Hello All
Following is a letter I have just sent to the Herald re their article on the declining numbers of births in the NSW public system, article follows letter. It has some interesting info.
In solidarity
Justine Caines
It is no surprise that pregnant women lured, or coerced into private health insurance are flocking to private hospitals. As a Mum of three I constantly hear women say they need to ‘get their money’s worth out of the insurance”; statistics prove that they will get a lot more than that however. Australia’s healthiest, most educated and affluent women are being grossly over-serviced in childbirth. Are the outcomes better? No. Australia has a highly medicalised maternity system and fares worse in terms of infant and maternal mortality than countries that have low intervention and high levels of midwifery care. At the same time we have soaring post and antenatal depression with support services oversubscribed..
Ms Wilson is right women are not informed about choice, however, there is little anyway. For the vast majority of healthy women the care of a known midwife has been deemed the most cost effective and appropriate care. In NSW there is not one on-going publicly funded program providing one to one midwifery care. The Federal and NSW Government’s have also refused to assist midwives providing this care privately with indemnity insurance, they did however provide $35 mil for Doctors, seem anti-competitive? It is.
Justine Caines
NSW President
The Maternity Coalition Inc
Maternity wards face axe as births decline
By�Danielle Teutsch, Health ReporterJanuary 19 2003
The Sun-Herald
Northern Sydney mums-to-be are rejecting public hospitals, leaving some maternity units with such low birth rates they may have to close.
The decline has been attributed to the large numbers of women with private health insurance choosing private hospitals, attracted to new facilities and "hotel-style" accommodation despite significant out-of-pocket expenses.
The sharpest fall has been at Ryde Hospital, where births have decreased by almost a third in three years. Only 518 babies were born there from June 2001 to 2002 - a birthrate comparable to district hospitals such as Wyong and Bathurst.
Manly and Mona Vale hospitals have recorded a drop of 21 per cent and 18 per cent, respectively, in births during the same time period. Even the area's flagship hospital, Royal North Shore, has been affected. Five years ago, the hospital registered about 2500 births a year. But that number has fallen steadily to 1390.
The Metropolitan Hospitals Report, released last year, recommended the merging of maternity units at Manly and Mona Vale; Ryde and Royal North Shore; and Sutherland, St George and The Royal Hospital for Women, among others.
The report, compiled by the Greater Metropolitan Transition Task Force, recommended these hospitals keep a labour ward at one hospital, while antenatal, postnatal and gynaecological procedures would be carried out at the other. There
is, however, expected to be community opposition to any move
to decrease maternity services. A spokesman for Health Minister Craig Knowles denied any maternity wards were earmarked for closure, but said linking wards was a "commonsense approach".
"No birthing services will be shut but there may be some shifting and relocating," he said.
Royal North Shore Hospital's head of women and children's health, John Pennington, said he was concerned by the declining birthrates at northern Sydney public hospitals as they raised the issue of whether the maternity units were viable. A certain number of births each year were needed to ensure a hospital had experienced medical staff and
efficient deliveries.
"Ideally, in a metropolitan Sydney maternity [ward], you would want to see 2500 to 3000 deliveries a year," he said. If your numbers drop below a certain level, you would have to question whether it's worth running it. It's a question of having enough patients to ensure quality."
The trend has not been confined to the north, with births at Sutherland Hospital falling from 1013 in 1999 to 707 last year.
Dr Pennington attributed the decline to the number of women who had been encouraged to take up private health insurance by their 30th birthday and the number of private hospitals in the area.
Some public hospitals also had outdated facilities, which could not compete with the accommodation offered by private hospitals.
For example, the maternity wards at Royal North Shore and Sutherland Hospital are more than 30 years old, though both are due for refurbishment this year.
Meanwhile, business is booming for private hospitals, with women undeterred by additional expenses.
The Sydney Adventist Hospital at Wahroonga and the North Shore Private have recorded rise of 10 per cent or more in the number of births over the past three years, while the Mater in North Sydney has recorded a 25 per cent increase in the same period.
Hospital headache for mum in waiting
Like many women from Sydney's northern suburbs, Robyn Wilson, 34, will give birth in a private hospital.
Mrs Wilson rang to book at the Mater Hospital in North Sydney when she was eight weeks' pregnant - only to be told the hospital was full.
Determined to get in, she stayed on the waiting list until she was finally accepted.
Mrs Wilson, now 19 weeks pregnant, said she was happy with her decision, as it meant she got the obstetrician of her choice, who would follow her throughout the pregnancy.
"It's our first baby, so it's nice to have the reassurance," she said.
She was shocked, however, at the out-of-pocket costs involved. Though she has top hospital cover, she has had to pay $1500 so far in visits to the obstetrician, for ultrasounds and a deposit for the hospital.
Each visit to the obstetrician costs $275.
Mrs Wilson said, while she had no regrets about her decision to go to the Mater, she would consider going to a public hospital if she had a second child. She had not been aware of the choices available, such as going to a public hospital as a private patient nor having team midwifery care.
"It was just assumed that [a private hospital] was the way to go," she said. "No one explained the options."
