Health New Zealand has disclosed alarming data highlighting the issue of “unbooked” pregnant women—those who arrive at hospitals in or near labour with little or no prior antenatal care. Senior journalist Nicholas Jones reports.
Nearly 300 women across the greater Auckland and Northland regions presented in labour last year having received minimal antenatal care throughout their pregnancies, according to figures released by Health NZ following an Official Information Act request by Stuff.
Health authorities explained that some cases involve women who were unaware of their pregnancy or chose to conceal it. However, the broader concern among maternal health experts is that inadequate prenatal monitoring puts both mother and baby at significant risk, particularly from undetected conditions such as gestational diabetes and preeclampsia.
Due to logistical challenges, Health NZ was unable to provide comprehensive national data or a detailed regional breakdown beyond Auckland and Northland. The issue was initially highlighted in an annual maternity services report from Counties Manukau, which described an increasing trend of pregnant individuals presenting for care late in pregnancy or only at labour.
The report noted, “Increasingly, pregnant people are presenting for care with no, or minimal, antenatal care from 20 weeks gestation to six weeks postpartum.” Middlemore Hospital alone has seen rising numbers of women arriving in labour without adequate pregnancy care, most commonly between 36 and 42 weeks of gestation.
Earlier this year, Health NZ estimated that approximately 200 women in Counties Manukau had little to no pregnancy care for most of their pregnancy. A request to break down these figures nationally was declined due to the complexity involved, but data from the northern health regions revealed that in 2024-25, 296 women were classified as unbooked in Auckland and Northland.
In Northland, 42 women—around 2% of all births—fell into this category. The definition of “unbooked” includes women who either booked care after 36 weeks of pregnancy or not at all, although some may have had minimal testing or scans earlier.
Waitematā District Health Board, which covers North Shore and Waitākere hospitals, reported 19 unbooked cases (0.3% of births). The majority were Pasifika (8) and Māori (7), with four women aged under 20. Health NZ attributes these cases primarily to failure to recognize pregnancy or concealment.
Similarly, in Te Toka Tumai (formerly Auckland DHB), 35 women (0.6% of births) were unbooked in 2024, with most being Pasifika (16) and Māori (10). Among these, seven were under 20 years old.
Counties Manukau, covering South Auckland and Middlemore Hospital, had the highest figures, with around 200 unbooked women, equating to 2% of births. Detailed demographic data for this group was unavailable, and it remains unclear how many had received antenatal care abroad or elsewhere in New Zealand.
Health NZ declined to provide further documentation or evidence underlying the maternity report’s statements, citing no available memos or reports.
Health advocates warn that the growing number of unbooked pregnancies poses a serious public health challenge, with potentially severe consequences for maternal and neonatal wellbeing.
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