- My DHB
- Key organisations
- Statutory framework
- Health Targets
- Eligibility for public health services
- Claims, provider payments, and entitlements
- Publicly funded health services
Who is eligible for publicly funded maternity services?
Pregnant women are eligible for free and subsidised maternity-related services if they:
- are eligible for publicly funded health and disability services in their own right OR
- their husband, civil union partner or de facto partner is a/an:
- New Zealand citizen OR
- New Zealand resident or permanent resident visa holder OR
- Australian citizen or Australian permanent resident visa holder who has been living, or who intends to live, in New Zealand for two years or longer OR
- refugee or protected person, or is applying or appealing for refugee or protected person status, or is a victim or suspected victim of a people trafficking offense OR
- work visa holder able to stay in New Zealand for 24 consecutive months (time spent lawfully in New Zealand immediately before the start of the work visa counts toward the two year requirement) (work visas start on the person’s first day in New Zealand) OR
- interim visa holder who was eligible immediately before the interim visa was issued OR
- are pregnant with a child that is found to be a New Zealand citizen by birth.
- Partners of NZ Aid Programme students studying in New Zealand are eligible in their own right.
The basis of this funding is to provide the child of an eligible person, regardless of whether the eligible parent is male or female, with antenatal, labour and birth, and postnatal care, so that the baby will be as healthy as possible.
Reference: B21, B20 of the Health and Disability Services Eligibility Direction 2011.
What maternity services are funded?
Most maternity care is free for women who meet the criteria above. There may be charges for antenatal or childbirth education classes, and some tests at a private laboratory. There may also be charges for ultrasound scans. Private obstetricians and private maternity hospitals will also charge a fee.
Provided they meet the eligibility criteria above, pregnant women are eligible for the following maternity-related services:
- primary maternity services within the meaning of clause B1 of the Primary Maternity Services Notice 2007 (see Primary maternity services below) AND
- all maternity services provided by DHBs AND
- any other secondary or tertiary services for a condition of the mother or child that a clinician has determined will significantly impact on the pregnancy or its outcome.
As mentioned above, these services are funded to ensure that the child of an eligible person has the best chance of being healthy. However, recognising that not all pregnancies are viable, the above definition of maternity-related services includes ectopic pregnancies, miscarriage services, pre-eclamptic toxaemia, eclampsia, and terminations of pregnancy for foetal abnormality.
HIV-infected pregnant women
Regardless of their citizenship or immigration status, pregnant women infected with HIV have free access to:
- a hospital-based lead maternity carer
- blood tests to determine HIV viral load in the pregnant woman
- a funded course of anti-retroviral drug(s), noting that there is no entitlement to ongoing anti-retroviral treatment for the mother
- information around safe alternatives to breastfeeding
- a Caesarean section for those instances where specialist medical opinion considers that a Caesarean section is required for delivery to effectively limit the HIV transmission risk to the child
- post-Caesarean section hospitalisation (approximately one week)
- postnatal hospital visits for the child for the purpose of disease exclusion, that is, to determine the HIV status of the child.
Reference: B22 of the Health and Disability Services Eligibility Direction 2011.
Primary maternity services
Most pregnancy and childbirth services are ‘primary maternity services’ delivered in the community by a lead maternity carer (LMC). Most LMCs are midwives and some general practitioners (doctors) and obstetricians also act as an LMC. Some primary maternity services are delivered in hospitals, with secondary and tertiary maternity services (eg, Caesarean sections, terminations for foetal abnormality).
LMCs are responsible for organising women’s maternity care. They may provide all of the care or share the care with one, or more, other practitioners. They also provide information to assist with decision-making during pregnancy, preparation of the birth and for parenting. Information will include a wide range of matters such as nutrition, exercise, the risks of smoking and drinking alcohol when pregnant, labour and the birth process, pain relief, breastfeeding, baby care, immunisation, community services, contraception and many other matters.
For more information about maternity services and choosing a LMC, call 0800 MUM 2 BE (0800 686 223). The phone line does not offer counselling, clinical or medical advice.
Cover under Reciprocal Health Agreements with the UK and Australia
Some women are not fully eligible for publicly funded maternity services, and do not have eligible partners, but are eligible for a limited range of services under reciprocal health agreements New Zealand has with Australia and the United Kingdom.
If a UK citizen or Australian resident is pregnant and covered under one of these agreements, they are eligible for immediate and necessary maternity care, including labour and birth, and immediate post-natal services. They must meet other eligibility criteria for fully funded LMC services.
Reciprocal health cover does not extend to partners or dependants of people covered by these agreements. See Reciprocal Health Agreements for further information.
Reference: B8 and B9 of the Health and Disability Services Eligibility Direction 2011.