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  • Writer's pictureFlow Australia

Bush maternity decline a red flag for rural health care

Doctors warn the loss of regional maternity services are often followed by the closure of other critical healthcare facilities and pose a problem for everyone.



When a rural town loses its maternity unit, operating theatres are often the next to go, then the emergency department, then local doctors and nurses.


That's the warning from the Rural Doctors Association of Australia after health leaders met in Canberra to address the maternity crisis in the bush, which is forcing women to give birth far from home.


Poor access to maternity care in the regions is a national concern, with more than 150 rural units closing over the last two decades and many others downgraded.


The maternity crisis is not just a problem for women and their families, but entire communities, the association's president Megan Belot said.


"We can't have any more maternity closures," Dr Belot told AAP on Wednesday.

"When we lose a maternity service that has theatre capability, there's no reason to keep the theatre up to scratch, so you miss out on other surgeries for the wider community.


"It can sometimes be a slippery slope; you lose your maternity service, then you lose your theatre, next you lose your emergency department, and then before you know it, you're a nursing home."


Dr Belot said the closure of rural services was the result of chronic underfunding over many years and city-centric attitudes shaping health care in the country.


"Rural maternity services have been told they're not good enough, they're not up to scratch, they're not the gold standard and and it's generally from our metro-centric partners.


"Whereas there's research to prove that if you're a low-risk woman, the safest place you could possibly have your babies is in your small rural maternity service."


A large 2016 national study found lack of maternity care close to home resulted in poorer clinical outcomes for mothers and babies, particularly for Aboriginal women who fared better when they gave birth on-country.


The study, led by the University of Sydney's Centre for Rural Health, found closures created social, financial and emotional risks for women, as well as being associated with more babies being born before arriving at hospital.


The forum at Parliament House on Tuesday heard stories from women who had to travel hundreds of kilometres for maternity care, or leave their families to stay in large regional centres weeks before their due dates.


It also heard of successful community-based midwifery services, including an Indigenous on-country birthing service on the NSW south coast, and a group practice at Goondiwindi in Queensland that balances care between nurses and doctors.


Dr Belot said rural health care needed to be shaped by individual regional communities.


"It's about trying to find the model that suits your small rural maternity service - that community input and that community voice to say what they actually want, and need."


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