Dear Macha: I liked Wendy's response. It seems that we should be writing grant/funding proposals for midwifery led care for rural communities throughout Australia. I was recently up in North Queensland and discovered that maternity care at the local hospital where I grew up (Tully) was basically discontinued and that women travelled to Cairns to have their babies at the base hospital. It is hard to understand why or how women are accepting this, but maybe they just feel they have no other options.
One concern might be the plan for transfer to hospital in case of an emergency. Where I am now (Seattle) if we need an aid car we can usually have one in 5-10 minutes and then another 5-10 minutes to the hospital which is within the 30 minutes required to set up for an emergency c/s, however for women in remote areas it is harder, though we do have emergency ambulance helicopters. Is such a service available in rural Australia? I would have thought so, but I don't know. Also while just recently in Australia I saw the NET helicopter transfer a sick neonate from Bali to Westmead in Sydney, so I think this is doable. I think it is critical to have a realistic emergency transfer of care plan and OB's who are oncall who you would be transferring to in such a situation. It is one of my pet peeves that the increasingly high tech nature of hospitals has made the practice of rural medicine (unfortunately, including childbirth) almost obsolete. I think it we have ti be creative about this before it disappears altogether. regards marilyn -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
