Wollongong Hospital is struggling to meet a growing demand for Midwifery Group Practice (MGP) services in the Illawarra.
With seven out of 10 women turned away annually, consumer advocacy group, Better Births Illawarra (BBI) is lobbying the hospital to expand the program.
Giselle Coromandel, the president of BBI said, “I really passionately believe that women in our area deserve this option.
“It’s unacceptable that there’s no plan or strategy that’s been committed to by the hospital on how we can fill this need.”
MGP is a midwifery-led maternity care model involving a small team, led by a primary midwife, who provide on-call support to women throughout their pregnancy.
‘’It’s extremely hard for women to get into the program. Women are calling up, basically the day they pee on a stick and sometimes they still can’t get in,’’ Wollongong-based postpartum specialist, Briony Goodsell said.
The NSW Health Department’s 2010 ‘Towards Normal Birth’ (TNB) policy stipulated a 35 per cent target for women accessing MGP services to be achieved by 2015.
According to documents obtained by BBI under freedom of information legislation, Wollongong Hospital failed to meet this target with only 13-15 per cent of women accessing the program.
There’s been some improvement – between January and March this year, 27 per cent of women who applied for the program at Wollongong Hospital were accepted. That’s a total of 80 women out of 292 referrals.
Ms Coromandel said, “No-one holds the hospital to account. Without any ongoing pressure, they’ve never grown the program in relationship to the demand.”
However, she said the hospital had recently established a steering committee, which she was providing input into.
‘’We are now having some meaningful dialogue with hospital management on how access to this program can be improved.’’
But Ms Coromandel said over three quarters of the NSW Health policy’s key measures and commitments had yet to be fully implemented at the hospital.
“They’re really out of touch with what the community wants and the experiences women are having by not getting access to this model of care,’’ she said.
Wollongong’s Kelly Hill was recently accepted into the program at 14 weeks pregnant. She said she wished it was an option for more women.
“I really didn’t like the idea of seeing someone different every time I went in and not knowing who was going to be delivering my baby,’’ she said.
‘’So I feel really lucky to now be accepted, but I know heaps of women have been turned away. I think it’s really important to have someone that you trust for something so major like having a baby.”
Working to redesign maternity services
Wollongong Hospital has announced it will review its Midwifery Group Practice program as part of a redesign of maternity services across the district.
Illawarra Shoalhaven Local Health District spokeswoman Melissa Cooke said Project 2020 – so named because it will run from now until the year 2020 – would work to build a better service.
‘’The (health district) is currently carrying out a full review and redesign of the Division of Maternity and Women’s Health,’’ she said.
‘’The primary goal (is to build) an enhanced service that places the needs of women and their families at its heart, and offers high-quality and safe care.
‘’One of the outcomes of Project 2020 is the completion of a Maternity Services Action Plan for Wollongong Hospital, which will guide the development of the service now and into the future.’’
Ms Cooke, the clinical co-director of Maternity and Women’s Health, said the hospital’s MGP program was established in 2004 and was one of the options of care available to pregnant women in the Illawarra. Under the program women have a primary midwife who, with the support of a team of midwives, provides care through pregnancy, birth and the two weeks after birth.
‘’MGP encourages active labour, natural birth, breastfeeding and early discharge home,’’ Ms Cooke said.
‘’Our midwives are trained specialists in normal pregnancy and birth and aim to facilitate an experience where women and their families feel informed, supported and in control of their care.’’
Ms Cooke said in 2016 the program provided care for 320 women: ‘’We acknowledge the growing demand for this service and are looking at ways to be able to increase the availability to women across the Illawarra.’’ – Lisa Wachsmuth
‘You build a great rapport’
Balgownie mother-of-three Samantha Linde is ‘’gutted’’ her fourth pregnancy and birth will not be overseen by the same midwife as part of a personalised program.
At 26-weeks pregnant, hope is fading that she will be accepted into Wollongong Hospital’s popular Midwifery Group Practice (MGP).
She’s experienced the best – and less than best – sides of pregnancy care having enjoyed the MGP service for only one of her pregnancies.
‘’My first two pregnancies I was under the normal program which was fine but there were downsides,’’ Mrs Linde said.
‘’There’s no continuity of care – you never know who you will see at each appointment and that uncertainty can create a lot of anxiety.
‘’There’s always different faces, different approaches, different opinions and it can be unsettling at an emotional time.’’
During her last pregnancy she and husband Peter, and their first two boys, were in Canberra and she was fortunate to be able to join an MGP program there.
‘’It was such a positive experience – by having the same midwife the whole way through you build a great rapport,’’ she said.
‘’They get to know you, they know your history and understand what’s best for you and you can put your trust in them.
‘’You don’t have to constantly advocate for yourself with different hospital staff – because they advocate for you.’’
NSW Health figures have revealed that just a third of women referred to Wollongong Hospital’s MGP program get accepted.
There are those who are ineligible – for clinical reasons or who have gone on to miscarry – but there remains many hundreds each year who are disappointed.
‘’It’s just an amazing service that needs to be expanded here in the Illawarra,’’ Mrs Linde said.
‘’In Canberra I was accepted straight away despite being 20 weeks pregnant, but even though I applied here as soon as I reached that 12-week milestone, I was too late.
‘’I was told most women apply as soon as they know they’re pregnant, and even then many don’t get in.’’
Even though she’s over halfway through her pregnancy, Mrs Linde said she’d only had one appointment at the hospital under an alternative midwifery program.
‘’I really miss the continuity of care where someone’s taking a holistic approach to my care – rather than just reading off a piece of paper,’’ she said.
‘’I’m on my fourth pregnancy so know what I want but I really feel for a first-time mum who needs that support, that comfort.
‘’I’m glad the hospital is reviewing access to this program as too many women are missing out.’’ – Lisa Wachsmuth