MEDIA RELEASE
WEDNESDAY, DECEMBER 7, 2005
New research advocates giving birth back to rural communities
The closure of small rural and remote maternity units in Australia has come under fire as new Australian research published in the British Journal of Obstetrics and Gynaecology this week shows small maternity units are safer for low risk women than large tertiary hospitals.
The study, titled Does size matter? A population-based study of birth in lower volume maternity hospitals for low risk women dispels the myth that large Australian tertiary hospitals in urban centres are safer than small maternity hospitals in both urban and rural and remote areas.
Study author, Dr Sally Tracy said:
"The research shows that low risk women have better outcomes in smaller units. In fact, the smaller the unit the better the outcomes.
"Women in these units were significantly less likely to be induced, have their labour augmented, have epidurals, instrumental births or caesarean sections after labour. Babies of these women were significantly less likely to be admitted to neonatal intensive care units or special care nurseries and there was a significant reduction in the rate of neonatal deaths in smaller units.
"One of the most surprising findings was that the rate of stillbirth was highest amongst women living in major urban centres and not in remote or regional centres.
"The information from this study should challenge assumptions that small hospitals are not a safe place for women with uncomplicated pregnancies to give birth, especially in rural areas.
"The lower intervention rates for women in the smallest hospitals corresponds with the lack of specialists in those units and the increased use of GP and midwifery care.
"When smaller regional and remote units close, increased travel time and distance may reduce accessibility to antenatal and postnatal care. …Rising rates of 'born before arrival' have been noted in Australia and currently constitute a greater proportion of out of hospital births than planned home birth.
National President of Maternity Coalition, Leslie Arnott said:
"This research has huge implications for the current trend towards closing smaller regional and remote units and the debate on whether to allow midwife-led units to operate in rural areas.
"Currently, women are forced to travel to large rural or urban centres away from their families to give birth based on the argument that bigger is safer. This is clearly not the case. The evidence for the safety of smaller birthing units which are mostly managed by midwives and GPs in rural areas is compelling.
"It is outrageous that women are denied access to midwife-led units in rural areas when being forced into the larger hospitals means they will be more likely to put themselves and their babies' lives in jeopardy.
"Women want care that is local and safe. They want to know their care providers so they feel safe and they want to have their families with them at this very special time.
"Midwives are the experts in normal pregnancy and birth and are able to provide safe maternity care in local communities for all bar those women who require specialist care."
Contact: Joy Johnston 03 9808 9614
04111 90448
Researcher Dr Sally Tracy: 0404811357