VALUABLE DISCUSSION: Local mother pushes for better maternity services amidst roadside births in Douglas Shire
MATERNITY CARE MATTERS
In the Douglas Shire region, the issue of births occurring before expectant mothers reach the hospital remains a pressing concern, with many women unexpectedly giving birth in ambulances, cars, on roadsides, or at home due to quick or unforeseen labours.
Despite Mossman Hospital being only a 20-minute drive from most homes on this side of the river, local women have been forced to travel over an hour to reach Cairns or Mareeba for birthing facilities since the Midwifery Group Practice (MGP) closed in 2003.
Since the closure, at least 56 babies born at this Level 1 Health Facility in Mossman - without midwives and in makeshift areas - over 30 of those are in the last 4 years.
In 2021, there were 26 recorded cases of ‘born before arrival’ (BBA) babies across the entire Cairns Hinterland Health Service region.
Local mom Jessie Goetze is taking a leading role in addressing this issue and continues her determined efforts to advocate with Queensland Health and state and federal parliament members.
In 2020, she started photographing the women and families impacted by Mossman Hospital’s lack of maternity services and to highlight the disparity between regional and metropolitan health care.
“Every single woman that lives in the Douglas Shire is statistically higher to birth before arrival,” she explained.
According to the QLD Health Clinical of Excellence, those residing 1 to 1.5 hours from a birthing unit have the highest statistical likelihood of giving birth in an unplanned location.
In 2022 alone, at least one woman residing in the Douglas Shire found themselves in the circumstance of giving birth en route to the hospital, while another delivered her baby at the Mossman Hospital Emergency Department, a space lacking the anticipated privacy and comfort.
Birthing risks
Ms Goetze’s own precipitous unassisted home birth at 41 weeks drove her to advocate for improved birthing options.
She recognised the limited choices in the Douglas Shire, including elective C-sections, temporary relocation to Cairns, or scheduled inductions, which often result in unnecessary interventions, instrumental births, and long and painful labours.
“I decided I wanted to give birth at home again as I didn't want to risk birthing on the side of the road like many of my friends have,” she said.
According to Ms Goetze it’s not only a roadside birth that might have a tragic outcome.
“The sheer fact that women have to travel on a dangerous road with reception black spots in the throes of labour is having horrific birth outcomes,” she noted.
“The discomfort and pain while travelling such a far distance under stressful circumstances often affects the body’s birthing hormones and labour can stall.”
Fragmented midwifery care
Ms Goetze highlighted the lack of local options for Centering of Midwife Care (CofMC), the gold standard in midwifery, particularly impacting low-risk women.
With Mareeba as the sole CofMC option, they are excluded from Cairns Base catchment with Cairns Private closing soon.
She emphasised the need to restore the Midwifery Group Practice (MGP) and birthing services in Mossman, highlighting the challenges of fragmented care and long drives to other facilities.
The current setup with only two midwives at Mossman Hospital, although doing their best, has limitations and can't attend births or emergencies.
“Women and babies have better outcomes when under continuity of midwifery care, particularly midwifery group practices (MGP) in a birthing centre and home births.
“Hospital births often result in one in three women reporting trauma, one in ten experiencing PTSD due to treatment, and one in seven dealing with postnatal depression.
“This lack of accessible, quality birthing services is both unsafe and against our human rights.”
Bleak outlook
Ms Goetze served on the advisory group for the Queensland Birth Strategy, which was put on the back burner during the COVID-19 pandemic.
“I don't know what it will take to convince state and federal governments to re-open birthing facilities at Mossman Hospital,” Ms Goetze said “I have been given every reason under the sun – no funding, not enough demand, no space.
“They even argue between themselves if it's a CHHHS, State or Federal responsibility. It is something that might happen sooner if a private birth centre was established.”
Statement from CHHHS
Newsport contacted the Cairns and Hinterland Hospital and Health Service (CHHHS) for an official response, receiving the following statement from Leena Singh, Chief Executive CHHHS:
“Cairns Hospital and Mareeba Hospital are both situated within a 50-70 minute drive from Mossman Hospital, a distance well within acceptable national and international benchmarks for access to specialist obstetric care.
“Nurses, midwives and medical staff at the Mossman Multi-Purpose Health Service are trained in imminent birthing, to mitigate the risks associated with unplanned births in non-birthing facilities.
“Queensland Health continues to implement a range of projects to improve the quality of public maternity services across the State.”
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