Midwifery in Australia – A Clinical Perspective

Wendy Foye, Maternity Services Manager, Hurstville Private Hospital Australia
Veronica Zupan, Director of Nursing and Midwifery, North West Private Hospital, Tasmania.

Midwifery in Australia is much like Midwifery overseas, where we strive to have the best of midwifery practice despite the difference settings. In most public hospitals throughout Australia, you will find a range of models of care that women can either choose, or depending on their circumstances, be placed into.

Public Hospital Maternity Services

Public hospitals see extremely large amounts of women, birth numbers go from 2500 to 5000. Due to these numbers, they run most models of care including obstetric, GP shared care, midwives clinic, team midwifery, case load midwifery and high risk models.

I believe that continuity of care comes when you work within a team midwifery model or case load model. However, given the large in-take numbers in the public hospital system, it would be very difficult to experience the true meaning of continuity of care. It is more than likely that you will be rostered into a unit for months at a time which may not allow you to follow through with patients.

Additionally, Public hospitals here also have a much reduced length of stay, with most mums being discharged home into 6 to 48 hours post delivery

Private Hospital Maternity Services

Private hospitals, like Hurstville Private believe in giving continuity of care. Currently at Hurstville Maternity we have an obstetric model of care. This is a model where the care is shared between the patient, Obstetrician and Midwife, with equal decision making.

Hurstville have a birth rate of approximately 75-85 births per month, and we know most of our patients prior to them presenting in labour / or for delivery. Our patients also return for baby number 2, 3 or even 4! Additionally, we run antenatal assessments and have a long length of stay of 5 to 6 days

2019 is bringing some new initiatives to our maternity services which will include the introduction of a midwifery home visit service. This is a first of its kind for the Private sector. Also, our plan is to introduce a midwifery / obstetric model of care service in line with many of the private midwifery hospitals in Australia. For example North West Private Hospital in Tasmania (part of the Healthe Care Group) allows midwives to participate in the Know Your Midwife Scheme (KYM) with our private obstetricians to provide continuity of care for women

Rotational Midwifery

Rotation and flexibility is a key requirement in maternity services. We want midwives that seek to expand their knowledge base, and continue to keep their skills updated and current.

At Hurstville Maternity we have 3 units within the maternity unit, which includes antenatal, delivery suit, postnatal unit and Special Care Nursery. Special Care Nursery cares for neonates delivered from 34 weeks, babies at an earlier gestation that require care will be transported to acute NICU service. Similarly in our sister hospital in Tasmania – North West Private, midwives will work across all in-patient maternity units.

All midwives on shift meet in the handover room and are then allocated according to the needs of the unit. North West Private is unique as it has a contract with the Tasmanian Government to provide all inpatient care for public patients on the North West Coast of Tasmania as well as caring for private patients

Maternity Services – the Numbers (Case Studies)

Hurstville Maternity Services – Case Study 1

  • We have a birth rate of 75- 85 births per month at Hurstville Maternity
  • In the last year we have seen births increase by 25% which is quite a dramatic change
  • Currently our c-section rate is at approximately 35%, with most of our elective c-sections being due to repeat c-section reasons
  • Most of our emergency c-sections are for foetal distress or failure to progress
  • All our c-sections are due to obstetric reasons and not for maternal request
  • We are continually benchmarked against other hospitals within NSW for comparisons and monitoring purposes

North West Private Hospital Maternity Services – Case Study 2

Based on our data for 2017 here are the numbers for maternity services:

989 births a combination of public and private deliveries

  • Elective C/s 13.55%
  • Emergency C/S 3.75%
  • Ventouse 5.26%
  • Forceps 2.22%
  • Natural Vaginal Birth 65%
  • Water birth 5.91%
  • Epidural rate 14.16%

For more information on Midwifery opportunities in Australia, ICE Group along with Hurstville and North West Private Hospitals are hosting a number of information sessions across UK and Ireland from 26th to 30th November 2018.

To find out more contact me on nurse@icegroup.ie or WhatsApp 00353 8712515310.

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