Regional Maternity Services Forum reaches consensus on solutions

Continuity and multidisciplinary care have been held up as the gold standard for maternity care internationally, and are key to preventing birth trauma.

A continuity model means women see the same allied health professionals before, during, and after birth. This has been shown to improve outcomes for women giving birth, and the satisfaction of workers involved in giving birth.

Among the five motions the forum passed in Canberra on Wednesday was an agreement to advocate for anything that would empower women to make choices about how, when and where they would like to give birth.

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The Australian College of Midwives chief midwife Alison Weatherstone said women needed to feel in control of the process or they were at risk of being traumatised.

"Women should be able to choose, whether it's publicly-funded homebirth, privately-funded homebirth, or they should be able to choose publicly-funded continuity models or private GP care," she said.

"It's really important there's an education and awareness campaign for consumers so they know what the optimal models of care that provide continuity and better outcomes for them.

"They should be accessible at low, or no cost to them."

The Regional Maternity Services Forum brought together members of The Australian College of Midwives (ACM), Rural Doctors Association (RDAA) and experts to discussed improved access to safe maternity care in rural, regional and remote Australia.

Their purpose was to come up with an agreed framework for practices that could be implemented by individual organisations, and to guide their advocacy into the future.

Ms Weatherstone said ACM and RDAA agreed on "pretty much everything". She said the problems are well understood and documented, all that's missing are the will and resources to solve them.

She said continuity model of care would solve many of the problems identified by women who have been traumatised by their birthing experience.

But access to this model is often limited outside metropolitan areas due to skill and general staffing shortages. Only 20 per cent of women in Australia currently have access to this kind of care.

"It's a no brainier to me that we need to absolutely re-prioritise maternity services, but in particular rural and remote maternity services. Women in these areas should not be compromised compared to their city counterparts," Ms Weatherstone said.

"There's 300,000 plus births in per year in Australia, and 30 per cent of those are in rural areas ... we know access to services is limited and women don't have the same access to different models of care.

"Continuity models have proven outcomes for women and babies, where you've got reduced stillbirth, reduced likelihood of preterm birth. You're more likely to have a normal birth, you're more likely to breastfeed and have a better experience."

Other key motions passed include a framework for birthing on country and culturally safe maternity practice, a significant update to the "best practice" guidelines for midwife led births, and the need for a unified framework to be implemented across the country.

While there is widespread agreement among healthcare practice about what needs to be done to ensure women aren't traumatised by the experience of giving birth, the resources to implement these recommendations aren't available in many places.

Boosting the regional health workforce is key to addressing the systemic issues that lead to birth trauma being such a widespread phenomenon in NSW.

Ms Weatherstone said even this wouldn't be sufficient. The crisis mentality many hospitals have developed due to chronic understaffing and under resourcing will take time to change - time she said we don't have.

"Prioritising maternity services is an absolute need - we don't have time to keep talking about this," she said.

"Women shouldn't be experiencing these sorts of events, but midwives and doctors shouldn't be subjected to these kinds of events either.

"It was brave and timely for NSW to put this forward, because it needs to be prioritised. For me and the College of Midwives, prioritising maternity care has implications for the whole lifespan of the child."

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