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JILL OVENS MERAS CO-LEADER (INDUSTRIAL)

St George’s midwives shocked at proposed closure

Midwives were left stunned after a meeting in mid-March between maternity staff and St George’s Hospital Chief Executive, Blair Roxborough. Much to the staff’s surprise, a ‘change proposal’ presented by the CE outlined four options for the future of the hospital’s maternity service, including closure.

The 22 midwives, all but one of whom are MERAS members, were left in no doubt that closing the maternity unit was St George’s preference. Two other options involved scaling the maternity service back.

In a submission detailing our response, MERAS made it clear members’ preferred option was to continue the full maternity service.

St George’s has been providing maternity care to Christchurch women since the 1940s. A new maternity ward opened in late 2020 included three purpose-built birthing rooms (two with birthing pools), and a 12-bed postnatal facility. The service is well supported, with more than 500 births and around 1,000 postnatal stays each year (including transfers from Christchurch Women’s Hospital).

Although St George’s is a private hospital, the maternity service is very reliant on its contract with the Canterbury DHB. Two rooms set aside for women paying privately were not well publicised, were rarely used, and the private service has since been discontinued.

Members were told that a drop in postnatal transfers from Christchurch Women’s Hospital over the past six months had affected financial viability. The trend towards early discharge, partly because of restrictive visiting policies due to Covid-19, resulted in fewer postnatal transfers to the unit.

St George’s was also concerned about the impact of a new DHB primary unit due to open next year in the central city. After years of lobbying from the midwifery community, the DHB announced that a new central city unit with 20 beds and four birthing suites would open in early 2023. It has since revised the opening time to mid-2023.

MERAS argued that closure of St George’s would leave a huge gap in primary birthing options in the meantime, and that there would still be an ongoing need for the service St George’s provides after the new DHB unit opens. Until 2016 there were two primary units in Christchurch – St George’s and one operated by the DHB at Burwood – both meeting the demand for primary birthing options and postnatal stays.

In the MERAS submission, we said birthing centres have different styles and ambience, and this is likely to occur in the Christchurch context with each unit appealing to different women, but increasing the overall number of women who birth in a primary setting.

St George’s midwife Noemi Gulliver has emphasised that women must have choices about where they have their babies, and the support they receive postnatally. She told the CE of St George's the midwives’ main concern was for the women of Christchurch.

L-R: James Gough and his second baby, who recieved postnatal care at St.Georges and St. Georges Maternity Unit staff

In an email to the CE, St George’s midwife Noemi Gulliver emphasised that women must have choices about where they have their babies, and the support they receive postnatally. She told the CE the midwives’ main concern was for the women of Christchurch.

“Having a choice and confidence in that choice play a key role in positive outcomes. I worked at CWH for 10 years and know that the closure of the St George's maternity unit would put much more pressure on CWH.”

St George’s midwives were encouraged by the support they received through media coverage of a petition started by Rata Midwives (see Bulletin, p. 8). Celebrities, consumers, the College of Midwives, LMCs and politicians publicly backed the petition, which quickly gained 31,000 signatures.

Christchurch city councillor and Canterbury District Health Board member, James Gough, whose wife and babies received postnatal care at St George’s, told Stuff he learned of the proposal for change through the media and was taken aback.

“I was surprised we didn’t have more visibility over it, and that is a concern. The approval of a new DHB primary birthing unit in the central city was never intended to replace the service contracted at St George’s, as it was recognised both would be needed to meet demand,” he said. “There’s a desperate need for a primary birthing unit in Christchurch in addition to the existing service at St George’s.”

It is clear that the St George’s maternity unit has been under considerable pressure since November 2021. Staffing shortages exacerbated by the vaccine mandate and staff off work due to Omicron-related issues, led St George’s to reduce the number of available beds from 10 to five. They closed their maternity service for several weeks over Christmas for the same reason.

The hospital claimed this was despite extensive recruitment efforts. However, as MERAS workplace representative at St George’s Pene Marshall explains, this is not supported by the experiences of several applicants.

“Some midwives who applied at the end of last year were shortlisted, but by January and February they still hadn't been interviewed. So from the end of last year to March, those midwives were left in the dark, while we were short staffed.”

However, in the MERAS submission Caroline Conroy pointed out that midwives generally enjoy working at primary maternity units and it is usually easier to fill midwifery vacancies there than in some larger services. With borders re-opening, it should become easier to attract midwives from overseas.

“We are aware of other maternity units successfully recruiting midwives from the UK and Australia, and more midwives participating in return to practice programmes. Additionally, last year’s cohort of new graduate midwives are coming to the end of their first year and may also be looking for new midwifery workplace opportunities.” The future of the St George’s maternity service remains uncertain at time of writing, with a decision expected at the end of May. square

“I was surprised we didn’t have more visibility over it, and that is a concern. The approval of a new DHB primary birthing unit was never intended to replace the service contracted at St George’s, as it was recognised both would be needed to meet demand."

- James Gough, Christchurch City Councillor

For MERAS Membership merasmembership.co.nz www.meras.midwife.org.nz