The roadside birth that took place outside Lumsden on Sunday has highlighted what appears to be a tenuous and unclear back-up plan for the downgraded maternity centre.

The birth of baby Levi on the side of a Southland road Sunday morning has quickly become a nationwide talking point for the Southern DHB's controversial downgrade of services at Lumsden Maternity Centre last month. 

But back in Southland, advocates for the downgraded centre have pleaded for authorities to have another look at the safety net in place for such rapid births, which is partially reliant on spread out volunteer ambulance services across Southland.

When the Southern DHB confirmed its plan to bring "Maternal and Child Hubs" to Te Anau and Lumsden, the health board said there would be processes in place, such as a "midwife is on call and protocols for urgent maternity transfers have been developed with St John and other primary and secondary care providers".

However, Advocate South understands the St John volunteer driving the ambulance Sunday morning was not on duty, and a lightning storm taking place that morning did not make for good flying conditions. 

When asked, St John district operations manager David Baillie only said a volunteer was on duty on Saturday night. 

Full-time midwife Sarah Stokes, who helped deliver the baby, and Te Anau midwife Jo Lundman both said they expected to use ambulance services more over the winter because of the eliminated services at Lumsden, on top of the more dangerous seasonal driving conditions. 

Mrs Stokes said she would be speaking with the DHB tomorrow (May 31) about her practice being more sustainable, and the issue of the Lumsden unit not being appropriate for emergencies. 

"I'm scared it's going to repeat itself."

Lumsden GP Dr Mathew Stokes also wrote to the DHB soon after Sunday's roadside birth, which he also attended as a PRIME (Primary Response in Medical Emergencies) doctor, asking for a copy of the Lumsden hub's documentation for the emergency birth plan.

As a maternity unit that was expected to prepare for emergency births on occasion, he said he expected it would be prepared, easily accessed, and have a single phone number for a midwife to call that would trigger a team response.

"At this stage, there is no such plan. One of the midwives was given four numbers of possible people to phone... That's not a functioning plan. It's grasping at straws."

In addition to not having a back-up midwife available at Lumsden, Mrs Stokes said the lack of oxygen tanks for resuscitation factored into her decision to call an ambulance.

Dr Stokes said only this week did the oxygen tanks for the resuscitaire arrive, but the unit was still not fully functional. 

Southern DHB executive director Lisa Gestro said the health board continued to have confidence in the primary maternity services it was implementing across the district.

"We face unique challenges in delivering health services in such a large district with a dispersed population. This means transport is a pivotal component of the health system, and we're grateful to our St John colleagues for their role in ensuring emergency care is provided where it is needed.

"We work closely with St John and in recent years have worked to develop further protocols, including the prioritisation of maternity call outs. Midwives also have access to urgent transport when required."

As well as emergency transport services, others in general practices, midwifery and community care contributed to the broader network of support across the district, she said.

Southern DHB chief executive Chris Fleming said in a media statement yesterday that, as a result of the weekend's roadside birth, the Southern DHB would be formally reviewing the implementation of its primary maternity strategy, but not the strategy itself because it has "already been thoroughly reviewed."

The health board would also be reviewing the particulars of the birth that occured on Sunday morning.

"I do want to understand more about the specifics of the case, the care she received, the decision making, and the overall network of support that was available to the woman, including the role if any that the changes to the primary maternity infrastructure may have played in this," the statement says.