New Zealand's ACC scheme is one of the things that makes Aotearoa genuinely different as a place to give birth. Since 1 October 2022, a significant change has meant that certain physical injuries sustained during childbirth can now be covered by ACC, including access to funded physiotherapy for postnatal recovery. Many mums do not know this exists. This post explains what the Maternal Birth Injury cover is, how to find out whether it might apply to you, and what it means practically for accessing the care you need.
A quick note before we get into it: postnatal support needs vary widely, and not everyone who has experienced birth-related symptoms will have a qualifying ACC injury. The right first step is always a conversation with your LMC, midwife, or GP.
Important: this is general information only
This post is intended to raise awareness of ACC's Maternal Birth Injury cover in plain language. It is not legal or medical advice. ACC's eligibility criteria, covered conditions, and funding arrangements can change. Always confirm current details directly with ACC (0800 101 996 or acc.co.nz) and your healthcare provider before making any decisions based on this information.
What is the ACC Maternal Birth Injury cover?
Before October 2022, birth injuries in New Zealand were generally not covered by ACC under its injury scheme, because childbirth was not classified as an accident. This meant that mums who experienced significant physical injuries during birth (including serious perineal tears, pelvic floor injuries, and obstetric fistula) often had to navigate the health system without the funded treatment support that ACC provides for other physical injuries.
The Maternal Birth Injury cover, which came into effect on 1 October 2022, changed this. It created a pathway for certain childbirth-related injuries to be classified as covered injuries under the ACC Act, making women eligible for ACC-funded treatment without needing to prove any fault or negligence on anyone's part.
This is consistent with the wider philosophy of the ACC scheme: that when New Zealanders are injured, they should be able to access treatment without needing to take legal action or prove someone was to blame. Applying the same principle to birth injuries was a meaningful and overdue change.
What injuries might be covered?
The specific conditions that may qualify under the Maternal Birth Injury cover include certain injuries that occur as a physical consequence of giving birth. Examples that ACC has included in this category are:
- Significant perineal tears (including third and fourth degree tears, which involve injury to the anal sphincter).
- Certain pelvic floor injuries sustained during birth, such as avulsion injuries to the levator ani muscle.
- Obstetric fistula: an abnormal opening between the vagina and bladder or rectum.
- Other specific injuries that occur as a direct consequence of the birthing process.
It is important to note that this list is not exhaustive, and ACC's criteria for what qualifies can be updated. Not all postnatal symptoms (leaking, pelvic heaviness, discomfort) automatically mean you have a qualifying injury, but they may be worth investigating with a healthcare provider who can assess you properly.
The cover is for injuries sustained during the birth event itself. Conditions that develop during pregnancy, or general postnatal discomforts without a specific injury, may not qualify, though your care provider is the right person to discuss this with.
How to access the cover
The process of making an ACC claim for a Maternal Birth Injury typically starts with your care team. You do not need to navigate this alone.
Step 1: Talk to your LMC, midwife, or GP
Your Lead Maternity Carer (LMC) is often the right first person to speak to: they have records of your birth and are well placed to identify whether you may have sustained a qualifying injury. Your GP can also assess you and initiate a claim if your LMC care has already transitioned away.
Be open and specific about any symptoms you are experiencing: leaking urine or wind, difficulty controlling bowel movements, pelvic pain or pressure, pain during sex when you return to it, or any sensations around a tear or scar. The more clearly you can describe what you are experiencing, the better placed your provider is to assess whether an ACC claim is appropriate.
Step 2: Your provider lodges a claim
If your LMC or GP considers that you may have a qualifying injury, they can complete an ACC claim form (ACC45) on your behalf. This is a standard process (the same form used for other physical injuries) and your provider will be familiar with it. You do not need to gather special documentation yourself.
Step 3: ACC assesses the claim
Once the claim is lodged, ACC will assess whether it meets their eligibility criteria. If accepted, they will confirm what treatment is covered and for how long. Funded treatment can include pelvic health physiotherapy, specialist consultations, and other relevant supports.
