College Cautions Against Further Strain On Maternity Services

The New Zealand College of Midwives is concerned about potential risks to new mothers and their babies after it was revealed Wellington Regional Hospital will turn one of the regularly-over-capacity women’s health wards into a medical ward to ease emergency department (ED) overcrowding.

The College, which represents midwives across the motu, says it is worried about a lack of consultation with frontline maternity staff on the move to sequester beds from maternity and gynaecological wards, and how the hospital will mitigate risks of discharging women too early as well as the proximity of medical patients admitted from ED to birthing women and newborns.

Midwives warn the plan will accelerate discharges, pushing mothers and newborns home before they are clinically ready and increasing the risk of readmission.

Chief Executive Alison Eddy says the College acknowledges ongoing pressures across the health system, including in the ED, to provide adequate and timely care. However, the College is concerned the planned four-month pilot plan to reprioritise beds is relocating risk from one overstretched service to another. Statistics show maternity wards in the Wellington central hospital are regularly overcapacity.

“Shifting pressure from one overstretched service to another is not a solution; it simply relocates the risk,” says Eddy. “Maternity wards already operate beyond safe occupancy, and postnatal care must never be compromised to improve ED waittime statistics.”

“We understand the need to improve access to emergency services, particularly in areas facing acute demand,” says Eddy. “But any changes must be carefully considered to ensure maternity care is not compromised as a result.

“Just like the emergency department, maternity is an acute service which experiences unpredictable demand, needing the capacity to receive admissions on a 24/7 basis.

“Wellington Women’s Regional Hospital services have the additional pressure of being a tertiary hospital and referral centre for the outlying provincial units, serving a large geographic area with many high-risk patients.”

Maternity occupancy rates already over 100percent

Monthly staffing data show Wellington’s maternity unit regularly exceeds safe capacity, yet the proposed fourmonth ‘trial’ would remove an entire pod of maternity beds and redesignate it for medical patients, freeing 12 inpatient beds for general medicine. The proposal would see currently single bed post-natal rooms being made into double rooms with overflow maternity beds in the gynaecology ward. Midwives warn this will accelerate discharges, pushing mothers and newborns home before they are clinically ready and increasing the risk of readmission.

Maternity spaces are purposedesigned to keep babies with their mothers and to enable essential support from a whānau member staying overnight. Reducing the number of single rooms and increasing room sharing will mean partners cannot stay to support a new mum with a caesarean section which will ultimately push people home too early. This is at odds with the government’s recognition of the needs of postpartum families in the three-day stay bill.

Lack of alternative facilities
Wellington midwives have long been calling for a community birthing and postnatal facility in central Wellington. The nearest maternity facility to Wellington Hospital is in Kenepuru, which is too far to expect women to travel for necessary postnatal care when Wellington Hospital is full. Before any capacity is reduced in the hospital, work needs to begin on an alternative facility.

A shortterm fix that ignores longterm planning

The College acknowledges the Government’s recently announced $1billion upgrade to deliver a new ED and an additional 126 beds by 2029, but stresses that relief is four years away. “We support the infrastructure investment, yet the interim strategy cannot come at the expense of safe, highquality maternity care,” Eddy says.

“Women and babies must not be the collateral damage of hospital flow targets. The College is ready to work with TeWhatuOra and Government to develop solutions that respect the unique needs of maternity care while addressing ED pressures.”

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