Canberra midwives raise alarm about maternity health services

Midwives said they held grave fears as a result of staffing, cultural and organisational issues across the capital's public hospitals.

"Midwives have been voicing this for a long time but it's now at a point where it is a breaking point - a point where we are looking at the potential loss of life of both women, babies, midwives and doctors," a midwife said.

More than a dozen nurses and midwives have spoken to The Canberra Times on the condition of anonymity, detailing the issues they faced on a day-to-day basis in the health system.

Staffing shortages were causing significant issues, midwives said. They said chronic understaffing was greatly affecting care.

"The lack of adequate care for women and families that they deserve and that's a huge burden that we as midwives take on, that we're not doing the role as we should be," one midwife said.

"I cannot stress enough that the lack of staffing is at a crisis point and so we're seeing more of those outcomes because we don't have the staff to prevent those things happening. We're seeing more drastic events."

Another said: "Every shift you go in and you just think, 'Is today the day where something really bad is going to happen'?"

All those who spoke to The Canberra Times reported concerns about a skills mix as many senior and experienced midwives had left or cut back their hours. This was a concern expressed by nursing staff across the service.

One midwife said the stress and burnout among senior midwives was "scary".

"You've got senior midwives coming in and having a poor skill mix, you come in and you've got three new grads and you've got to run a birth suite and have a patient load and make sure everyone's safe. You just have to have a million eyes on everything," one said.

"In terms of the early career midwives, we want to support them, we want to invest in them to help build our midwifery workforce but because the system is so broken they're not able to be provided the support they need because those midwives who should support them are too busy working on the floor.

"They're drowning and we're drowning."

They said the mental health of midwives was drastically worsening as traumatic events were being normalised. They said they did not feel supported.

One midwife likened the response from management as: "It's like we all have a septic wound on our faces and instead of giving us antibiotics they are just saying pack it full of some gauze."

Midwives also said cultural issues continued to plague the service.

"Psychologically unsafe. These places are psychologically unsafe," a midwife said.

"It's toxic, it's utterly toxic."

Midwives raised alarm about conditions within the Centenary Hospital for Women and Children more than four years ago.

In a letter sent to then-ACT health minister Meegan Fitzharris, the group of midwives said mothers and babies' lives were being put at risk by chronic overcrowding in the maternity unit.

They wrote in the 2018 letter: "It is only a matter of time before there is an adverse outcome for a mother, baby or staff member.

"Some may say this has already been the case."

This letter prompted a parliamentary inquiry, which recommended a mandated staffing level for midwives and nurses and that there be a focus on midwife-led care.

But since then, midwives said conditions had only worsened.

"We are begging for help and have been begging for a really long time and it's just at a point where we are begging our heads against the wall and nobody's listening," a midwife said.

"We started banging our heads years ago when it was about to be broken but at this point it's broken."

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Canberra Health Services provided an overarching statement to 26 questions from The Canberra Times about concerns and allegations raised made by nurses and midwives.

A spokesman said the organisation was committed to delivering quality and safe care to the community.

He pointed to a recent accreditation survey where Canberra Hospital met all criteria set by the Australian Council on Healthcare Standards.

"The independent surveyors, who undertook an extensive week-long review of our services, were highly complementary of the quality and safety of our care and the systems and processes which underpin it," the spokesman said.

The spokesman pointed to the recent release of a 10-year plan to improve maternity services in the ACT public health system in response to some of the concerns raised by midwives.

There was $12 million allocated to the rollout of the plan in this week's territory budget. The strategy outlined plans for workforce planning, scholarships for dedicated midwives and doctors and an expansion of maternity services in Canberra's north.

The government has also agreed to accelerate the roll-out of midwife-to-patient ratios in Canberra's maternity wards. The ACT would be the first jurisdiction to do so.

The plan said changes would take time and would be implemented in stages.

"Some changes to the public maternity system will take time, including building workforce diversity and capacity to expand services and respond to increasing workload," the plan said.

The budget also allocated $7.2 million towards improving staff safety with a focus on addressing occupational violence and psycho-social wellbeing.

The plan also pointed to media coverage from the parliamentary inquiry, saying this could distract from high-quality care provided from staff.

"Media attention around the inquiry and culture at our public maternity systems often distract from the high-quality care and professionalism provided by our maternity workforce, which has also felt the additional pressure of COVID-19," the plan said.

"While there are improvements that can be made to better support staff and increase workforce capacity and capability, the current efforts cannot be diminished."

The Canberra Times understands there were some concerns from midwives about a lack of consultation on the plan.

Canberra nurses have been rallying over the past month calling on the ACT government to put forward a recovery plan.

A petition calling for the plan with more than 2600 signatures was presented to the Legislative Assembly by Greens member Johnathan Davis.

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