Recommendations: (a) Provide information on the impact of measures being taken to ensure the right to mental health for women and girls, including perinatal mental health. (b) What steps is the Government taking to achieve equity for wāhine Māori in accessing mental health and addiction services. Reproductive and sexual health 9. Disabled women do not have equal access to mainstream sexual and reproductive services, and are being provided little to no sexuality education.14 Non-consensual sterilisation and provision of contraception to disabled people is deemed to be lawful in certain circumstances.15 The Ombudsman has found that that the electronic information system for recording the number of involuntary sterilisations performed on women and girls with intellectual disabilities was inadequate.16 Recommendations: (a) Provide statistical data on the number of girls and women who have undergone sterilisation and other non-therapeutic medical procedures in New Zealand without their consent, including steps taken to improve methods of collecting and reporting data. (b) What progress has been made on repealing or enacting legislation to prohibit the use of sterilisation or any other non-therapeutic medical procedure on disabled women and girls without their prior, fully informed, and free consent? Maternity care 10. There is a chronic shortage of midwives, who act as lead maternity carers for most New Zealand women.17 This shortage has been attributed to low pay, high overhead costs, overwork, and long-term under-investment in midwifery (including lack of support for student and graduate midwives and lack of career opportunities for experienced midwives).18 In July 2021 the government announced measures to help increase the midwifery workforce.19 Recommendations: (a) Provide information on the effectiveness of measures taken to address the critical shortage of midwives. (b) What steps is the Government taking to ensure women and girls, including those in rural areas, have equitable access to maternity care. 14 15 16 17 18 19 YWCA “Young Women & Disability in Aotearoa NZ” (2019) https://www.ywca.org.nz/media/1686/young-womendisability-front-cover-merged.pdf at 6 - 7. Contraception, Sterilisation, and Abortion Act 1977. Office of the Ombudsman “Annual Report 2015/2016” (2016) https://www.ombudsman.parliament.nz/resources/annual-report-20152016-full-report. For example, in December 2021, Invercargill hospital was reported as having just 12% of the midwives it needed. See Radio New Zealand “Midwife shortage at Invercargill Hospital an ‘extreme risk’ – DHB” (7 December 2021) https://www.rnz.co.nz/news/national/457371/midwife-shortage-at-invercargill-hospital-an-extreme-risk-dhb. Coinciding with this shortage, the population in New Zealand is increasing and the population of midwives is aging. According to 2021 workforce figures, 58% of midwives were over 45, and only 21% were under 35. See Midwifery Pay Equity Claim “Changing the conversation” (7 April 2022) https://meras.midwife.org.nz/wpcontent/uploads/sites/4/2022/04/Midwifery-Pay-Equity-presentation-to-the-bargaining-060422-v5-003.pdf. Hon Dr Ayesha Verrall “Increased support for midwives” New Zealand Government (14 July 2021) https://www.beehive.govt.nz/release/increased-support-midwives. 5