No Risk Births?

As the regional maternity crisis continues to roll out across the country, Queensland Health bureaucrats are attempting to address the high-profile maternity bypass at Gladstone Hospital by enabling ‘No Risk Births’ to take place there.

Superficially, this may appear to be good news for the expectant mothers of the Gladstone district. However, NASOG has a number of significant concerns that I’m sure are shared by many.

What exactly is the definition of a “No Risk Birth”. It is certainly not a medically recognised concept and does not appear in any textbook of Obstetrics and Gynaecology. While thorough history taking can identify a number of known risk factors and therefore presumably find a group of women with “lower risk”, no delivery can be classified as having no risks attributed to it at all.

A/Prof Gino Pecoraro on 10 News, Brisbane, 12 April 2023

As all obstetricians know well, pregnancies and deliveries are normal until they aren’t. The change from normal to ultra-high risk can happen in the blink of an eye and place both mother and baby at risk of losing their lives or permanent disability.

A number of studies looking at lower risk pregnancies managed in a number of different midwifery led settings without automatic oversight by an obstetrician, quote varying rates of up to 50% ultimately needing the input of an obstetrically trained doctor to effect safe delivery of the baby.

Statistics such as these should be of great concern to the people of Gladstone who are living with the prospect of having a baby at a unit without access to emergency lifesaving obstetric input.

These figures should also encourage caution on behalf of the department when making announcements to the public without the necessary contingencies in place to handle emergencies when they inevitably occur.

While everybody is understandably incredibly keen and anxious for maternity care to be delivered once more from Gladstone Hospital, it is imperative that such care is safe for both mothers and babies who are at a particularly vulnerable time in their lives.

This safety must not be sacrificed for expediency or to dampen adverse political recriminations.

Members of NASOG know that reinvigorating private obstetric practice and removing the discrimination in access to Gold level Private Health Insurance will make a genuine difference to the provision of maternity services throughout the country.

NASOG has been highly vocal in the Queensland media and actively meeting with stakeholders at State and Federal level to encourage my home state to work with the Federal Government on policy decisions that will return full maternity services to our regions.

The same approach needs to happen across the country before we see more regional hospitals turning to a ‘No Risk Birth’ model.

LISTEN: A/Prof Gino Pecoraro on 4BC, 13 April 2023

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