Queensland's rise in baby deaths after obstetric unit closures sparks urgent rethink
Woeful access to maternity services in rural and remote Queensland has prompted the state’s health minister to summon Australia’s top medical experts to take part in a summit examining the issue.
It comes after the Sunday Mail revealed 23.3 babies in every 1,000 were dying in some rural Queensland towns where no birthing services are available, compared with 6.1 babies in rural areas with obstetrics. Rural doctors told the Sunday Mail that the closure of 40 rural and regional obstetric units had contributed to the higher death rate in those areas, with women forced to deliver their babies at home or on the roadside trying to get to a hospital.
Queensland’s health minister, Steven Miles, said the death of even one mother or baby in childbirth was a “tragedy”.
“I’ve asked the Department of Health to establish a summit, including reconvening an expert panel formed in 2014 to look at these issues,” he said. “Doctors and medical practitioners are the right people to make these decisions based on patient safety.”
However, he said overall data showed Queensland was one of the safest places to give birth.
Queensland Health’s deputy director general, Dr John Wakefield, said he understood “everyone would like every facility or service right there in their own community”. However, he said there needed to be enough women and births in rural areas to justify appointing teams of doctors and opening maternity services there.
“This decision is never made lightly and involves careful and honest consideration of the risks and consequences by health services and their communities,” he said. “Each situation is unique.”
But a professor of midwifery at the Western Sydney University, Hannah Dahlen, said “you don’t need a maternity service in every single tiny town”.
“What you can do, however, is rethink your models of care so you at least have midwives who are able to provide antenatal care, and midwife-run units for low-risk women who can triage women and send those with more risk factors to a more medically managed unit,” she said.
“The problem is we treat every pregnant woman as the same. We need a more finessed approach. Not every woman needs a doctor but every woman needs a midwife. So why don’t we design maternity services to meet that reality?”
She added that Queensland did not have a publicly funded homebirth program, which was exacerbating the issue.
The Rural Doctors Association of Queensland vice-president, Dr John Hall, agreed that expectant mothers were being backed into a corner.
“Women are left with very poor choices – leave your life and kids behind for a couple of weeks or take the chance of doing it alone,’’ he said.
Rural doctors in Queensland say the closure of 40 rural and regional obstetric units contributed to the higher death rate in those areas.