Mother of all journeys

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PREGNANT women are being bumped from NSW hospitals ... as the baby boom and an increase in birth complications put more pressure on maternity units.

Many large public maternity units have introduced a cap on numbers and geographical limits on patients.

... When Prue ... went into early labour with IVF-conceived twin boys ... she was told there was no room at the Royal Hospital for Women in Randwick.

The 15 high-care cots in its neonatal intensive care unit were occupied, and the closest ones available were at Canberra Hospital, John Hunter Hospital in Newcastle and Liverpool Hospital.

Ms Corlette chose Liverpool ...

''But from the moment I got into the back of the ambulance, the continuity of care I had built up with the staff at the Royal was gone,'' she said.

''Up until then I had been seeing one dedicated midwife and obstetrician throughout my pregnancy. They knew the type of birth that I wanted and I knew what their preferences were.''

... Ms Corlette's midwife and obstetrician were unable to attend the birth at Liverpool Hospital as they are both employed by the Royal Hospital for Women.

Born nine weeks premature, baby Theodore weighed 1840 grams and Hugo 1770 grams. They stayed at Liverpool Hospital's neonatal intensive care unit for 10 days. Ms Corlette was discharged after three days.

But she could not drive after the caesarean and was forced to undertake a four-hour round trip on public transport to take expressed breast milk to her babies.

... While geographical limits apply to the Royal Hospital for Women, it accepts women with high-risk pregnancies from outside the area.

''If RHW's neonatal intensive care unit reaches capacity, babies can be referred through the state-wide network to other NICUs within NSW, and then return to RHW's NICU when a cot becomes available,''

... The Royal Hospital for Women is one of the state's busiest hospitals, delivering about 4000 babies a year.

The busiest is Royal Prince Alfred Hospital ... where 5321 babies were born last year despite being designed for a capacity of 4000 births ...

Two years ago the hospital was forced to transfer about two women a month to nearby Canterbury Hospital when it reached critical mass ...

Westmead Hospital, which delivers 5200 babies a year despite being funded for only 3800, has also introduced caps on women living outside the area.

Australian Medical Association president Andrew Pesce, also an obstetrician at Westmead, said: ''The birth rate has increased and yet beds have been closed and the funding has not expanded in the way that it needs to to look after the number of women booking in.

''The staff-to-patient ratio - especially the number of midwives - is not what it should be. All of these are contributing to the situation.''

The birth rate in NSW has been steadily increasing since the introduction of the baby bonus in 2004, rising from about 85,000 a year to 96,000 last year.

... The NSW government will spend $42 million over four years to meet the demand for maternity services.

Reducing the caesarean rate to 20 per cent by 2015 is part of the plan to alleviate pressure on public maternity hospitals.

Part of the solution may be to encourage private midwifery care which reduces the staffing requirements of the hospital and enables women to have their pregnancy and postnatal care outside of the hospital. Another strategy would be to encourage home births for all well women with healthy pregnancies who are anticipating a natural birth.