assistants in midwifery

Ryan Park accepts birth trauma inquiry recommendations

October 11, 2024 by Madeline Lucre Leave a Comment

Health minister apologises and accepts 42 of 43 recommendations but fails to address staff shortages.

The NSW health minister, Ryan Park, has apologised to women who were failed by the maternity care they received, and says the government will support 42 of 43 recommendations from a state inquiry into birth trauma.

Park said the government recognised and appreciated “the courage of the thousands of women who shared their deeply personal and difficult experiences with the select committee on birth trauma”.

“We apologise to women who have not received the high standard of maternity care they should have.”

He said over the next 12 months the government would fast-track numerous initiatives, including those to improve access to continuity of care and to ensure informed consent.

The NSWNMA welcomed the state government’s support for the recommendations but was disappointed by the lack of immediate and proactive measures to improve workforce challenges and maternity care.

NSWNMA Assistant General Secretary Michael Whaites said the state government needed to focus on fixing the midwifery staffing crisis.

“Midwives strive to deliver the best possible care to women and babies in a system that has been chronically understaffed, under-resourced and neglected for far too long. This cannot continue any longer,” he said.

NSWNMA welcomes state’s first Birth Trauma report

May 30, 2024 by Rayan Calimlim 2 Comments

The NSW Nurses and Midwives’ Association (NSWNMA) has welcomed the release of the NSW Select Committee on Birth Trauma report, which includes 43 recommendations to overhaul maternity care in the state.

The recommendations focus on investing and expanding midwifery-led continuity of care models, including Midwifery Group Practice, and addressing staffing shortages through improvements to pay and conditions for midwives.

The inquiry acknowledged that a ‘one size fits all’ approach was inadequate, and that tailoring care to meet the needs of women was essential for improving outcomes.

NSWNMA Assistant General Secretary, and midwife, Michael Whaites, said this inquiry had been a long time coming to address birth trauma and the impacts on women and midwives.

“Midwives do an extraordinary job and they strive to provide the best care they can to women and newborns in a system that is under-resourced and understaffed,” said Mr Whaites.

“This inquiry shines a light on areas of midwifery and maternity services that have been ignored for too long. We hope this is the start of positive change that will benefit women on their maternity journey, and ensure this incredibly rewarding profession has the structures, resources and support systems to deliver safe, patient-centred care.

“We are pleased to see the inquiry supports our view of addressing midwife shortages with competitive pay and working conditions, and a staffing model with the appropriate skill-mix.

“We continue to advocate for safe staffing ratios in maternity with one midwife to every three women in postnatal wards, and urge the state government to fund this important workforce initiative.

“One recommendation involves establishing formal debriefing clinics to decrease birth trauma, which would be run by midwives. Given the current workforce shortages, this wouldn’t be feasible without ratios that provide adequate staff and skill-mixes.

“We continue to hold concerns around the dilution of the midwifery workforce, with midwives roles being eroded and replaced by assistants in midwifery (AiMs) and nurses. If we want to see improvements to the way maternity care is provided in NSW, we need to start with rebuilding the workforce.”

Mr Whaites also acknowledged the efforts to provide psychological support to both women and midwives, as well as education and training.

“It’s encouraging to see the committee recognises the impact of birth trauma on midwives too, by recommending debriefing and psychological support for maternity clinicians following their exposure to a traumatic birth,” said Mr Whaites.

“We know birth trauma is avoidable and preventable and we’ll continue to advocate for universal access to midwifery-led continuity of care, as we know these models provide the best outcomes for women.

“We hope all 43 recommendations are implemented by the state government so we can begin to create long lasting change in the way maternity care is provided in this state.”

Minister warned on unlicensed midwives

September 29, 2017 by Rayan Calimlim

Many of the state’s badly understaffed midwifery units are using unlicensed workers to fill gaps in rosters.

The NSW Nurses and Midwives’ Association has warned of “poor to tragic outcomes” if hospitals continue to fill midwifery vacancies with unlicensed staff.

NSWNMA General Secretary Brett Holmes has told the NSW Health Minister, Brad Hazzard, that the staff skill mix in midwifery units is “poor to dangerous” with registered midwives being replaced by Bachelor of Midwifery students, RNs without midwifery training, AiNs and assistants in midwifery (AiMs).

“Maternity services cannot continue to utilise unlicensed workers …to fill vacancies and be assigned full patient loads,” he wrote.

“This critical situation must be addressed urgently as the current situation will surely guarantee poor to tragic outcomes and cannot be sustained.”

Brett said significant roster shortages existed in maternity services at Blacktown, Campbelltown, Fairfield, John Hunter, Nepean, Westmead and Wollongong hospitals, with Wollongong probably the worst.

He said several factors were to blame.

An increase in high-risk births had led to a cot shortage in special care nurseries and forced special care babies to be placed in postnatal wards with their mothers.

This had placed more stress on staff and some-times resulted in an AiM or RN caring for babies with postnatal issues.

Misuse of BirthRate Plus

Some local health districts were misusing the midwifery staffing mechanism, Birthrate Plus, by using exempt categories of midwives to take patient loads and using unlicensed workers to plug staffing gaps.

Postnatal inpatient units everywhere are understaffed because they were not properly considered when Birthrate Plus was adapted from the UK model.

In addition, new regulations covering foreign midwives had resulted in most LHDs deciding not to recruit overseas.

“Some LHDs have been very proactive and have incentives in place to recruit midwives … However, most LHDs do not consider this option due to budget restrictions.

“Before the ministry devolved responsibility to the LHDs, the implementation of Birthrate Plus was working and we believe it is a tool that if implemented properly, results in an adequately staffed maternity unit.”

Brett said the ministry should have a closer relationship with the LHDs on maternity services to ensure that all women, regardless of their postcode, have access to quality maternity care.

In reply, the Health Minister conceded that some services, mostly in western and south-western Sydney, had “workforce challenges associated with increasing levels of activity and acuity.”