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Maternity review

By johnboy 28 November 2013 31

Chief Minister Gallagher has made known her response to the ACT Centenary Hospital for Women and Children – Maternity Model of Care and Demand Review:

“The key finding of the review into the model of care and demand for these services is that there is a safe and effective service that exists within the Canberra Hospital maternity service and this is something the government is committed to protecting.

“The high level of demand for the new Centenary Hospital for Women and Children is also a strong vote of confidence in the facility and the government’s investment in this essential new piece of health infrastructure.

“The way the ACT is providing maternity services is a progressive approach with proven benefits for both mothers and children and is widely used in hospitals in the UK and New Zealand.

“The model focuses on having continuity of care- that is having the same midwife during pregnancy, birth and the postnatal period. The model also includes early discharge for well women and babies with follow up provided by midwives visiting the home.”

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Maternity review
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maxblues 6:58 pm 03 Dec 13

BimboGeek said :

EvanJames said :

Hospital care is stunningly expensive. If there’s no medical need for someone to be consuming that stunningly expensive care, then the medically trained people will make that call and send you on your way. While being waited on hand and foot is nice, it’s not an entitlement.

Having babies is a choice, not a sentence. It’s not cancer.

Actually, when my mother in law had cancer, she was sent home earlier than she wanted, too. She was enjoying the rest and was still very tired and intimidated about the idea that she had a lot more work to do when she went home, but they knew she had a supportive husband, that his sister was very close and generous, that her kids and their partners had been in and brought lots of fruit, flowers and books, and spent lots of time with her, and they knew she didn’t need 24 hour observation, just checkups, and that she could easily come in for those.

I am not qualified to comment on the maternity situation, but after having neurosurgery at Canberra Hospital a few years ago, I made sure that when the surgeons came around for their morning rounds
that I was always sitting in the chair next to the bed and not in bed (even the morning after in intensive care). I ended up getting out of hospital two days earlier than originally scheduled after one of the surgeons commented that I was never in bed (and obviously had recovered). It looks like I will have to do it all again (probably early next year), so I hope I will be able to use the same ‘ploy’. It is not that I don’t appreciate the care given by ALL staff at Canberra Hospital, but for me, being out of hospital is better than being in.

Evil_Kitten 6:10 pm 03 Dec 13

A friend has just given birth there, and despite it being uncomplicated they were in there for 3 days, to the point where they actually had to say “Look, we’re leaving.”

Stress less people!

Masquara 11:27 am 01 Dec 13

sepi said :

Not everyone is a martyr/superwoman type person who has a baby and is back to normal routines only hours later.

No, you’re so right. Not everyone. Just around a billion women in developing countries …

JC 10:24 am 01 Dec 13

miz said :

You definitely need more than 24 hours to establish the breastfeeding side of things for the first baby. Subsequent babies you may want to go early, but possibly not if things went awry previously. There should be more care about who gets sent home within 24 hours. My understanding about the UK scheme s that there are lots of follow up home visits by midwives after the mother goes home. Do Canberra mums get these, or are we simply applying the UK hospital aspect because of the savings?

Yes this happens in Canberra, it is called the midcall program and applies for a week after birth, and then after that there are the health clinics which have drop-in sessions every few days and a heap of other programs to help mum and baby (and dads too). As mentioned above if there are issues after going home the midcall midwife just needs to make one call to the duty doctor and mother and baby are back in hospital, and as also mentioned when on the midcall program mum and baby are still technically hospital patients too.

As for breastfeeding you are right it does take more than 24 hours to get the baby feeding properly. Though personally don’t think you need to be in hospital for that to be established. Indeed feeding is the issue that lead my wife and baby to go back in. Being in hospital wouldn’t have made a difference, but having the midcall support to identify the issue and being able to go back in when it was clear there was an issue was.

Also I don’t think it is purely a cost saving measure either, they do it because they genuinely believe that it is best to not be in a hospital, hospitals are full of sick people! Beside if everyone was ‘allowed’ to stay 4 nights the size of the maternity ward at the hospital would have to be at least 2-3 times bigger and yes an increased cost in staff. Currently the post natal ward has about 20 or so beds (most single rooms too and quite nice) so would have to be 60+ to handle 3 night stays for everyone.

They of course also have another ward for babies that are sick and need extra care and an overflow area in the adjacent ward.

