Middlemore Hospital's made urgent changes after three baby deaths were linked to a lack of staff and beds

An internal review shows the South Auckland hospital struggled to cope with big increases in the number of pregnancies needing more care and monitoring.

Counties Manukau DHB has since made a number of changes.

It now has a maternity assessment clinic - and more midwife, nursing and support staff roles, including senior positions.

Jenn Hooper, founder of support group Action to Improve Maternity, urges women and families to use hospital services - and to push staff for quality care.

She says people should not be afraid to question and challenge.