A perfect storm of health problems has created a substandard environment for pregnant women at Middlemore Hospital in south Auckland.
A scathing review of the local DHB's maternity staffing and bed numbers has found urgent changes are needed.
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Too few staff, not enough beds, and a break down in best practice has lead to the recent deaths of at least three babies in Counties Manukau. It's also an area where stillbirths are the highest in the country.
"There's more than 100 babies every year who are stillborn or die in the first four weeks of life in Counties and that's nearly a fifth of all of the babies in New Zealand," says Auckland University Obstetrics and Gynaecology Professor Lesley McCowan.
The reasons are complex and there are no easy solutions.
"40 percent of the population lives in the highest deprivation areas," Prof McCowan says.
"There's very high rates of obesity, particularly among Pacific women. There's high rates of diabetes, there's difficulties accessing care."
When women use the health board's services, other factors are stacked against them.
The review found that last year, the staff and hospital were unable to meet proper standards of care.
In 2017, around 1200 women or babies who should have stayed at least 72 hours after birth instead stayed less than 48 hours.
And nearly 700 women were discharged straight from Middlemore's birthing unit - most within eight hours. More than half of them had babies requiring more support.
"We need adequate funding and adequate services," Prof McCowan says.
The DHB has since freed up some beds, recruited more staff and started a new maternity assessment clinic with more work in the pipeline over the next two years.
But there are some things expectant mothers can do. Be in the best health you can be when you're pregnant, see your GP or a midwife as soon as you know you're pregnant and have regular antenatal checks.