Consumer power pushes for better births
An active group of Wollongong mums is showing how health care consumers can influence hospitals in ways that align with the campaign goals of midwives and nurses.
Giselle Coromandel gave birth to her two children through Wollongong Hospital’s midwife-led Midwifery Group Practice (MGP) program.
Having Isabel, aged 2½, and Zac, 3 months, through MGP was “a really empowering birth experience”, Giselle says. Other MGP mothers also felt “overwhelmingly positive” about the program.
“However, we all had friends and family who could not get into MGP due to a lack of places.”
Giselle and other mums decided to form a pressure group, Better Births Illawarra (BBI) to try to get MGP expanded.
MGP supports women throughout their pregnancy, at birth and for about two weeks after. It encourages active labour and natural birth.
“Women who go through MGP report a greater sense of satisfaction due to the relationship and trust they build with their midwife,” says Giselle, an industrial designer who became BBI’s president.
“It’s an issue I’ve grown really passionate about.”
A 2014 Wollongong Hospital review showed the MGP program resulted in lower caesarean section rates, lower use of pain relief and higher rates of established breastfeeding.
However, only one third of women who apply for the program get accepted and BBI estimates about 800 women miss out every year.
BBI started about two years ago by using Survey Monkey – a free, online survey tool – to gather information from current and former maternity patients.
They also used freedom of information legislation to get hospital data on MGP outcomes and to determine that the hospital was well short of NSW Health’s Towards Normal Birth policy targets.
Better STAFFING makes ‘complete sense’
The 2010 Towards Normal Birth policy set a 35 per cent target for women accessing MGP services to be achieved by 2015.
However, Wollongong Hospital was managing only 13–15 per cent early last year though the number has since improved.
Within a few months of setting up, BBI established regular meetings with the hospital executive.
“We set up a Maternity Circle that meets with the chief executive and her staff. It came about because of our persistent contact,” Giselle says.
BBI has received considerable media coverage, met local MPs, written to Health Minister Brad Hazzard and met with his policy staff.
The group supports the NSWNMA campaign to include babies when determining staffing and has raised the need for more staff at meetings with the hospital executive.
“Heaps of women have come forward to us with their experiences of how they’ve been impacted by staff shortages, Giselle says.
“We are trying to hold the executive to account and improve the service with more staff and models of care that work better in line with what the community wants.
“It makes complete sense that if you have got a better ratio of midwives to mums and babies they are going to get more support.
“We absolutely love the midwives at the hospital whether they are with the MGP program or not. The public recognise that the staff do an amazing job under the circumstances.”
Pressure brings improvements
Giselle says BBI also sought improvements to the “dirty, outdated and understaffed” birthing suites.
“We felt that with minimal investment the birthing suites could be drastically improved.”
BBI’s first achievement was the reintroduction of birth props that facilitate active labour such as stools, mats, balls and beanbags. They had been removed from the birthing suites years earlier.
BBI has joined a hospital project group looking at a redesign of the “old, sterile and medicalised” birth units and obtained a “verbal commitment” that MPG will be expanded, Giselle says.
Concerns raised by BBI recently prompted the hospital to review its ‘skin-to-skin’ policy and advertise for a caesarean section midwife.
A BBI survey found that 89 per cent of 200 women who underwent caesareans at Wollongong Hospital said they had been separated from their newborns during recovery – mostly without explanation.
Many said they had been separated for longer than two hours and 90 per cent said they were anxious and stressed as a result. One in five reported being diagnosed with postnatal depression.
Health experts recommend skin-to-skin contact due to its benefits for bonding and breastfeeding.
Giselle says that although skin-to-skin is part of the hospital’s policy, one of the reasons it is not offered is because there is a “chronic” shortage of staff.
“This not only affects mothers and babies. It puts staff under immense pressure as well.”