Birthing women in rural and remote Australia

Maternity Coalition is seriously concerned for the safety and health of expectant mothers and their babies living in rural and remote Australia if the Federal Government succeeds in pushing through changes about ante-natal care.

What are the changes?

Why are the changes unsafe?

A tragic story

Who is concerned?
What you can do

Media messages
Contact us

What are the changes?

The proposal by Health Minister Tony Abbott and his Department is to provide a new Medicare item 16400 so midwives, registered nurses and Aboriginal health workers can do ante-natal checks on behalf of a GP or specialist obstetrician for women living in rural and remote Australia.

The only positive from this proposal is that the Federal Government has finally acknowledged there is a problem accessing quality maternity care for women and families living in rural and remote Australia.  But their solution to the problem is just a

‘quick fix’ that gives women in the bush second-rate maternity care from unskilled workers. If anything, it will probably lead to more lives being put at risk in the bush.

Why are the changes unsafe?

Maternity Coalition is concerned about a range of issues that this proposal raises but our key concern is with the safety of care women will receive under this item:

• Regulatory bodies for nurses and midwives have developed national competency standards. Antenatal care is outside the educational background and scope of practice of all nurses. They have neither the qualifications nor the experience of providing antenatal care to pregnant women. It is dangerous for women to receive antenatal care from a nurse who is being pressured to provide care outside the nurse’s scope of practice.
• The competency standards for midwives include antenatal care. Midwives are educated for between 18 months and 3 years in all aspects of maternity care. They are registered or endorsed to provide antenatal care across Australia. Some Aboriginal Health Workers have also obtained an educational qualification in antenatal care.
• Many rural GPs do not themselves have formal education in the provision of antenatal care, except where they have obtained a Diploma in Obstetrics. They are therefore not well placed to assess the skills and competence of nurses who also lack education in this, let alone ‘supervising’ nurses to provide this care.
• There is therefore no guarantee under this policy that rural/remote women will receive antenatal care from someone who is competent to provide it. Unskilled care is more dangerous than no care as women are likely to assume their health is being adequately checked and not seek care from an obstetrician or midwife.

Why should women in rural Australia accept such care when we’re sure the Federal Government wouldn't suggest the idea for city dwellers?

A tragic story

Already in QLD we have seen the tragic consequences for a woman being cared for by a non-midwife. A nurse with no midwifery training, working on a post-natal ward, didn't understand the need for women to urinate after having a baby.  Because of this, the woman, a first-time mother in her mid-20s had to undergo a complete hysterectomy because of this simple omission. The mother will never be able to have any more children naturally.

If this proposal by the Federal Government gets through, we may see more tragic cases like this where pregnant women develop a pregnancy-related complication and the unskilled carer seeing them antenatally does not realise and does not refer them on to a midwife, GP or specialist obstetrician.

Who is concerned?

Maternity Coalition, a national maternity consumer group, is really concerned about this situation. Other professional bodies including the Australian College of Midwives also have major concerns about the safety for women if this change is adopted by the government. Many nursing organisations are concerned because they realise it will put nurses in difficult situations where they are practising beyond their competencies.

What you can do

Maternity Coalition and the Australian College of Midwives are preparing a massive media/lobbying campaign to draw attention to this proposal.  But we need mothers and families from all over QLD/Australia to help.

You can do a number of things:

• Volunteer to speak about this problem to your local and national media – we can get you fully briefed on the issue so you feel prepared.

• Write a letter to your Federal MP and the Health Minister, Tony Abbott (Tony.Abbott.MP@aph.gov.au).

• Write letters to your state’s senators

• Display this flyer on a community noticeboard – at your ante-natal clinics, maternity outpatients, child health centre, playgroup, C&K, daycare centre, supermarket, Council chambers etc

• If you’re a member of an organisation, such as CWA, National Farmers’ Federation, a sporting association or school community, get their support for this campaign (media, letter writing, MP visiting, information sharing)

• Tell your family and friends about the situation

• Send a link of this webpage onto others you know who may be affected by this proposal.

• Send any ideas/suggestions you’ve got about this campaign to us on ruralbirth@maternitycoalition.org.au

• Email ruralbirth@maternitycoalition.org.au if you want to stay updated on this campaign – we’ll try to keep everyone informed of what’s happening, when, and progress we’ve made.

Your efforts will help the extensive political lobbying and media campaign Maternity Coalition is driving in the lead-up to Parliament re-opening after their winter break. Your personal effort could make a big difference as women will be doing this all over Australia, especially in rural and remote areas. It will show the Government the grass-roots, widespread opposition to this major change to ante-natal care.

Media messages

It’s important we get our message into as many different media outlets as possible across Australia. You can help us to do this:

• Send Maternity Coalition’s media release raising awareness of this issue to your local newspapers, radio and TV stations. You may offer to organise a group of local women (pregnant or with babies as these make great pictures) to localise the story.
• Send a letter to the editor to your local newspaper or your state’s weekly rural paper
• Call talkback radio and tell all the listeners what’s going on
• Use Internet forums and discussions to inform others

To give you a few examples, women affected by this proposal could say to the media:

• “For the sake of my unborn child I cannot accept ante-natal care given by unskilled carers.”
• "Mothers in [give town/area name] want quality, safe maternity care close to our homes"
• "Why should we accept third world care simply because we don't live in a major Australian city?"
• "My health, and the health of my baby, could be put at risk by this proposal.”
• "If by trying to fix the problem, the Federal Government is actually putting lives at risk, why are they even considering it as an option?"

Contact us

To find out more about this campaign, or to offer your assistance with the media so you’re fully briefed, contact:

Justine Caines, campaign coordinator: email ruralbirth@maternitycoalition.org.au . 

Your state branch president of Maternity Coalition