Dear ozmid friends, just to keep
everyone up to date nationally, the media has been buzzing here in WA
this week with the announcement of the pending closure of a major regional
hospital maternity ward (Peel Health Campus, Mandurah) directly related
to the PI insurance issue. Three of the local GP/ob's had withdrawn
their services from today onwards due to PI expense and unworkable
arrangements with the privately operated PUBLIC hospital. The pregnant
women were told they would now have to go to another hospital. The PHC
has about 600 (public pt) births per year and 70 private births. A
"last minute rescue deal" has been struck and the closure is presently
averted, but anxiety levels were very high among women and midwives over the
past few days. I see this as a golden opportunity to push the
political barrow for midwifery care and have written to our local MLA's
and WA Health Minister, as well as the hospital admin. A copy of the
letter is pasted below:
Dear Sir
The threatened closure of the maternity ward at Peel Health
Campus this week due to withdrawal of obstetric services as a result of the
PI crisis highlights the limited care options available to women in the Peel
Region. I am writing to endorse
the comment made by Health Solutions chairman Jon Fogarty as reported in the
Mandurah Mail 4/7/02 :-
"We believe
the Government - both State and Federal should act immediately to address
these issues and put in place long term
reforms".
The present system where women's wellbeing during pregnancy is
monitored by GP/obstetricians (who are extremely busy maintaining medical
practises caring for sick people), and hospitalised birth is considered
"normal" in our society.
However this "medical model" is not the only system of care for well
pregnant women.
Countries such
as New Zealand, Holland and England have efficient and cost-effective
maternity systems based on midwifery models of care. Registered Midwives provide well
women with high levels of support and safe, satisfying outcomes,
collaborating with obstetricians only when risks indicate the need for
medical intervention. The World
Health Organisation recommended in 1994 that "midwives are the most
appropriate primary health care provider to be assigned to the care of
normal birth."1
This view has been consistently supported in subsequent
studies and reports throughout the world 1b. In a midwifery-related policy
released last year The Health Department of WA stated "it respects the
differing needs of WA childbearing women and recognises that families have
the right to select and accept responsibility for their choice of model of
maternity care best suited to them"2. A recent WA survey indicated that
"many childbearing women expressed a desire for an increased range of
options in the provision of maternity services"2b. The recent maternity services
crisis and the associated anxiety for expectant families and care providers
can be relieved through:
1. Reinstatement of the government
funded Family Birth Centre which functioned in Mandurah until it
was "absorbed" by the Peel Health Campus in 1998. This should be a separate facility,
government funded and midwife managed, with collaborative support of
obstetricians for referral, and transfer to hospital if
indicated.
2. Establishment of an Antenatal Clinic
where care is provided by midwives
at Peel Health Campus, supported by GP/obstetricians in a "shared-care"
arrangement. This type of
service is already in place in progressive maternity units located at
Armadale and Bunbury hospitals.
3. The Community Midwifery Program
should be expanded to include the Peel Region. This service was recently described
by Mr. Bob Kucera WA Health
Minister as "the gold standard of maternity care". The CMP provides free primary
midwifery care to women who choose homebirth in the Perth metropolitan area,
and as a fully government funded service midwife-practitioners are insured
under the Health Dept's "RiskCover". Women residing in the Peel
Region who choose home birth have accredited midwives available to provide
this care but private PI Insurance cover is unavailable. Expansion of the CMP would address
the insurance problem as well as improve the range of birth options
available to women of the Peel Region.
These initiatives could be rapidly achieved if maternity care
providers and the government collaborate effectively and the true value of
midwifery care is recognised. I
would welcome the opportunity to participate in the collaborative process
necessary to develop these resources which would largely resolve the
maternity crisis in the Peel Region.
Yours sincerely
Lois Wattis,
RN, RM,
IPM-ACMI
