Maternity proposals ‘add risk’

A push to encourage women to give birth away from Christchurch Women’s Hospital restricts choice and increases risk for mums and babies, maternity advocates say.

The Canterbury District Health Board (CDHB) is running forums this month with midwives to promote ’’more actively’’ primary maternity units (PMU), where women give birth with limited pain relief and no medical assistance.

The move came as an expected increase in birth rates in the region would put further pressure on a stretched Christchurch Women’s Hospital (CWH), where most women choose to give birth.

Action to Improve Maternity (AIM) founder Jenn Hooper said the CDHB’s strategy ignored women’s wishes.

‘‘Women are not choosing birthing units. They want the security and safety of a medical space.’’

Any birth had the potential to go ‘‘horribly wrong, horribly quickly’’.

‘‘If they want to encourage women to birth in PMUs, they should build them alongside hospitals so medical help is there straight away in case of a complication.’’

Last year, 89 per cent of the 5855 women who gave birth in a Christchurch facility did so at CWH.

More than one in three women had a medical intervention, including C-section (28 per cent), epidural (19 per cent), assistance including forceps and ventouse (12 per cent) and episiotomy (12 per cent).

Of the 724 women who intended to give birth in a Christchurch PMU last year - including St George’s, Rangiora, Burwood (now closed) and Lincoln - 46 had to transfer to CWH during labour because of complications.

College of Midwives Canterbury West Coast branch chairwoman Violet Clapham said international research showed healthy women were at a higher risk of having medical intervention if they gave birth in hospital than in a primary setting.

Pain-relief options available in PMUs included warm water, gas and pethidine. Epidurals were only available in hospital.

Transfers from a PMU to hospital was not a common occurrence and when it happened, it was rarely an emergency, she said.

A Christchurch mother, who did not want to be named, had three births in a PMU. Two resulted in healthy babies, but the third went horribly wrong.

She said her first two times at Burwood were ‘‘the ultimate birth experience’’. But her third child, born in 2005, suffered major brain injury. She said she should never have gone to a birthing unit in the first place because she was 12 days overdue and her baby had reduced movements.

By the time her midwife realised there was a problem, she was already pushing at Burwood. It was too late to transfer. Her son, now 12, had ‘‘the function of a baby that’s a few months old’’. The mother received ACC compensation for failure to treat.

She had been informed of the risks of having an epidural and a C-section, but said information about complications and poor outcomes was ‘‘brushed over’’.

CDHB general manager planning and funding Carolyn Gullery said low risk women birthing at CWH put pressure on the already stretched facility.

CWH was geared specifically for women who need more complex or specialist care.

‘‘For low risk women, a PMU is the ideal environment for giving birth.’’