Equitable access to maternal health services

22 June 2020

RANZCOG has renewed its call for equitable access to maternal health services for all women in Australia, including those in regional and rural areas.

The call came last week amid a public debate following remarks by the Prime Minister Scott Morrison.

During question time on Wednesday, June 17, Mr Morrison suggested a highway upgrade was the answer to women giving birth on the side of the road outside Canberra.

Responding on social media, RANZCOG President Dr Vijay Roach said giving birth on a highway should be treated as a serious matter. Read the tweets below.

In an article in The Canberra Times on Friday, June 19, Dr Roach said retaining maternity units in rural towns was a priority.

Read the article here and below

Yass mother who gave birth on the side of Barton Highway continues advocating for local maternity ward

Jasmin Jones is in the middle of planning a party for her son Apollo, who turn nine on Saturday.

But for her, the day is also a reminder that another year has gone by without women in the Yass Valley being able to access proper maternity care.

Nine years ago, Mrs Jones gave birth in the guide map bay of the Barton Highway, near the border of NSW and the ACT.

She can still feel the cold early morning air as the doors of the ambulance were flung open so her husband, frantically trailing behind, could be a part of the birth.

She had been turned away from Yass Hospital, where there has been no maternity ward since 2004, and sent to Canberra, more than 70 kilometres away.

"For days, weeks, months afterwards, I would stand in the shower and cry about how shocking and wrong it was," Mrs Jones said.

She swore to herself that night she wouldn't let another mother go through that.

And yet two weeks after Apollo's remarkable entrance into the world, another baby was born by the side of the Barton. Another followed two weeks after that.

For nine years, Mrs Jones - now a Yass Valley councillor - has lobbied for maternity services to be restored.

Prime Minister Scott Morrison drew condemnation on Wednesday, when he suggested the $150 million upgrade of the highway would assist women in labour.

In a statement on Thursday, his spokesman said Mr Morrison misheard the question.

"Of course, the care of mothers and their babies is critical and that must be determined by the medical experts," the spokesman said.

Mrs Jones challenged Mr Morrison to take a drive down the Barton Highway with her to see for himself what women faced.

She can point out many areas where women have delivered babies by the side of the road.

"Mums are having babies in the backs of boots, in front of road workers, beside the Barton Highway in ambulances," Mrs Jones said.

"They're having them in their bathrooms and showers because they've been turned back from the Canberra system because it's too soon.

"Women are being induced and being pressured into caesareans by the hospitals which are trying to manage the distance of these women from care and that leads to complications, that leads to post-natal depression. Suicide is the second greatest killer of mums."

Mrs Jones said there are even cases of women whose tailbones have been dislocated because they've been in a car speeding down the Barton instead of lying in a hospital bed in the correct birthing position.

When Mrs Jones was in labour with her next child, she was racing down the highway again, with contractions one minute apart. The stress of the experience caused her labour to shut down when she arrived at hospital, and she gave birth nine hours later.

"I was in tears, thinking 'oh my God, this is going to happen again'. That's the story of our women," Mrs Jones said.

Rural Doctors Association of Australia president, Dr John Hall said more than 130 birthing units had closed over rural and regional Australia over the past 20 years.

This had a huge cost to the community, both in terms of the loss of health services and worse outcomes for mothers and their babies, he said.

"I guarantee that if the Prime Minister had been faced with the situation of his own wife giving birth on the side of the road, hoping that paramedics would arrive in time, he would not find it amusing in the slightest," Dr Hall said.

The case for the Yass maternity ward grows stronger by the year. Plans are underway to grow Yass from 17,000 people to 27,000. Murrumbateman - a village 15 minutes away - is expected to grow to 10,000 people.

Areas like Cowra, Forbes and Leeton have full maternity wards despite having fewer births, Mrs Jones said.

A review of the need for maternity services in the region now sits on NSW Health Minister Brad Hazzard's desk.

Royal Australian and New Zealand College of Obstetricians and Gynaecologists president Dr Vijay Roach said a maternity unit had broader benefits than just providing care to women and babies.

A unit required staff, including midwives and allied healthcare professionals, which in turn meant there was more demand for schools and businesses in town. If a unit reached a point where it needed to provide caesareans, that required a theatre and anaesthetics which meant even more jobs and medical capability.

"From that point of view if you want to reinvigorate rural towns, you need to retain the maternity unit. From that flows everything," Dr Roach said.

"A GP obstetrician or a maternity unit is a gift to the entire community."

He added, "There are no circumstances that could make a highway a safe place to give birth. Women outside metropolitan areas have a right to a high standard of healthcare and facilities."

Mrs Jones said it was untenable for a community with 200 babies born each year to continue without a maternity ward.

"Time's up as far as I'm concerned. I've been advocating for nine years. If there is a death beside the Barton Highway of a baby or mother, it is on this government who've stood by and let it happen.

"This highway was named after a great prime minister. We need to see a great prime minister now meet with a mum, drive the Barton Highway, understand the issue of why improvements don't solve the problem of our distance from maternity care."

Mr Morrison's spokesman said decisions about the Yass maternity ward were a matter for the NSW government.

"The Australian Government provides funding for public hospital services based on activity - if maternity services are delivered, the Australian Government will provide funding for it. And we have increased funding to the region to record levels," the spokesman said.



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