith, and maintained funding arrangements that treated midwives unfairly. Those arrangements, delivered through funding notices rather than negotiated agreements, were ruled to amount to unlawful discrimination on the basis of sex.
The case was driven by years of concern from midwives who say their work has been undervalued and underpaid, despite the critical role they play in caring for pregnant women, pēpi and whānau across the country.
For the College, the decision validates long-standing claims that midwifery has been structurally underfunded compared to other parts of the health system, reflecting gendered inequities in how care work is valued.
The ruling is expected to have major implications for midwives’ pay and conditions, with calls now intensifying for the government to move quickly to establish fair, sustainable funding and to properly recognise the profession.
Advocates say the outcome must lead to tangible change, including a shift away from piecemeal funding decisions toward a formal national agreement that reflects the complexity, responsibility and cultural importance of midwifery care.
The implications extend beyond pay.
For Māori midwives and whānau, the decision is seen as a critical step toward strengthening culturally grounded care, including support for homebirth and kaupapa Māori models of maternity services. Many argue that chronic underfunding has disproportionately affected Māori providers and limited access to culturally safe care.
The sustainability of midwife-led care is also at stake. Workforce shortages, burnout and retention challenges have been growing concerns, with many midwives leaving the profession or reducing their hours due to financial pressure.
The Court’s findings are likely to increase pressure on the government to act urgently, not only to address historic inequities but to ensure the future of maternity services is secure.
For whānau, the outcome has real-world implications. Midwives are often the primary point of care throughout pregnancy, birth and the early weeks of a baby’s life. Any changes to funding and support structures will directly impact the quality, accessibility and continuity of care available to families.
The decision marks a significant turning point in the long-running struggle for recognition within the profession, and sets the stage for what could be one of the most important reforms in maternity care in decades.
