MIDWIFERY shortages in Western Australia's regional towns are leading to expectant mums having to drive up to 500 kilometres to give birth.
Recent revelations about the lack of maternity services at the Carnarvon Health Campus put the spotlight on a dire midwife shortage in regional WA, and the impact this is having on expectant mothers and their families who live outside of the metropolitan region.
The Nationals WA North West MLA Vince Catania said the situation was placing unacceptable stress and anxiety on affected parents.
"Staffing shortages in Carnarvon are forcing expectant mothers to travel many hours to access medical care or to safely give birth to their children," Mr Catania said.
"I wrote to the Health Minister directly in April and raised it again during Budget Estimates (last week) to make sure the minister appreciated the gravity of this issue to Carnarvon and surrounds.
"The safety and wellbeing of expectant mothers, their babies and families is paramount, and it is incumbent on the McGowan Labor government to address these service gaps through their $5.7 billion surplus."
Responding to Farm Weekly's questions on the midwife shortages facing the regions, a Minister for Health spokesperson said currently Carnarvon was the only birthing site across country WA that had temporarily changed the level of birthing care offered locally, with the situation interim and "a direct result of workforce pressures".
"Carnarvon women needing to access obstetric services in Geraldton are having 100 per cent of their travel and accommodation expenses met by the State government," the spokesperson said.
"The WA Country Health Service (WACHS) is committed to re-establishing the service as soon as possible and has no plans to reduce or remove maternity services in rural or regional WA."
The spokesperson said there was a national shortage of midwives, with the situation not unique to WA, but one that has been exacerbated by the pandemic.
"While WACHS is doing everything within its power to recruit staff, they continue to manage ongoing workforce pressures in regional WA," the spokesperson said.
"We acknowledge that offering maternal services on country is a fundamental part of meeting the physical and social needs of expectant mothers - that's why the State government has expanded services, most recently that included establishing a Midwifery Group Practice (MGP) service in Margaret River.
"In Geraldton, WACHS stepped up when St John of God Healthcare temporarily suspended their maternity services.
"Here, teams cared for expectant families impacted by the change and supported them to birth at Geraldton Regional Hospital."
However The Nationals WA and State opposition leader Mia Davies said the government's initial rejection of a proposal by Geraldton Universities Centre (GUC) to train local midwifery students in regional WA - for regional WA - was a missed opportunity and that we were now seeing the product of this neglect.
"Expectant mothers in WA, regardless of where they are based, deserve access to a high level of maternity care and services within their community, close to friends and family," Ms Davies said.
"New parents should not have to travel to Perth to access an obstetrician, as it forces expectant mothers to travel when it may not be medically advisable.
"It places an added financial burden associated with accommodation and travel expenses, at a time when cost-of-living pressures are biting the back pockets of many Western Australian families."
When the issue was raised in parliament last week, WA Health Minister Amber-Jade Sanderson said the State government would be revisiting the GUC proposal.
With about 33,000 births occurring in WA (public and private) each year, of these, about 4200 occur in regional WA, with another 1200 families accessing antenatal and/or postnatal care through regional health services.
Tori Kopke, who lives in Cunderdin, is one regional mum who opted to give birth in Perth at St John of God Hospital, Subiaco, about two hours away from her home.
The mother to a four-year-old suffered from preeclampsia during her second pregnancy - a potentially dangerous complication characterised by high blood pressure.
As a result, in the lead up to the birth, she was required to travel to Perth every week to be monitored and had to leave her four-year-old in day care.
"I reckon every time they went to take my blood pressure it was through the roof because I was stressed out from the drive and then trying to find a carpark," Ms Kopke said.
"Eventually I was able to be monitored in Northam, but that was still a 200 kilometre round trip to get there and back."
After spending 10 days in hospital, Ms Kopke was forced to stay with family in Perth for an additional three weeks while her newborn son, Houston, was required to stay in the hospital's neonatal intensive care unit (NICU).
"Because my husband is a farmer and was still seeding at the time, another burden that I didn't foresee was that, because I had a caesarean and wasn't allowed to drive, I had to take an Uber twice a day to get to the hospital to see my son," Ms Kopke said.
"If I didn't have family in Perth to stay with during that time, three weeks in rental accommodation would have been a huge stress and financial burden for my family.
"I definitely think there needs to be more support out there for people that find themselves in extreme circumstances, like we did.
"Whether it be a non-profit or government initiative, there needs to be more support for those families who basically have to pick up and move to the city for a month when they give birth."
The WA Country Health Service Patient Assisted Travel Scheme (PATS), funded by Royalties for Regions and administered by WACHS, aims to support WA country patients' access to specialist medical services, by subsidising travel and accommodation of country patients and enable them to access specialist medical services.
PATS applications are assessed by regional PATS offices and, on average, the scheme assists 35,000 country patients and subsidises 99,000 travel journeys each year.