BimboGeek 12:25 am 01 Dec 13

Yup Canberra mums get lots of follow-up visits and checkups.

I’m not surprised private hospitals try to sell you a 4 day stay in bed for no reason. We already know they sell a lot of caesarians and I wouldn’t be surprised to learn that they are also selling more drugs. They are businesses trying to get your money, not provide services for the common good.

Comic_and_Gamer_Nerd 11:20 pm 30 Nov 13

miz said :

You definitely need more than 24 hours to establish the breastfeeding side of things for the first baby. Subsequent babies you may want to go early, but possibly not if things went awry previously. There should be more care about who gets sent home within 24 hours. My understanding about the UK scheme s that there are lots of follow up home visits by midwives after the mother goes home. Do Canberra mums get these, or are we simply applying the UK hospital aspect because of the savings?

By asking that question, you are admitting you have no idea what you are commenting on…

My wife did two nights with the first and one night with the second. No point holding up beds for no reason. Leave them for peeps who had complications or had a sickly child.

Just because you have a baby, does not give you the right to hog hospital beds and resources just because you feel like it.

miz 9:17 pm 30 Nov 13

You definitely need more than 24 hours to establish the breastfeeding side of things for the first baby. Subsequent babies you may want to go early, but possibly not if things went awry previously. There should be more care about who gets sent home within 24 hours. My understanding about the UK scheme s that there are lots of follow up home visits by midwives after the mother goes home. Do Canberra mums get these, or are we simply applying the UK hospital aspect because of the savings?

thatsnotme 4:25 pm 30 Nov 13

When it comes to length of stay, all else being equal, you can’t discount whether it’s baby number one or not either. My wife, and so many other friends and acquaintances I’ve heard stories from talk about how much easier it was the 2nd time – both physically and mentally. Their bodies are better prepared, they’re more mentally prepared, and less stressed in general.

I think if you looked at first time mums, most wouldn’t be ready to leave after 24 hours – but most 2nd time mums would be. All assuming no other complications or issues of course.

BimboGeek 3:03 pm 30 Nov 13

sepi said :

In private hospitals they keep you for 3 nights as it takes 3 days to establish breastfeeding.

Lucky you! It took me six months. Obviously it would have been completely stupid for me to spend 6 months in hospital dealing with it which is why I went home and got daily help from my midwife for the first few days plus plenty of support from friends and family (ABA also has great resources for ongoing help.)

BTW I’m sorry your baby got sick. That must have been terrifying. They say most immediate problems appear within about 6 hours which is why they do require at least a few hours of observation between birth and discharge. Generally mum needs a good rest anyway, and bub will need to be fed immediately after birth and then maybe again after mum’s had a long sleep, so for many families, there’s not much waiting in hospital, because bub gets the all-clear well before mum’s ready to even stand up.

With the midwife programme you can relax at home and make sure the cat’s also doing OK once the danger period has passed while knowing that help is just a phone call away. Obviously it’s not as safe as being in a hospital but we don’t all live in a hospital, so it’s a question of how long to observe a baby before pronouncing it healthy. This will vary, but the Birth Centre currently discharges as soon as 4 hours after birth if APGAR scores are excellent. They have the option to keep you if your baby starts out well but looks like it might deteriorate.

Madam Cholet 1:28 pm 30 Nov 13

I had my son five years ago too – at John James, which has a four night standard stay for normal deliveries. We had a prolonged delivery, but all was well in the wash up. Whilst I was kicking back reading the paper by day 4 and baby was being all very good, the first two days were a bit of a fog and it took probably 24 hours to get the feeding thing going according to plan. I recall seeing women who could not move without wincing and who would have struggled with just an overnighter. You also need to have care available once you go home. It would not be good enough to get left at home to manage alone.

So whilst as someone (who I believe is not yet a parent although memory could be wrong there), posted previously, it is not cancer, it’s each to their own.

sepi 12:13 pm 30 Nov 13

In private hospitals they keep you for 3 nights as it takes 3 days to establish breastfeeding.

Not everyone has a fabulous easy birth and hops up for some coffee and toast soon after.

My first baby became critically ill during her first night, after being fine at birth, and needed resucitating twice, so I’m not a fan of making it the norm to go home after 24 hours. If people want to , then fine, but it should’ be expected.

Not everyone is a martyr/superwoman type person who has a baby and is back to normal routines only hours later.

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