[ozmidwifery] SMH

[Denise Hynd]

Brief: DPLAUTO MEDIA MONITORS Phone: 02 6239 5233 Sydney Morning Herald Thursday 26/6/2003 General News Page 12 Circulation : 253,740 Size: 195.44 sq.cms. No doctor in the house Midwives already deliver babies on their own. Millions of them. What is radical about the �midwives only� bnth plan for the state�s public hospitals is that a doctor d no longer be required to be on duty or on call. Midwives at Shellharbour hospital, which has been unable to fill its ohsterna roster, are expected to be the first granted permission by NSW Health to deliver alone. Similar staffing problems at other regional and rural hospitals, hr jwever, mean a quick flow-on is likely. In these hospitals, midwives will decide when to call ior an anibulance transfer to a larger hospital during a ddficult birth. This is the most risky time to put women in labour on the road. The success of the proposal, then, must rest on the implementation of sttict guidelines to ensure a transfer occurs when problems are first indicated. This means before an emergency, not dunng one. There is much to be said for giving midwives greater responsibilq in birthing. NSW Health says the �midwives only� buth plan is part of an expected shake-up in public matemty services. Midwives would be assigned to mtiividual patients throughout their pregnancy, rather tltm allotted to rotating shifts in the labour ward. �Llidwves have long been lobbying for this kind of enhanced responsibhq, and have cited the impersonal roster system as a reason for leaving the profession. Mothers tended by midwives they know well are also happier and less likely to have caesarean buths. High-risk pregnancies would not qualify for the midwifeonly service. There are more than enough doctors in NSW to cover all births. Why is such a step needed? Recent increases in medical indemnity insurance premiums have pushed many GPs - and some obstetticians - out of obstetrics. But, other issues, such as the clustering of doctors in cities and the larger incomes private city practices offer, have contributed to an uneven distribution of services. The midwife birthing plan is not a solution, but a reasonable, practical measure whch is already working in ,wme parts of Britain and Canada. Crucial to the safety of mothers and babies is a well-funded and wellrm ambulance service, and close contact with the nearest hospital with a full obstemc service. NSW Health should also consider the British model, which accepts that high-speed transfers might sometimes be required to bring a doctor to a women in labour, not just the other way round. Ref: 81 27057