Mothers in the bush are spending up to $20,000 before they have even had a baby because of a shortage of maternity services in regional and rural NSW.
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Sixty-five services have shut down across state in the past 20 years with more facing an uncertain future, forcing country mothers to travel hundreds of kilometres to give birth.
They not only have to travel huge distances, but they must pay for accommodation and are faced with the stress of being separated from their families.
Leah Hardiman from Maternity Choices said in some cases country women were spending between $10,000 and $20,000 on relocation costs to have their baby.
“Living away from home means for some mothers five weeks worth of accommodation and food,” Ms Hardiman said.
“Some people can stay in the charity houses and some are eligible for patient travel rebates, but for the rest, they get nothing.”
Rural Doctors’ Association of NSW president Emma Cunningham said the state could not afford to lose any more maternity units or have them downgraded.
She said at least six services had closed or been downgraded in the past decade, including Pambula, Bourke, Yass, Ballina and Casino, however, as many as 50 per cent of maternity units (65) had closed in the past 20 years.
RDANSW's figures suggest a further five rural hospitals are under extreme workforce stress, and risk sudden unexpected loss of medical services.
“We want our women to give birth as safely as possible as close to home as possible,” Dr Cunningham said.
We want our women to give birth as safely as possible as close to home as possible
- Rural Doctors’ Association of NSW president Dr Emma Cunningham
“We know that attracting and retaining doctors and midwives to rural areas moves beyond incentives. Maintaining a robust obstetric unit requires not just a single obstetrician and midwife, but rather a number of clinicians to fulfill the requirements of 24/7 on call safely.”
With ongoing commitment to the National Rural Generalist Program training the next generations of rural GP obstetricians, Dr Cunningham said over-time the workforce could allow for the re-opening of previously abandoned services, with budgetary support from the Local Health Districts.
First time mother Melissa McGovern thought with a new hospital in Orange she would have all the services needed for her birthing experience.
But when she went into labour five weeks early, she was told there was “no room” for her at the hospital, with too many babies already in special care.
“They could only support four babies and there was already five in there,” she said.
Mrs McGovern was then flown Nepean Hospital where she had her baby, Kobe, and spent five days in the neo-natal intensive care unit before being transferred back to Orange.
“Being in Orange with a new hospital I never thought I would have to go anywhere,” she said.
NSW Shadow Health Minister Walt Secord has described the level of maternity services in rural and regional areas as “dangerous for young mums and babies”.
“Rural and regional mums and babies are being treated like second class citizens – given a lower quality of health care than their counterparts on Sydney’s leafy north shore,” Mr Secord said.
“In recent months, we have heard dangerous cases of mums giving birth on lonely stretches of highway because they have to race to get to a birthing centre hundreds of kilometres away.”
But Mr Secord said Labor’s plan announced in late-July for nurse to patient ratios – especially in maternity wards – would massively increase the number of nurses outside Sydney.
“Labor wants to invest in nurses and increase the number of midwives in rural and regional NSW. This is about supporting young mums and newborn babies,” Mr Secord said.
“Young mums are being forced to travel great distances and when they get to the hospital, they find that there are not enough medical staff to provide the most basic care for them.
“The medical facilities simply do not have the necessary staff for birthing suites and intensive neo-natal care.”
A spokesperson from NSW Health said there were more than 70 public maternity services in NSW, including 46 provided by rural and regional Local Health Districts (LHDs). In some rural and remote NSW Hospitals, birth numbers may be as low as 50 per year.
“Not all maternity services provide birthing facilities, however, outreach antenatal and postnatal services in remote communities increase access to care for women that is closer to home,” the spokesperson said.
The spokesperson said there were workforce challenges with midwifery in some districts associated with population growth, but the government had been putting in place programs to address this including scholarships for midwives.
“The aim of these scholarships is to support the recruitment, retention and skill development of registered nurses and midwives currently working in the NSW public health system,” the spokesperson said.
More than 2400 new graduate positions were being recruited in 2018 across local health districts and networks, and of these, the spokesperson said about a third were graduate nurses and midwives that would commence in rural and regional locations of NSW.
In 2018/19, $37.2 million was allocated by the NSW Government to employ up to 100 midwives, with around half to be employed in rural and regional areas.