Midwives accused of threat to babies

New Zealand's top public health official has accused midwives of endangering the health of babies by distributing anti-immunisation messages to expectant mothers.

Dr Colin Tukuitonga, the director of public health, says some midwives could be held legally responsible for babies or children who become sick when they could have been immunised against disease.

The College of Midwives strongly denies the accusation, but Dr Tukuitonga is furious at what he calls anecdotal evidence that midwives are handing out anti-immunisation literature.

He said he was seeking a legal opinion, as he believed midwives who did not promote immunisation were in breach of their contracts as lead maternity caregivers.

Dr Tukuitonga said general practitioners and hospital paediatricians had told him that some midwives were opposed to immunisation and had disseminated leaflets warning of the risks.

"If a child is damaged by a disease that could be prevented by vaccination, the provider could be liable for damages."

Providers who claimed subsidies from the state had a contract to promote good practice, he said.

And those who did not agree with guidelines and good practice should not claim subsidies.

"If they do, they are in breach of their contract."

Dr Tukuitonga said the anti-immunisation pamphlets being distributed were biased and misleading.

He wanted midwives to be more discreet about their personal views.

"Young parents with babies are easily confused."

Dr Tukuitonga said there were still epidemics of diseases such as measles and whooping cough that should be controlled by immunisation.

New Zealand had very poor immunisation coverage despite its being one of the few cost-effective interventions known.

Immunisation Advisory Centre director Dr Nikki Turner believed that the misinformation was being spread by midwives throughout the country.

"At first we thought it was just a few isolated cases ... but we then realised through our networks it was quite widespread."

Dr Turner, a University of Auckland primary health care researcher, said she had heard of anti-immunisation leaflets being offered alongside ministry material.

The ministry pamphlets and booklets explained immunisation, the diseases, vaccines and the side- effects.

Dr Turner said the antenatal period, when midwives were most involved, was crucial for parents making up their mind whether to immunise.

"Our research shows 88 per cent make up their mind then, so the information provided by midwives is crucial."

Dr Turner said parents were easily scared so it was very important they received clear and accurate information.

But the information contained in pamphlets published by the Immunisation Awareness Society was incorrect.

"It is a whole pile of scaremongering. Large parts of it are wildly inaccurate."

Dr Turner said midwives justified their actions on the basis of balance and informed consent.

"But when the data is wrong, it is not informed consent."

Dr Turner said the Immunisation Advisory Centre was working to assess the level of immunisation, but believed that well under 90 per cent of babies were being immunised at six weeks.

College of Midwives president Sandy Grey said 94 per cent of babies were being immunised at six weeks, which proved midwives were doing a good job.

Mrs Grey said it was "absolutely incorrect" to say midwives were deliberately spreading anti-immunisation messages.

"It is not our job to influence people with our opinions ... Our care centres around educating, promoting and supporting immunisation."

The founder of the Immunisation Awareness Society, Hilary Butler, said she did not know midwives were using the pamphlets, but would be happy if they did.

"We are just attempting to provide a bit of balance ... Colin Tukuitonga is stifling debate."

She said the society's pamphlet had been revised after the ministry complained to the Advertising Standards Authority, which later approved a slightly amended version.