Midwives warn of reform dangers

Last updated 05:00 01/04/2012

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Midwives say health reforms in the lower North Island could endanger expectant mothers and their babies.

They say midwifery services will be under pressure if hundreds of women a year are forced to travel to Palmerston North under a district halth board proposal.

The Whanganui and MidCentral district health boards are considering a proposal to drop acute and emergency maternity procedures from Whanganui Hospital. That would mean at least 400 women with high-risk pregnancies would be transferred to Palmerston North each year.

Women from Manawatu, Horowhenua, Tararua, Rangitikei and as far as Taranaki could be affected, the College of Midwives says, and the hundreds of extra deliveries at Palmerston North would create pressure for maternity teams there.

The college is concerned that the proposals include only three additional antenatal beds and no new delivery rooms at Palmerston North. "That stretches an already busy service's ability to provide the best possible outcomes for women."

The MidCentral board's $3.7 million business case shows plans to provide for an additional 76 acute caesarean sections, and 154 acute gynaecology cases. It also says an extra four to five maternity beds and one delivery bed would be needed.

The board's proposal is to better manage acute procedures such as inductions, epidurals and emergency caesareans because of a lack of obstetricians and gynaecologists in the area, a shortage that reflects a national trend as specialists are tempted by Australia's higher pay, Association of Salaried Medical Specialists spokesman Ian Powell said.

Whanganui-based consultant obstetrician and gynaecologist Mark Stegmann said consolidating specialist care on one site was the best way forward, and clinical leaders believed it would ensure better services and attract specialists.

But midwives want an investigation into MidCentral's maternity services before agreeing to the proposal.

Ministry of Health data for 2009 shows that out of 330 babies born at MidCentral, 20 per cent were caesareans, while the national rate for women who gave birth to one child was 15.8 per cent.

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