Pregnant mothers turned away from Perth hospitals due to healthcare worker shortages

There was no room in a Perth hospital delivery room when San-Mari Andrea Krugel arrived after feeling contractions.

She had received all of her previous maternity care at this hospital, but on the day her baby Mias was due to arrive, she was turned away.

“I felt like [if] I’ve booked at Osborne Park, I’ll have my baby at Osborne Park no matter what,” she said.

“Am I just going to have my baby on the floor? What’s going on?”

For more than 12 hours, Mrs Krugel and her husband were stuck in limbo without knowing where they would end up.

Eventually, a space opened up at the Armadale Health Department, about a 45-minute drive away.

The Krugel family were all smiles, but endured a tumultuous 24 hours before this photo.(ABC News: Cason Ho)

“We are extremely grateful to all the staff for how they handled this whole ordeal,” Ms Krugel said.

“Even if it was really difficult, it could have been much worse.”

Hundreds of pregnant women turned away

Hospitals in the Perth metropolitan area have been forced to turn away pregnant women during times of high demand.

WA Department of Health figures show pregnant women were bypassed or diverted from Perth hospitals 311 times between June 2021 and May 2022.

In some cases, they had to travel up to an hour from St John of God Midland State Hospital to Northam Hospital, around 80 kilometers away.

Maternity bypass also occurred at Fiona Stanley Hospital, Osborne Park Hospital and Rockingham General Hospital.

A little boy is holding a book while sitting in his parents' lap on a sofa.
The family say the first year with their little boy has been great, despite how it all started.(ABC News: Cason Ho)

Ms Krugel said the ordeal had eroded her faith in the public health system.

“Just for my peace of mind, next time I’ll go private,” she said.

Ms Krugel had hoped for a natural birth, but had to undergo an emergency caesarean section, which she attributes in part to anxiety resulting from the situation.

“[The baby’s] the heartbeat was all over the place from all the stress,” she said.

An album full of photos of a little boy.
Ms Krugel says the staff involved in her work were “incredible” despite the circumstances.(ABC News: Cason Ho)

“Part of me thinks that if we hadn’t had to move the hospitals, maybe I would have been… more likely to give birth the way I wanted.”

Caesarean sections on the rise

The World Health Organization indicates that the ideal cesarean birth rate should be between 10 and 15%.

The proportion of caesarean births in Australia exceeds 30% and has been increasing for more than a decade.

In WA, it has risen from 33% in 2008 to over 40% in 2022, according to figures from the WA Department of Health.

Having an emergency C-section contributes significantly to the risk of postnatal anxiety, depression, and PTSD after childbirth.

Advocates push for midwife-led births

Consumer advocacy group Maternity Choices Australia says stressful childbirth, including bypass, can also contribute to an increased risk of postnatal mental health problems.

The advocacy group is writing a brief to the WA Minister of Health on state maternity services.

“Emotional trauma is exploding,” Vice President Azure Rigney said.

A woman smiles at the camera
Ms Rigney says WA is falling behind other states and territories in providing adequate maternity services.(ABC News: Michael Lloyd)

Ms Rigney said allowing midwife-led units to manage low-risk pregnancies would reduce the need to divert mothers to other hospitals.

“It’s like a birthing centre, a midwife-led unit where they have all the lifesaving equipment…it just means you don’t have caesarean section and medical intervention facilities,” he said. she declared.

“If there was anything very rare and complicated for a low-risk woman in this setting, what we’ve learned from COVID is that the midwife can face the obstetrician and have this specialized contribution if necessary.”

“Something has to change”: midwife

But it can be difficult to implement Ms. Rigney’s recommendations in the face of a nationwide labor shortage.

The North Metropolitan Health Service has described maternity bypass surgery as “standard operational practice” to cope with high demand.

“WA Hospitals are working together to ensure that all mothers giving birth can access midwifery care at all times,” a spokesperson said.

“This may mean that some women are transferred to less busy maternity units.”

But a midwife who works at a metropolitan hospital in Perth told the ABC it put undue stress on the hospitals receiving the diverted patients.

“Other hospitals that are doing bypass surgery…make us take their wives,” they said.

“It leaves the women who are from our establishment, sometimes they are the ones who have to wait.”

The midwife told the ABC that some hospitals are put on maternity bypass almost daily.

“It just boils down to funding all the time.”

“We can’t hire midwives because we need funding. We can’t get better equipment because we need funding.”

Advocacy for the return of retired midwives

The state government recently wrote to retired midwives encouraging them to return to work.

“It is no secret that we are facing pressures on the workforce,” said Minister of Health Amber-Jade Sanderson.

WA Health Minister Amber-Jade Sanderson speaks with a puzzled look.
The health minister said the women’s and newborn hospital project was an opportunity to ‘reset’ and ‘review’ maternity care in WA.(ABC News: Keane Bourke)

Ms Sanderson described maternity bypasses as ‘unfortunate’ but ‘necessary to ensure women can give birth safely’ when some hospitals are unable to meet demand.

“I understand being told to go to another hospital can be very stressful for pregnant women,” she said.

“But I am confident that no matter where a woman in Western Australia gives birth, she will receive the highest quality care.

“The decision to divert or transfer birthing mothers is always made in the interest of patient safety.”

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