[ozmidwifery] Saturday Courier Mail double page spread

[Wayne and Caroline McCullough]

Title: Message

Just wanted to let you all know there was a fabulous double page spread in the Saturday CM by Leane Edmistone. Leane is a fairly green journo and very young and did not have a great understanding of the issues when we first approached her about birthcare reform but she seems to have handle on it now. She should be congratulated for her stories. They are simply excellent and great publicity for the birthcare reform campaign. If you would like to write a letter to the editor about these stories You can send a letter to the editor by emailing [EMAIL PROTECTED].   Here is the main story from the spread featuring our MC Qld president Bruce Teakle ...   Cheers,   Cas.   Courier Mail SAT 13 SEP 2003, Page 10  to 11  Doctor shortage sparks panic for pregnant women No wonder the birth rate is declining. Rising insurance costs are making it harder then ever to find an obstetrician. Leanne Edmistone reports Susana and Kirk Boaldin's excitement at learning they were expecting their first child was quickly tempered by growing panic at being unable to find a private obstetrician. The young Bulimba couple had almost worked their way through two lists of practitioners provided by their private health insurer before having any success, and by then Mrs Boaldin said she wasn't fussy about who she ended up with.    ``We must have phoned around 20 (practices) and they kept saying we're booked out, we're booked out, we're not available . . . pretty much as soon as I got one that was available I just took it because I thought my chances of finding another one were pretty limited,'' Mrs Boaldin, now 10 weeks' pregnant, said.    ``(At one stage) I said to my husband he'll have to study up pretty quick!''    Fortunately she likes her new obstetrician Dr Glenda McLaren, who only recently returned to work after taking time off for health reasons, and who is also the Royal Australian and New Zealand College of Obstetrics and Gynaecology Queensland chairwoman.    Dr McLaren said experiences such as Mrs Boaldin's were too common.    She said the choices available to pregnant women were rapidly decreasing and the future was not looking healthy for the private or public sector. Lifestyle flexibility and the crippling cost of medical indemnity insurance were the main reasons obstetricians were retiring from delivering babies, most to concentrate on gynaecology.    Obstetricians this week received IBNR (incurred but not reported) tax bills of up to $130,000 from the Federal Government, payable over the next 10 years.    The cash is to be used for medical mistake claims made up until 2000 that have not been settled by United Medical Protection. These factors were also a major deterrent to attracting new recruits to the speciality.    At least 25 per cent of doctors training in obstetrics said they did not plan to deliver babies when they graduated.    Dr McLaren said those who did stay in private practice would have no choice but to pass the costs on to patients, much of which would not be covered by health insurers.    Today's average gap of $1500-$2000 could rise by the thousands, she said, adding that some Brisbane doctors were already charging up to $3000 gap.    ``We're already seeing privately insured women booking into the public system because they can't afford the gap, and potentially that number will increase as the gap costs increase,'' Dr McLaren said.    ``And the public system can't cope, they are already swamped . . . obstetricians aren't just leaving the private sector, they're leaving public hospitals as well.''    Most Australian births occur in hospitals -- 70 per cent in the public sector.    'We must have phoned around 20 (practices) and they kept saying we're booked out' - Susana Boaldin    Queensland Health figures revealed 33,521 babies were born in state hospitals in 2001-2002, 35,986 in 2000-2001 and 36,318 in 2000-1999. The decline most likely reflected the fall in birthing rates.    The average cost to the public system of a vaginal delivery without complications was $2408, rising to $4009 for a vaginal delivery with multiple complications.    A caesarean without complications costs about $4670 rising to $7181 for a caesarean with multiple complications.    Workforce shortages and insurance concerns also have depleted the ranks of midwives. The Australian College of Midwifery estimated 1400 positions are unable to be filled nationally.    And the situation is expected to worsen in the next three years, as midwives leave the profession faster than new students are trained.    The college's Queensland spokeswoman said there were about 550 midwives in Queensland and 90 per cent worked in hospitals, more than half of these public.    ``There is an absolute shortage in rural and remote areas, but most of the cities will have no trouble filling positions,'' she said.    ``Some (country) areas don't have birthing services at all, women driving 300km or more to the city for the last four weeks of their pregnancy, just when they need their families the most.''    Rural Doctors of Australia president Damien Nevin said rural, remote and even regional women were among the hardest hit by a lack of birthing services.    He said the number of general practice obstetricians was rapidly dropping and limited private services were available.    Exacerbating the shortage of midwives was an expected drop in the number of rural GP obstetricians from 250 several years ago to just 120 this year.    ``The right of women to safely deliver their babies in their own region is being threatened and it will go,'' Dr Nevin said. ``It's a really dismal situation for rural women.''    The midwifery sector hardest hit has been the ranks of independent midwives, who assist women with home births, which account for about 1 to 2 per cent of births.    Not able to access affordable insurance cover since early last year, there are now ``less than 12'' operating across the state -- all without insurance. When Maternity Coalition Queensland president Bruce Teakle and his wife Erika had their two children, they could choose from six independent midwives ``without looking too hard'', as well as book into a midwifery centre.    Jasper, 7, and Rose, 3, were both born in their Mt Glorious home, delivered with the assistance of independent midwife Claire Brassard. Now Mr Teakle said there were only about three independent midwives delivering in southeast Queensland and they were far outnumbered by the number of inquiries the coalition and its member groups received each week from pregnant women.    The demand for midwifery services has overflowed into the Royal Brisbane and Women's Hospital Birthing Centre, which is so popular a ballot system was introduced.    The centre, the only of its kind in Brisbane and the second in Queensland (there is also one in Mackay), is staffed by nine full-time equivalent midwives.    Only healthy women without medical risk can be considered for admittance.    More than 4000 babies have been born in the motel-like environs of the centre since it opened in 1995.    Women's health nursing director Patricia Schneider said that for every 50 women able to access the centre each month, another 50 to 70 miss out and were forced to make other arrangements.    Ms Schneider said the main attractions of the birthing centre were the continuity of care throughout the pregnancy, labour and post-birth; the total involvement of partners during and after the birth; and the home-like facilities.    Ms Schneider said there were plans to add another two rooms to the centre within the next six months.    In its submission to the Senate Select Committee on Medicare, the Maternity Coalition argued for a system similar to that operating in New Zealand, under which the Government makes a set payment to the birthing service provider of each woman's choice, be it a midwife, doctor or specialist obstetrician.    Mr Teakle said 70 per cent of NZ women choose a midwife, have the baby in hospital and enjoy continuity of care throughout and after the pregnancy.