A Wanaka midwife is pleased at the acknowledgment that birthing facilities for women in rural and remote areas need work.
The Southern District Health Board (DHB)’s primary maternity services report, produced using feedback from midwives, consumers, facility providers and other healthcare professionals revealed at the beginning of June how changing demographics and shifting populations needed to be addressed in the configuration of birthing facilities.
Findings and recommendations in the report included supporting a strong and sustainable primary maternity care workforce and ensuring more consistency in the operation and funding of primary birthing facilities across the southern district, which has the highest primary birthing rates in the country.
Midwife at Wanaka Midwives, Morgan Weathington, said she was happy that there had been an acknowledgement the Central Otago population was growing.
“We were really happy to see the acknowledgement that the area is growing and there is a need for more services. That in itself is a good start as the 2013 census didn’t show the growth in this area which increased for the next year,” Morgan said.
“What came from the feedback that we provided is that there is a lot of work to be done and Southern DHB is going back to the drawing board and putting together another working group to try and address some of the issues in a bigger picture. Some of the original reasons for this report were to look at inequities in the DHB and ensure good services delivered across the DHB.
“We’re now hoping that places like Wanaka are going to be acknowledged and how we can work as a network, helping each other out.”
Southern DHB launched the urgent maternity transport protocol in May, aiming to offer improved access to emergency transportation for pregnant and birthing women in rural areas.
“We have been discussing this for years and the need for women to be able to be transferred out of remote and rural areas became apparent within the primary maternity services meetings,” Morgan said.
The protocol has guidelines to help rural midwives access urgent transfers directly from St John and upgrade to helicopter transfer if necessary.
Southern DHB Chief Executive, Chris Fleming, said the need to improve the system of urgent maternity transfers was identified in the primary maternity services project consultation.
“The development of the protocol has meant that women birthing in remote rural areas have improved access to the appropriate level of response at the right time, whether it be an ambulance or helicopter transfer,” he said.
Morgan said the protocol was good news for midwives in Wanaka.
“We acknowledge that some delay will happen if you call for an ambulance. Some delay is acceptable, but over an hour for the ambulance to reach the woman is deemed unacceptable and then we have the possibility of upgrading to air if appropriate,” Morgan said.
“We could always do that but there was some resistance in asking for a helicopter. Now it has been acknowledged that we can upgrade when unacceptable delays occur.”
Coordinator for the maternity quality and safety programme at Southern DHB, Heather LaDell, said the Southern DHB was unique as it spanned the district that covered the largest geographical area in the country, yet it had a relatively small population.
“We have seven primary maternity units and there are challenges in ensuring transportation is timely and appropriate,” Heather said.
Southern DHB will now organise a workshop in July with consumers and clinicians to test the proposed principles for future design of a district-wide primary maternity service.
The outcomes of the workshop will be the basis of future recommendations for the configuration of primary maternity services for the southern district.
Pictured: Newborn baby at Queen Mary Maternity Centre, Dunedin Hospital. Photo: Nikki Heath
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