Documents obtained by Newshub show a community midwife is worth $241,000 - almost three times their average wage - but the Health Minister ignored the value placed on maternity workers.
The Ministry of Health and New Zealand College of Midwives reviewed how much midwives should be paid through a co-design project.
They advised Minister David Clark that a "fair and reasonable remuneration for the work of a community midwife [would] be a total of $241,000 for full-time work".
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"The amount takes into account the 24/7 on-call expectations and cost of operating their businesses," they said.
It would comprise $170,000 base income, $30,000 for on-call costs and $41,000 for business costs.
The reality is very different. On average, community midwives currently earn around $53,000 a year after costs. Almost all New Zealand midwives are women.
The Minister received the report in December 2017.
National Health spokesperson Michael Woodhouse told Newshub it's a slap in the face for gender pay equality.
"It's incredibly sad, the first opportunity they have to walk the talk on gender equality, they've simply ignored the advice," he says.
"Worse than that, we had a rally here at Parliament in early May where the Minister stood in front of them and said 'I'm listening very carefully', knowing four months before that he'd brushed that advice completely away and said it was unaffordable.
"What it says to women is that they're not worth the value that they provide."
If the proposed model was adopted, it would cost $353 million a year - an increase of $237 million per year above current funding levels.
The report also advised the Minister not to proceed with recommendations because it's unlikely to be affordable for the Government in the short or long term.
Minister Clark told Newshub that's realistic.
"The Ministry advised me that they didn't think that was their best advice, and so they advised me not to proceed down that path, and I agreed with them," he says.
"In the Budget there was $103 million over four years to increase midwives' pay, and also to make sure we had a situation where midwives could hand over after a long and difficult labour and not face a financial penalty to another midwife, so money set aside for that.
"And also some additional money to recognise the distinctive operating model that they're under to compensate midwives further."
The co-design project which made the recommendations was set up under National after midwives sued the then-Government over pay discrimination, arguing in the High Court that they were underfunded and discriminated against because of their gender.
An earlier version of this article stated that the advice said midwives are worth fives their average salary. That was comparing the current net salary to the proposed gross salary. The article has been amended to compare net baseline salaries.