Local birth facility badly needed | Wanaka Sun
Wanaka Sun (page 1) 16 March 2017 by Danielle Butler – email: firstname.lastname@example.org
The message from mothers and midwives to the Southern District Health Board is clear – we need more birthing facilities and we need them now.
Wanaka’s home birth rate is currently at around 30 percent compared to the national rate of 10 percent according to Wanaka midwife Morgan Weathington, due to the frequency of quick births in and around the town.
“The issue of women birthing at home instead of a unit is either one of women’s choice or because that is the best option due to the speed of labour and distance to a unit. It is safer for women to birth in a building than on the side of the road trying to get to a unit. Home births, like primary unit births, are always attended by two midwives with emergency equipment,” Morgan said.
“They are not an unsafe option for low risk women. And in the fast birth cases, they are the only option.”
Morgan said that there are two key issues facing Wanaka’s midwives, the first of which is the ever-increasing population one hour or more from a primary maternity unit, and three and a half hours or more from the closest full service hospital in Dunedin.
“The District Health Board (DHB) is under obligation to provide a maternity unit within 60 minutes of its populations with over 100 birthing women, and therefore has not lived up to its expectations for over ten years in the area,” Morgan said.
Mum-of-four Jessie Boyd lived in Hawea Flat when she had her fourth child Zara at home 20 months ago after originally planning to travel to Alexandra.
“It was about 4am and my midwife told me it was too late to risk the drive and it would have been so painful travelling that far. Looking back it was a wonderful birth but it really annoys me that there is nothing closer,” Jessie said.
“It’s dangerous for driving especially in winter or if complications arise and the car ride in labour would be hell.”
Hawea Flat mum Emma Burlinson who lived out at Glendhu Station when she gave birth to son Alfie 15 months ago, had to abandon her plan of travelling to Charlotte Jean Maternity Hospital in Alexandra and gave birth in her midwife’s office.
“Close to the birth Alfie had stopped growing which caused some concern, and it was likely that had he not come eight days early I would have been induced at Dunedin. However, he arrived a little early and a lot faster than expected, ” Emma, pictured with Alfie, said.
Emma headed to her midwife’s office where she was checked over before she planned to continue on to Alexandra, but found that she was fully dilated and would have to give birth there and then.
Alfie was born only 40g over the “cut off” minimum weight limit of babies required to be sent straight to Dunedin and Emma was injected with oxytocin due to a large bleed, but both went home happy and healthy.
“I was very relieved that everything stacked up in our favour and felt extremely lucky to have a healthy baby, as well as an excellent midwife that made me feel comfortable enough to give birth in such unexpected surroundings. There was a real concern that if things had been different at a number of stages it could have worked out differently,” Emma said.
Wanaka currently has seven qualified midwives in the area who aren’t practicing and in 2018 the town will only be left with two, which is the second problem.
“Due to a maternity contract that is tied up in national legislation, lead maternity carers, which is what the midwives of Wanaka are, are being paid less and less each year with the expectation that all business expenses, mileage and equipment comes from this ever decreasing payment/women cared for,” Morgan said.
“The payment for the work is not sustainable anymore and the personal toll for midwives and their families too great. Not factoring in on-call hours we are making less than minimum wage. With the on-call hours included it is almost a volunteer profession. For this reason it is hard to recruit midwives here.”
In terms of solutions, Morgan said that a sustainable community-led and funded model like Balclutha’s primary unit could work.
The unit, funded in part by the DHB and Ministry of Health and in part by a community trust, employs community midwives who staff it and provide antenatal, birth and postnatal care.
“A Wanaka primary unit with space for antenatal assessments and community care, a birthing room and postnatal beds, staffed by salaried midwives would work here too,” Morgan said.
“If we positioned it strategically we could also have access to more health care providers in emergencies and quick helicopter access.”
Liz Disney, Southern DHB’s Acting Executive Director, Planning and Funding said that the board’s primary maternity services project is seeking to identify improvements in service delivery in order to enhance sustainability, quality and access.
This includes ensuring appropriate access to primary maternity facilities across the district, as well as transfer and transport processes when secondary care is required.
“Southern DHB is committed to ensuring all women in the district have equitable access to maternity services and that the service is provided in the most safe and effective manner possible,” Liz said.
“Currently primary birthing rates are about 12 percent for all births in the Southern district, which is one of the highest rates of primary birthing in the country.”
Liz added that Charlotte Jean in Alexandra and the Lakes District Hospital in Queenstown both provide primary maternity services in the Central-Lakes area as well as postnatal facilities.
RELATED: Local midwives at breaking point | Wanaka Sun (2 March 2017)
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Wanaka Sun | 16 – 22 Mar 2017 | Edition 809