As obstetricians and gynaecologists, we are trained to act decisively in moments that matter. Operative obstetrics, the theme of this edition, reminds us that technical skill is only one part of excellent care. Every clinical decision is made within a wider system of relationships, culture, leadership, and equity. For He Hono Wāhine, that broader context continues to guide our work across RANZCOG as we strive to improve outcomes for wāhine Māori and their whānau.
The past few months have provided an opportunity for both reflection and renewal. Day 1 of the RANZCOG Aotearoa Annual Scientific Meeting (ASM) 2026 showcased the depth of expertise, innovation, and commitment that exists across our profession. At the same time, He Hono Wāhine has been reviewing progress against Te Rautaki Māori me te Ara Whakamua, considering what has been achieved, where challenges remain, and what priorities must shape the next phase of our journey.
Reflections from Aotearoa ASM 2026
Day 1 of the Aotearoa ASM 2026 provided an opportunity to step away from our usual clinical environments and reflect on the broader contexts that shape health outcomes. Held at the University of Auckland’s Waipapa Marae, the day focused on cultural competence, hauora Māori, and cultural safety as essential foundations for achieving Māori health equity. The programme began with a pōwhiri (welcoming ceremony) on the marae, setting the tone for a day grounded in whakawhanaungatanga (establishing relationships), shared learning, and mutual respect.
Presentations hosted in the Fale Pasifika explored topics spanning gynaecology, maternity care, and health equity. Sessions highlighted Māori and Pacific women’s experiences of endometrial cancer and menopause, drawing attention to the ongoing inequities experienced across the continuum of women’s healthcare. Discussions reinforced the need for services that are not only clinically effective, but also culturally responsive and accessible.
The maternity care sessions, including presentations on hapū wānanga (Māori birthing practices) were particularly powerful reminders that cultural identity, whānau connections, and traditional knowledge remain central to many Māori pregnancy and birth experiences. These presentations challenged us to think beyond procedures and consider how cultural safety can be upheld even within highly medicalised environments.
Reflections on Māori experiences during caesarean section and operative birth highlighted the importance of ensuring that tikanga and cultural practices are supported throughout the birthing journey. For many Māori whānau, practices such as whakawhanaungatanga (establishing relationships) are not optional extras but essential foundations for trust, partnership, and belonging. Taking time to establish meaningful connections with women and their whānau can significantly influence how care is experienced, particularly in situations where operative intervention is required.
Presenters also spoke about the value of creating space for karakia (prayer) before surgery when requested by whānau. Karakia can provide spiritual grounding, reassurance, and connection during what may be an anxious and uncertain time. Facilitating these moments demonstrates respect for Māori values and reflects a commitment to culturally safe practice.
Another example shared was the growing recognition of the muka pito tie (umbilical cord tie), supporting the preservation and tying of a baby’s pito (navel) with muka (prepared flax fibre) prepared according to tikanga Māori. Although a small component of a surgical birth, this practice carries deep cultural significance and helps maintain important connections between pēpi (baby), whānau, and whakapapa (genealogy).
Supporting tikanga-based practices such as these ensures that cultural traditions do not become unintended casualties of operative care.
These discussions reinforced an important message: cultural safety and operative excellence are not competing priorities. Rather, they are complementary aspects of high-quality healthcare. The ability to safely perform a caesarean birth is critical; the ability to do so while honouring the values, beliefs, and aspirations of the woman and her whānau is what transforms clinical competence into truly person-centred care.
As Māori, we understand health as encompassing physical, emotional, spiritual, and whānau wellbeing. Day 1 of the Aotearoa ASM 2026 demonstrated encouraging progress in recognising these dimensions within obstetrics and gynaecology. It also challenged us to continue asking an important question: how can we ensure that every woman, regardless of how she accesses care or gives birth, experiences healthcare that is both clinically excellent and culturally safe?
Reviewing Te Rautaki Māori me te Ara Whakamua
Over the past year, He Hono Wāhine has continued to advance the priorities set out in Te Rautaki Māori me te Ara Whakamua, RANZCOG’s Māori strategy and action plan. The strategy provides a framework for embedding Te Tiriti o Waitangi (Treaty of Waitangi), advancing equity, and strengthening Māori leadership across all areas of the College.
As we undertake a review of the current strategy and plan for its next phase, it is timely to reflect not only on what has been achieved, but also on the whakaaro (idea) behind its design.
Te Rautaki Māori me te Ara Whakamua is represented through three interconnected pou (pillars): Wāhine Māori, Members, and Organisation. Together, these pou recognise that achieving health equity requires change at multiple levels. Sustainable improvement cannot come from focusing solely on patients, clinicians, or systems in isolation. Instead, each pou supports and strengthens the others.
The Wāhine Māori pou reflects our commitment to improving health outcomes and experiences for Māori women and their whānau. It acknowledges the right of wāhine Māori to receive care that is clinically excellent, culturally safe, and grounded in mana-enhancing relationships. This pou serves as a reminder that the ultimate measure of our success is the wellbeing of the communities we serve.
The Members pou focuses on supporting Māori trainees, Fellows, and all RANZCOG members to develop the knowledge, confidence, and skills required to provide equitable care. This includes strengthening Māori workforce recruitment and retention, developing culturally safe training environments, and fostering leadership opportunities. The recent establishment of the Kaiāwhina role is one example of how this commitment is being translated into practical action.
The Organisation pou recognises that lasting equity requires institutional commitment. Policies, governance structures, systems, and accountability mechanisms must actively support Te Tiriti obligations and equitable outcomes. Progress in Indigenous representation within College leadership, alongside the ongoing integration of cultural safety into education, accreditation, and professional standards, demonstrates the importance of organisational change in supporting individual and community aspirations.
Importantly, the three pou are not intended to stand alone. Their interconnectedness reflects a core Māori understanding that relationships drive outcomes. When the organisation is strong, members are better supported. When members are supported, wāhine Māori receive better care. When wāhine Māori and their whānau thrive, we move closer to achieving the vision that sits at the heart of He Hono Wāhine’s mahi.
Our review has highlighted meaningful progress across all three pou, while also reinforcing that equity is a continuous journey rather than a destination. As we look ahead to the development of the next iteration of Te Rautaki Māori me te Ara Whakamua, He Hono Wāhine remains committed to ensuring that the strategy continues to be practical, measurable, and grounded in the aspirations of Māori communities.
Ultimately, Te Rautaki reminds us that achieving equity requires more than good intentions. It requires coordinated action from individuals, from the organisation, and from the profession as a whole. Just as successful outcomes in operative obstetrics depend on every member of the theatre team working together, progress towards equity depends on all of us contributing to a shared purpose.
Looking Forward
The connection between operative obstetrics and equity may not appear immediately obvious, yet both share a common goal: achieving the best possible outcomes when it matters most.
Whether in the operating theatre, the training environment, or the governance of our College, excellence requires us to continually reflect, adapt, and improve. The Aotearoa ASM 2026 reminded us of the strength of our profession. The review of Te Rautaki Māori me te Ara Whakamua reminds us of our responsibility to ensure that strength benefits everyone equitably.
He Hono Wāhine remains committed to working alongside members, communities, and partners to advance Māori health equity and uphold Te Tiriti o Waitangi across obstetrics and gynaecology. Progress is rarely achieved through a single intervention. Rather, it is built through sustained effort, collective leadership, and a shared belief that better outcomes are both possible and necessary.
As we move into the next chapter of our work, we carry forward that belief with purpose, optimism, and determination.
