Wednesday, November 10, 2010

What the women said ... (2)

... in their submissions to the Maternity Services Review.

Today's theme is, for want of a better word, 'rural'. This means distance, relative isolation, lack of access to services, and much more. Here are some direct quotes. Women's descriptions of their own feelings have been highlighted. The number noted in square brackets [n] denotes the reference number for the submission.

Theme 2: Giving birth in Rural Australia
2.1 Excluded from local hospital 'low risk' maternity service [030]
I write this to you as a mother of four children who had to travel 80 kilometres just to give birth to them.

When my husband and I found out that we were expecting our first child, due to be born in early 2001, we were hoping that we would be able to birth him in our brand new local hospital, which was completed in the previous year. It was a state-of-the-art facility, complete with Maternity ward and we were excited to think that our child could be born there. Although we knew that in the “old” hospital that the Maternity unit had been downgraded to only accept those women considered “low risk” – women who had no previous complications during birth and those who were multiparas (women on subsequent pregnancies), we hoped that with this new hospital it would bring a new opportunity for those women previously excluded to be able to birth there.

But we were to find out that the status quo would continue at the new hospital. This meant that I was excluded from our local hospital and that I would now have to travel a 160 kilometre round trip to the next town to see a Doctor I had never met before, in a town I didn’t frequent and give birth in a hospital far away from family. There was the vague hope that after I gave birth I would be able to travel back to my local hospital for my post-partum hospital stay, but within 6 months of my falling pregnant, even this option was taken away from me.

And even then there was no guarantee that I would give birth in this hospital. It was only a small District Hospital and could only take women after 38 weeks of gestation, women with singleton pregnancies, women with no health complications for themselves or their babies. If you were in any way considered to be “high risk” then you were forced to travel to the NEXT hospital, which was a further 80 kilometres away.

The situation has only become more dire as the years have gone on. Not one single pregnant woman I talk to doesn’t have concerns that she will not make it to the hospital in time and fears either giving birth at home unattended or by the roadside. This raises another, separate issue, in that the husbands and partners of these labouring women are under even more pressure to get them to the hospital “on time”.

It makes me wonder if women and their babies will have to start dying before anything is ever done about this situation.

2.2 What models are needed for maternity services for rural and remote communities? [279]
All women wherever they live throughout Australia, want the option of giving birth to their babies in their own communities in a shared experience with their families, even if this does not eventuate, but most importantly they want to be sure that the experience will be safe, both for themselves and for their baby.

Women in rural and remote areas are no different from their city sisters in having the same wishes, but rarely are these wishes realised. If their preferred option is not available locally they have to travel away from home, sometimes long distances to metropolitan centres, where they are dislocated from their support structures. They often have significant financial outlays for travel and accommodation. However, like most people who live in rural, regional and remote areas, they are pragmatic, and accept that they need to make some compromises for living in small communities. Nevertheless they have a right to access more options than currently exist for them.

The most pressing needs faced by families in rural and remote areas are to have
• A range of service options that are Geographically accessible
• Assistance with travel to access services only available at a distance.
• Special consideration for women with complex needs.

2.3 Midwife in local community, and suitable accommodation for families [272]
I live in a very small rural community on Eyre Peninsula, South Australia. Our home is a two and a half hour drive from the Port Lincoln Hospital, where my two children were born.
In particular we feel that the services provided by the Community Midwife were exceptional. It was a joy to have this naturally caring and very experienced lady visit our home during pregnancy and in the early weeks of our babies’ lives. She was always ready to listen and offer practical advice to help us through various issues, either in person or over the phone. By completing a range of tests at home, we were spared long and expensive trips to see the doctor. The Community Midwife is an essential service for small, remote areas such as ours.

The biggest concern I have had is lack of suitable accommodation for pregnant women from surrounding regions in Port Lincoln. Two weeks before my second baby was due I had to stay at my sister’s in-laws nearer to Port Lincoln. Other local women’s experiences have included staying for several weeks at a caravan park, and having to clean a rental house immediately after leaving hospital. We need a better solution.
I feel very strongly that women from the areas surrounding Port Lincoln need access to a special house in Port Lincoln where they can stay with their partner and family in the final week or two of pregnancy. Partners and older children also need somewhere to stay while mum stays in hospital. Mothers may even be able to leave hospital earlier and stay in the house with a midwife’s support. A special ‘Rural Maternity House’ would take away many concerns that long distance mothers have. It would make pregnancy and labour safer and more positive for all.

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