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Local Maternity SOS

Think Local

Maternity services at Mona Vale and Manly Hospitals are set to move at the end of 2018 to the new state-of-the-art Northern Beaches Hospital in Frenchs Forest.

While both hospitals close next year, Mona Vale will retain some health services, including the likes of palliative care, physiotherapy, dental, podiatry and mental health services. Yet more than 1200 local women - including mums, midwives and health workers - also want a midwife-led birth centre at Mona Vale, and they have united to make the Friends of Northern Beaches (NB) Maternity Services group to push for this.

A multimillion dollar investment was made to build a new maternity unit at Mona Vale Hospital in 2012 and the Friends of NB Maternity Services insists it should remain open. The women are petitioning through to keep a Midwifery Group Practice (MGP) there for low-risk expectant mums.

The group is lobbying peninsula politicians, including Pittwater MP Rob Stokes and NSW Health Minister and Wakehurst MP Brad Hazzard, to support them. To date, more than 2000 people have signed the petition.

One mum who is fighting for the centre to stay open is Collaroy resident Alex Trikoulis. She tells Peninsula Living many of the 1500 mums who give birth in the public system locally "don't want to be part of a great big conveyor belt in an impersonal, cold and clinical hospital”.

"A mother-centric, midwife-led birthing centre is an important intermediate option between the medical model and home birthing,” she says. "We're not anti-doctor or anti-collaboration - this is about keeping women close to where they live.”

Alecia Staines from the Maternity Consumer Network says the organisation has been inundated with SOS calls and emails from worried consumers on the Northern Beaches seeking advice.

"Closing Mona Vale's maternity services is disadvantageous to women," she says.

"It’s so frustrating because now, many women will either end up birthing on the roadside, or there will be more intervention because they'll go to the hospital too early in labour, and rather than go back home will end up being induced or having C-sections."

When the Northern Beaches Hospital opens, there will be extensive birthing services, including a midwife group practice, 10 purpose-built birthing suites - five public and five private - and 12 special care nursery cots. It also offers water immersion in labour and birth, as per the NSW Health Policy Directive: Maternity - Towards Normal Birth in NSW.

But mum Helena Mooney from Balgowtah says, "The policy also states that women should be given choices in where they want to give birth, but what options are we giving low-risk women? The only option if they're public is the new hospital, so there's no choice."

Caroline Homer, president of the Australian College of Midwives, says at least 15 papers, including a Cochrane review - a meta-anatysis of international literature and studies - prove the choice of where to give birth and MGP continuity of care is safe and highly beneficial for mothers and babies.

"Given the strength of that, it's unethical for health services not to provide this way of women having care - and it's cheaper. On average, a woman having her first baby under MGP saves the health system around $1375.45," she says. "We don't have cost-effective research from free-standing units but there's no reason to think it would be higher than the hospital system, mostly because the interventions are less and the length of stay is shorter, and it's those sorts of situations that drive the cost up."

Local midwife-led birthing units are not without precedent.

There is a stand-alone birthing unit at Ryde that transfers to Royal North Shore Hospital, which is 17 kilometres away.

"We want to replicate that in Mona Vale," adds Mooney, who is also a doula. "And if required, they can be taken to the Frenchs Forest hospital These are rarely lights and sirens emergencies, and skilled midwives are capable of managing common emergencies, like haemorrhaging or if the baby needs resuscitation."

However, one local midwife who doesn't want to be named, says not everyone wants a free-standing birth unit.

"We're not all singing from the same song sheet," she says. "MGPs have a strong, naturally-managed approach and when 99 per cent of births are low risk that's absolutely fine.

"But you have no idea when a low-risk pregnancy is going to turn into a high-risk birth. The idea of having a separate large-scale maternity unit 15 minutes away from the hospital is not a practical, clinical solution."

Pittwater MP Rob Stokes is supportive of the current MGP at Mona Vale, but is twitchy about the lack of obstetrics support with a free-standing birthing unit.

"If the clinical council through the Northern Sydney Local Health District and the Ministry of Health are supportive of the model being promoted, then of course I will back it," says Stokes. "But I'm not going to endorse a model without clinical support."

Meanwhile, some members of Friends of NB Maternity Services are concerned they're being "shut out" by Australian private healthcare provider Healthscope and NSW Health as consumer representatives when it comes to the hospital's maternity facilities.

"We had a meeting with Healthscope approximately 18 months ago and have tried for over a year to engage with its consumer representatives team but unfortunately they won't speak with us," says one member.

"Initially, we were told there wouldn't be any water births.

There was an outcry and suddenly birthing pools were going in three of the 10 rooms.

"The fact they... won't engage - even about nature of the rooms - is a huge red flag. It feels like we're not being represented as consumers."

A Northern Sydney Local Health District spokesperson insists a comprehensive range of quality maternity services will be provided at the Northern Beaches Hospital, including water immersion in labour and birth.

"The hospital will offer maternity services as outlined in the NSW Health Policy's directive Maternity - Towards Normal Birth in NSW," the spokesperson says. "Women who choose midwifery group practice and have a low-risk pregnancy are provided care by a midwife who follows the woman through her pregnancy, onto delivery and then back into the home.

"The new hospital has been designed to accommodate current and future demand for maternity services on the Northern Beaches."

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