Mums speak out about maternity shake-up

Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448. Link

LOCAL women have expressed grave concerns about the standard of maternity services on the northern beaches, claiming a doctor-free birthing unit at Mona Vale Hospital is a risk to their health.

With the Health Department and midwives’ groups angrily denying the changes would jeopardie the health of women and their babies, The Manly Daily yesterday spoke to the most important people in the debate - new and expecting mums.

Amee Harland said she would wait for the Mona Vale maternity ward to reopen in full before having a second child there.

“I had a 24-hour labour and then they had to call the doctor because the baby’s heart rate was falling and he was there in five minutes and had to use a surgical vacuum,” she said.

... “You wouldn’t want to drive to Manly (or St Leonards) in the middle of labour ...

“I would prefer to go to Mona Vale - it is my home town. Why would I want to go anywhere else? They were so good there.”

Mother-of-three Kellie Finney said low-risk births could also require immediate action.

“If there’s an emergency, the time it takes to get to another hospital would be pretty risky for babies in distress,” she said.

Luckily, research is showing that low risk maternity units are a safe option for women and babies, just as homebirth is a safe option for low risk women and babies. Several low-risk maternity units are in operation: Belmont, Wyong, Ryde just to name a few. The provide a fantastic solution to the issue of maintaining local birthing services.

“I don’t know how long exactly it takes for the baby to stop breathing or have serious medical problems.”

Thankfully, midwives can make such assessements. Transfer policies in place would ensure that women and babies who were at risk would be transferred to an appropriate facility in a timely manner.

``After the baby is born, what happens if the mother is bleeding out of control?’‘

The midwife would administer medications to stop the bleeding, insert a drip and start IV fluids, insert a urinary catheter to drain urine and supervise transfer. It is very rare for a woman to "bleed out of control" and most bleeds are controlled with medications to stop the bleeding.

... if a doctor was needed during the birth, such as to deliver the baby by caesarean, use certain medical instruments or administer an epidural injection, women will be transferred to Manly Hospital or Royal North Shore 45 minutes away.

And the problem is ... ?

While mothers at the Mona Vale playgroup praised the role of midwives and welcomed the return of some maternity services to Mona Vale, they said they would not give birth without a doctor present.

You can't please everyone! The majority of midwifery-led units are over-subsctibed with many women wanting to birth there where they're assured a known midwife and maximum chances of a natural birth. No-one is being forced to birth at Mona Vale; women who prefer to go to manly or RNSH would be able to go there.

Most mothers said a doctor was called in during their previous births, despite some being in a low-risk category.

That might be a larger reflection on the rates of intervention in obstetric-led births rather than on actual need in a natural labour. Let's not forget, high risk births would not take place at Mona Vale: no-one with diabetes, high blood pressure, premature, over 42 weeks, bleeding, broken waters for more than a certain period of time, anyone needing an induction or caesarean, twins, breech, anyone planning an epidural and so on.

... Catherine Kane, who is expecting her second child, said she is ``not low risk enough’’ to give birth at Mona Vale. ``I wouldn’t be allowed to go to Mona Vale although I’m not high risk, I’m not low risk enough either.’‘

Andrea Whitlock, from Terrey Hills, said she would expect the maternity unit where she gave birth to have a doctor on hand. ``I had a natural delivery but if I didn’t have a doctor there I wouldn’t have been able to do it,’’ she said.

Hmm. I think you did do it! No-one else birthed your baby.

... The model will first be tested at Manly Hospital in October and is scheduled to begin at Mona Vale in December.

The Mona Vale maternity unit will also be reduced from 720 births to just 200 a year, with mothers only able to stay four hours after birth ...

Melissa Maimann, Essential Birth Consulting 0400 418 448