If your claim is declined and you believe the decision is wrong, you have the right to seek a review. Citizens Advice Bureau or a community law centre can provide guidance on this if you need it.
How this connects to pelvic floor recovery
One of the most meaningful practical outcomes of a successful ACC claim for a Maternal Birth Injury is access to funded pelvic health physiotherapy. A women's-health physiotherapist can assess your pelvic floor function properly, identify any injury or dysfunction, and create a personalised rehabilitation programme. This is significantly more targeted than any general postnatal exercise guide can provide.
If you have any of the following symptoms, it is worth talking to your LMC or GP about whether an ACC claim might be relevant:
- Leaking urine when you cough, sneeze, laugh, lift, or exercise.
- Urgency: feeling like you cannot get to the toilet in time.
- Difficulty controlling wind or bowel movements.
- A feeling of heaviness or dragging in the pelvis, as though something is falling out.
- Pain during sex once you have returned to it.
- Pain or discomfort that does not seem to be resolving months after birth.
These symptoms are common, but common does not mean normal or inevitable. They often respond well to proper treatment, and ACC cover can make accessing that treatment much more accessible.
What if ACC does not cover your situation?
Not every postnatal symptom will meet the criteria for an ACC Maternal Birth Injury claim, and that is okay. There are still pathways to support:
- Ask your GP for a referral: some District Health Board services offer postnatal physiotherapy at subsidised rates.
- Many private pelvic health physiotherapists offer an initial assessment at a lower cost to determine what is needed.
- Easy Peasy's practitioner-reviewed programme is designed to support your recovery between professional appointments, not to replace them.
Please confirm with ACC directly
ACC's Maternal Birth Injury cover criteria, covered conditions, and funding amounts can change. This post reflects our understanding at the time of writing (June 2026) but is not a substitute for checking the current position with ACC. You can call ACC on 0800 101 996 or visit acc.co.nz for the most up-to-date information. Your LMC or GP can also advise you based on your specific situation.
Common questions
What is the ACC Maternal Birth Injury cover?
ACC introduced a dedicated Maternal Birth Injury cover on 1 October 2022. It recognises certain physical injuries sustained during childbirth as ACC-eligible injuries, meaning women may be able to access funded treatment (including physiotherapy) without needing to prove negligence or fault. Examples of potentially covered injuries include certain perineal tears and some pelvic floor injuries sustained during birth. The specific criteria are set by ACC and can change, so it is important to confirm current cover details with ACC directly or through your healthcare provider.
How do I make an ACC claim for a birth injury?
The process typically starts by talking to your LMC, midwife, or GP. They can assess whether your injury may be covered and complete an ACC claim form (ACC45) on your behalf. You do not need to navigate the system alone: your care provider is there to help. Once a claim is lodged, ACC will assess it and let you know what treatment is covered. If you are unsure where to start, calling ACC directly on 0800 101 996 is a good first step.
Does ACC cover pelvic floor physiotherapy after birth?
If your pelvic floor injury is assessed as an eligible birth injury under ACC's Maternal Birth Injury cover, ACC may fund a course of pelvic health physiotherapy. This could include assessment, hands-on treatment, and exercise guidance. The extent of coverage depends on your individual claim and ACC's assessment. Not all pelvic floor symptoms after birth will meet the threshold for an ACC claim, but it is worth asking: many women who could access this support do not know it exists.
What if my injury does not qualify for ACC cover?
If ACC declines your claim or your situation does not meet the criteria, you may still be able to access pelvic health physiotherapy privately, or through a referral from your GP. Some health providers also offer postnatal physiotherapy services at subsidised rates. Cost can be a barrier, but it is worth exploring your options: even one or two sessions with a women's-health physiotherapist can provide valuable, personalised guidance for your recovery.
Easy Peasy's practitioner-reviewed programme is designed to support your recovery at home, in between professional appointments. Join the early access list to be the first to know when we launch.
