These two stories are in the Sydney Morning Herald today, along with a big
colour photo, on page 3:
Pregnant pause as birth program gets the push
By Ruth Pollard, Health Reporter
September 2, 2005
No continuity
Lisa McLean, with son Luke, two, has lost her midwife.
Photo: Peter Morris
The NSW Government has abandoned a midwife project at Mona Vale and Manly
hospitals, leaving up to 200 women - some of whom are due to give birth in
the coming month - to scramble to find places at other hospitals.
Just days before the project was to go ahead, the Northern Beaches Health
Service decided to shelve it and undertake a review of maternity services
in the area.
Lisa McLean, who is due to give birth in eight weeks, has been affected by
the change. She was attracted to the program because of the continuity of
care it provided to expectant mothers, who were to have been allocated to
one midwife for prenatal, birthing and postnatal care.
Now, the women must choose to give birth at the unit without personalised
midwives, or find obstetricians or birthing centres elsewhere.
Mrs McLean will stay with the unit but has no idea which midwife will be
caring for her and her baby. "It was to become more of a personal,
one-on-one experience; they are on call, they are there for the birth and
the follow-up afterwards. That is the reason a lot of women go to
obstetricians, even though they don't really need to, to have that
continuity of care."
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The general manager of the Northern Beaches Health Service, Frank Bazik,
said he was not prepared to give his final approval to the project before
having all maternity services reviewed to determine which birthing model
was appropriate for each hospital.
Insisting that it had been deferred for only two to three months, Mr Bazik
said there had been no safety concerns about the program. "There have been
some meetings with the obstetricians about this proposed model and they are
supportive of it."
However, the Herald understands that staff have been told that "severe
budget problems" at the health service were a factor in the decision.
Sally Tracy, an associate professor of midwifery practice development at
the University of Technology, Sydney, said there was no reason to defer the
program. "I have no doubt that they have been bullied into not allowing
this service to go ahead
Clearly, there are people who have vested
interests in this, who do not want to see a service where women go to
midwives."
---------------------------
Doctors irked at lack of say in midwifery talks
September 2, 2005
A rift has emerged between the NSW Government and the Australian Medical
Association, which says it has been shut out of consultations on the
development of maternity services.
So deep is the division that the association has begun a vigorous campaign
to reclaim ground in the debate.
Andrew Pesce, an obstetrician and senior member of the association, told
the Herald that while a recent review of six international studies had
found some "modest benefits" from midwife-assisted births, it had also
found "significant risks".
"It showed an 83 per cent increase in the risk of infant mortality," he said.
Dr Pesce said NSW Health had made a policy decision to exclude the
association from consultations, "presumably because they know how we will
respond". But Kathleen Fahy, the dean of midwifery at the University of
Newcastle, and the co-author of the review, Denis Walsh, have disputed Dr
Pesce's interpretation.
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The review, by the international non-profit group the Cochrane
Collaboration, had not found "a significant difference in baby deaths and
it is less then honest of Dr Pesce
to imply that it did", Professor Fahy
said. After reviewing each of the studies included in the review she found
60 per cent of women who were supposed to give birth assisted by a midwife
had been transferred to a hospital.
"Yet all the baby deaths were blamed on the birthing centres, even if the
baby died hours, days or months after transfer to medical care."
Most deaths were due to gross prematurity, gross abnormality or an
unexplained stillbirth, she said.
"Their [the doctors'] fear is that midwives will get a Medicare number and
set up in competition and women may choose midwives as their primary care
providers rather than doctors."
The association's NSW president, John Gullotta, said yesterday that he had
also received no response to a request for a meeting with the Minister for
Health, John Hatzistergos.
"It is very important that he does talk to his major medico-political lobby
group. As health minister if you are not talking to the AMA you are not
talking to the major group."
Mr Hatzistergos would not say whether the Government had excluded the
association, but said it had not put its concerns to him.
Ruth Pollard
-----
Andrea Robertson
Birth International * ACE Graphics * Associates in Childbirth Education
e-mail: [EMAIL PROTECTED]
web: www.birthinternational.com
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