Restoring rural birthing services in Australia

Hazel Brittain is currently the Director of Midwifery Services at the Gold Coast University Hospital in Queensland, Australia. Previously, she was the Director of Nursing and Midwifery at Beaudesert Hospital – the hospital she talks about in this video. She’s a UK-trained midwife with a wide variety of experience, and she’s passionate about women having access to quality free midwifery services through the public health system.

In this video, Hazel talks about the positive aspects – and some of the challenges – of reopening her local hospital’s maternity unit using midwifery continuity of care as the foundation, alongside upskilling rural doctors, and with a nearby large hospital for referral when needed. Although there was some initial resistance to reopening the service without 24-hour on-call obstetric support, the alternative was women needing to travel sometimes hours away from home to get to a maternity unit – and that is potentially unsafe in itself. Without local services available, some women were choosing to induce their babies early or even have an elective caesarean section to avoid either having to drive hours in labour, or staying close to the maternity service with perhaps weeks of accommodation to pay for.

You can hear in this video Hazel talking about how midwifery services sit within the larger maternity care system: midwives collaborate with others in order to provide the best service for women and families. This is the Integrality Framework in action. Alongside the rural doctors, allied health and other specialists they can refer to when needed, the midwifery group practice (MGP) at Beaudesert Hospital provides maternity care for women and families. The community is elated to have relationship-based midwifery care available in their local area.

Over to you

Many rural hospitals globally have had their maternity units closed down because of obstetric shortages and the inability of the hospital to provide 24-hour caesarean services. Yet Beaudesert Hospital, along with others such as Mareeba in North Queensland, Australia, managed to re-open with a redesigned birth service focused on midwifery continuity of care.

How did they manage it? Can we emulate it? What did Hazel do to make change happen that could be useful in maternity services in your area?