AS THE debate over maternity services in the Bega Valley continues, a local woman has spoken out in favour of having one service.
Cindy Turner, the representative of the Far South Coast Maternity Coalition and the mother of three children under six years of age all born in the Valley, said that maternity services were not just a hospital’s ability to provide surgical services.
According to Ms Turner, maternity services encompass antenatal education, antenatal care, care during labour and the immediate post delivery period, postnatal care, breast feeding support and management of breastfeeding problems, prevention and management of postnatal depression, early parenting support, care of infants at risk, triage and evacuation of mothers and infants at risk.
“Maternity services are provided by midwives, general practitioners (GPs) and obstetricians,” she said.
“They are provided in the hospital, in the clinics and in our homes. “Maternity services are an intricate multidisciplinary fabric that should place birthing women in the centre of safe and sustainable care.”
Ms Turner said there was a need to look closely at maternity services in the Valley.
“Across the Bega Valley there are no more than 300 women giving birth per year,” she said.
“Even with a generous caesarean section rate of 25 per cent the total of women needing a caesarean would be 75 per year.
“Divide this between two hospitals and you are providing a surgical service 24-hours a day, 7-days a week, for 30 to 40 women per year.
“Although this doesn’t take in all the issues, it is a good indicator of surgery needs.
“Providing two sets of surgical services is duplication and an inefficient use of precious resources.
“The issue is an absolute ‘no brainer’ and everyone can see it - especially when you consider a new hospital with only one set of surgical services.”
Ms Turner said the numbers of women giving birth locally were important.
“In a recent communication with NSW president of the Maternity Coalition, I was told that services with a many as 500 women per year have been deemed unsafe and closed down,” she said.
“Here, with only 300, and the numbers dwindling, we face being packed up and sent off like women in remote areas.”
Ms Turner said maternity services in the Blue Mountains were recently closed down, with all women having to travel to Nepean.
The Maternity Coalition and hundreds of women protested and the service was reopened, but without surgical services.
It is now run by midwives in a birth centre like capacity for antenatal and postnatal care and for women having low risk births.
“I am not suggesting that we can have births without the back-up of a caesarean,” Ms Turner said.
“I am just trying to explain there are many different models of maternity care that can help to make a service sustainable.”
Ms Turner said she was in no doubt the latest review will make the same recommendations as the one conducted in May 2005 that called for combining of surgical services to one site and the improvement of antenatal and postnatal services to give women a choice of carer and care in their own community.
“This is the ‘other’ part of maternity services, the part that is being neglected,” she said.
According to Ms Turner, when pregnant women go to booking clinics in other parts of Australia they are asked what type of care they would like.
Would it be shared care with the GP?
Would there be an obstetrician - or midwives?
“NSW Department of Health states that women should be given a choice of care, continuity of care and control over their births,” Ms Turner said.
“In other areas of Greater Southern Area Health this is provided to women. There has never been a choice of care for women in the Bega Valley and with the current system the options are getting worse.”
Ms Turner said that if women were given choices, they were given control and if women are given control they have much better outcomes and everyone benefited.
“The recent resignation of GPs in our community is another loss of valuable maternity service providers,” she said.
“I could not have lived without my GP; she was there supporting me through the birth of my three children and she still looks after them now.”
Two of Ms Turner’s friends were cited as examples of the problems associated with giving birth locally and women who could be attracted back to local services if there were alternative models of care.
“What about my friend who had twins and needed an obstetrician?” she said.
“Travelling in pain upside-down in her car all the way to Moruya then all the way back again with tiny infants.
“And what about my other friend who tried a homebirth by herself because she didn’t want a medicalised birth and she didn’t want to access the substandard facilities that are currently on offer?”
Ms Turner said that “we need a quality service with GPs, midwives and obstetric services - we need a choice”.
“This will provide us with control and sustainability and will attract more women and more staff,” she said.
“Negativity and discord will only continue the demise of our already ailing services.”
There was a need for everyone to work together, Ms Turner said.
“Women, managers, doctors and midwives in partnership to achieve the common goal - a safe and sustainable maternity service.”
• Bega District News believes the review is
due for release this week, but Ms Turner said if
it wasn’t released, then people should contact NSW Health Minister, John Della Bosca at office@smos.nsw.gov.au and ask for its immediate release and the implementation of the recommendations.