Abstract: Recent changes to the way that health services are provided and issues related to the rural health workforce are creating an international crisis in the availability of rural maternity care. International trends show a workforce decline in rural general practitioner obstetric specialists and rural midwives, as well as a decline in rural births. The aim of this study is to highlight the maternity needs of rural New Zealand women. Further, it discusses how the changes to maternity services in New Zealand, over the last sixteen years, have impacted on the rural nurse and midwife role and therefore on service provision. This information is intended to identify issues that could be used as the basis for development of a uniquely rural model of maternity care.