Patients are eligible for accommodation assistance if they live more than 100km from the treatment centre and the medical specialist certifies that you need to stay overnight for follow-up and the forward and return journeys cannot reasonably be completed in one day because of factors such as the time required traveling and/or your medical condition.
Those who stay in commercial accommodation are eligible for subsidies up to $100 per night, or $20 per night for private accommodation.
Despite having claimed some PATS subsidies throughout her own pregnancy, Alyce Last, who lives in Merredin, said more maternity services needed to be made available to those living in the regions.
"I gave birth to my son, who is now 18-months-old, at St John of God, Mount Lawley and throughout my pregnancy we travelled to Perth seven times for my appointments," Ms Last said.
"Because I wasn't required to stay overnight, it was about a seven-hour round trip each time, so PATS subsidised our fuel, but they didn't cover our accommodation, so we were still out of pocket in that sense."
As Ms Last didn't have any family to stay with in Perth, upon her doctor's advice she booked two weeks of accommodation prior to her due date on December 5.
However when her baby didn't arrive as scheduled, Ms Last discovered she couldn't extend her stay at her accommodation.
"I pretty much ended up begging my doctor to induce me because the whole situation was stressing me out," Ms Last said.
With plans to have another baby soon, Ms Last said she sympathised with mothers and families who had numerous children, as having to travel and find accommodation would be a bigger financial burden for them to bear.
"I also think a lot of regional mums don't even know that PATS is available to them - I had a fair few doctors who had never even heard of it," Ms Last said.
Her sentiments were echoed by Hannah Foulds, who lives on a farm 25km out of Hopetoun in the Shire of Ravensthorpe with husband, Stefan.
"I think PATS definitely helps a lot of farmers and those living in the regions, but having said that I don't think everyone really knows about that service being available to them," Ms Foulds said.
Already mum to a 15-month-old girl, Shelby, and 34 weeks pregnant with her second child, Ms Foulds said her options for her second birth were to travel to Esperance, about a two and a half hour trip away, or to Albany, which is about three and a half hours away or to travel the longer distance to Perth.
"Esperance is smaller, so if you run into complications there, you are most likely to get flown out," Ms Foulds said.
"So we've decided to head to Albany when I'm 39 weeks.
"Although it's a bigger hospital that has a maternity ward, if you have big complications you could still get flown out of there as well."
Ms Foulds said part of her anxiety of giving birth in Albany was not knowing how long to book her accommodation for.
"You don't know how long you're to have to wait, so I've booked a week already and I will be doing everything I can to get this baby on the move within that week, but if we have to stay longer than that, we will have to find accommodation again and it will be during the school holidays," she said.
Acknowledging that having to travel some distance was part and parcel of living regionally, Ms Foulds said travelling ultrasounds and more travelling midwives would be helpful services for expectant mums living in the regions.
"I need to travel to Esperance for my ultrasounds and they get sent to my obstetrician in Albany," she said.
"When I was pregnant with my first child and lived in Newdegate there was a travelling midwife who was from Narrogin Hospital and she would call in and do my blood pressure and check on you and your baby's wellbeing.
"She would come to the farm too so that was really great, as it took a lot of strain off me, but unfortunately we don't get that service in Hopetoun."
Mum of four, Shara Cervantes who lives in Merredin with her husband Steve, and gave birth to their youngest daughter, Willow, 12 weeks ago at St John of God Hospital, Midland, agreed that having an ultrasound service available full-time in her region would be a priceless service for expectant mums.
"There is a midwife that works out of Merredin Hospital through Midwifery Group Practice in Northam, so I was able to do shared care with them and a lot of my appointments were able to be done up here thankfully," Ms Cervantes said.
"However if something had of gone wrong and the midwife wasn't available on her usual days in town, the GPs out here are trained the best they can, but I would have had to travel to Northam, which is almost two hours away, in order to be seen properly," Ms Cervantes said.
"They have had a few deliveries at the Merredin Hospital, but they're not fully trained, so that's a pretty scary prospect - to know that you're that far away from help if something does happen."
Ms Cervantes said while she also had the option to give birth in Northam, epidural services aren't available there and so she opted to travel the extra distance and give birth in Perth instead.
"Having a 14, 12 and a nine year old as well, and with my husband and I owning our own business, having to be away for two weeks to give birth in Perth was not ideal," Ms Cervantes said.
"It created a bit of stress on our family because I was missing out on events with my kids and just seeing them day to day."
When asked during Budget Estimates last week about the extent of workforce shortages plaguing WA's health system, including midwife shortages, the Health Minister didn't provide answers, directing the opposition to place the questions on notice (meaning the answers would not be available for at least 45 days).
"It's either incompetency or deception, because we know the department would have data on staff vacancies in our struggling hospitals," Ms Davies said.
"Severe staff shortages are impacting our hospitals right across the State, it's a significant issue impacting the department, yet there was no answer to our questions."
During Budget Estimates, the Health Minister said for 2022, WA Health is employing 1411 nurses and midwifery graduates, and that it was the first time in a number of years every single graduate had been offered a job.
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