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http://www.couriermail.news.com.au/common/story_page/0,5936,15268550%255E3102,00.html Push to strip hospitals of birthing Renee Viellaris and Margaret Wenham 13may05 MATERNITY services should be stripped from hospitals and transferred to new holistic community "bub-hubs" to improve care for pregnant women and babies, a major report recommends. The Rebirthing report, which followed a sweeping review of Queensland's maternity services headed by Cherrell Hurst, also advised the State Government to expand midwives' clinical roles. Welcomed by the Australian Medical Association, midwives and maternity advocacy groups, the report said inconsistencies in a range of clinical areas across the state were of major concern. Women reported being disempowered and not respected and called for continuity of care, while health professionals felt under-valued by Queensland Health. Other recommendations included: the creation of an independent 10-15 member board called the Centre for Mothers and Families, which would facilitate and monitor reform; the reintroduction of birthing services in rural and remote communities; and an allowance to be paid to women who have to relocate to give birth. There were more than 450 submissions to the report, which described how "two distinct cultures" currently existed in maternity care – the medical model and the natural model – which needed to be reconciled. The 151-page report was tabled in State Parliament yesterday and will be sent to stakeholders for their feedback before the Government considers the recommendations. A spokesman for Health Minister Gordon Nuttall said there was no timeframe set but the reform process would be done quickly. Many of the recommendations are medium to long-term, and are aimed for 2010. Australian College of Midwives state president Jenny Gamble said to reorient maternity services in the way the report recommended would relieve doctor and midwife shortages. "There will be less demand for doctors to be involved in low-risk births so their expertise will be used more efficiently," she said. "And the reform will lead to the retention of midwives in the system who are currently leaving because they are so dissatisfied with the current model of care and the current culture of care where they are seen as subordinate to or in need of supervision by doctors." Dr Gamble said she also expected the reforms would result in a reduction in the high caesarean rate, without safety being compromised. AMAQ president Dr David Molloy said the report was "intelligent and carefully considered". "It provides a blueprint for gradual evidence-based change with a focus on safety in outcomes and on team management of pregnant women," he said. Dr Hurst's report found Queensland Health had a strategic plan that "scarcely" mentioned the care of pregnant women, new mothers and babies, and funding, which also came from the Federal Government, was structured around the health system's needs rather than families' needs. |
