About maternity services in the Southern district
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The way we deliver primary maternity services in the Southern District is changing.
These changes have been about closing the gaps in our large district, putting the right services in the right places to serve changing populations. We have done this by matching services to populations and doing more to support the sustainability of LMC midwives in our rural communities.
Where we’ve come from
LMC midwives are at the heart of maternity care in New Zealand. But in the Southern district, they were facing significant challenges. They were leaving their roles and there was a real risk that areas such as Wanaka, Te Anau, Queenstown and Central Otago could be left with little or no LMC midwives – we had to make changes.
As you can see below, in the past there were significant inequities in services; in Southland there were three primary birthing units within around 40 minutes of each other in Gore, Winton and Lumsden, despite low populations and small numbers of births particularly in Winton and Lumsden. In Lumsden, the primary birthing unit was staffed 24/7 for less than one birth per week. Meanwhile, other areas such as Wanaka and Te Anau had significant populations, but no formal maternity infrastructure.
At the same time, we wanted to strengthen the integration between rural general practices and rural midwifery care.
This required us to think differently about how primary maternity services are delivered. The new system directs resources differently, to provide more financial support to LMC midwives and increase the reach of services across the whole district. Altogether, we’re now investing more in primary maternity services in rural areas than previously.
To view a timeline of changes, click here.
What does this mean for you?
The new configuration means that if you do have an urgent, rapid birth there are now more places across the district that have more resources than under the previous configuration.
We also have more midwives to support you, partly thanks to the $268,000 in special payments we have paid in the past year to midwives who provide LMC care to women in remote areas. We have also paid $22,400 in room rental for midwives (a cost normally met by midwives).
We have been working with general practices in more remote areas to strengthen their role in maternity-related medical emergencies so there is more support in those communities for you. This means more equipment, expanded stocking of emergency general medications and free attendance for LMC midwives and rural GPs and nurses at emergency maternity education. We have spent $5000 on consumables.
Your options for place of birth and postnatal stay in Otago and Southland
You can decide where you want to give birth – at home, in a local primary maternity unit, or at a base hospital.
Home birth is a safe choice for many women. Women who have home births use less pain relief and are more likely to have a normal vaginal birth than women who give birth in hospital. If you want to know more about this choice talk to your midwife and/or doctor. You can find out more on the Home Birth Aotearoa website.
At a home birth your midwife will have another midwife there to support you and her during and after the birth. Your midwife will stay with you for at least 2 hours after the birth. Postnatal care at a Primary Maternity Unit is also an option.
Primary Maternity Units:
These units provide a home away from home environment and are a good option for women with uncomplicated pregnancies. Like home birth, women who choose a Primary Maternity Unit are more likely to have a normal birth and are less likely to require medical interventions.
Your care in labour and birth will be from your LMC midwife, supported by the maternity unit staff. You are entitled to up to 48 hours of postnatal care following birth and will receive care from the maternity unit staff during your stay. If you develop a complication during labour or after you have your baby, you will transfer to one of the base hospitals for medical care. Staff are well trained to assist with establishing breastfeeding and to deal with complications and transfers to base hospital.
Use the links provided for each Primary Maternity Unit to find out more and visit: https://www.southernhealth.nz/publications/maternity-quality-and-safety-annual-report-2017 to look at outcomes for each unit.
Serving the Waitaki community
Two birth rooms and three postnatal rooms.
Serving the Clutha community
One birth room and three postnatal rooms.
Charlotte Jean Maternity Hospital, Alexandra
Serving the Wanaka/Central Otago region
One birth room and three queen-size postnatal rooms. Partners are encouraged to stay.
Serving the Queenstown Lakes region
One birth room and five postnatal rooms.
Serving the Southland region
One birth room and two twin postnatal rooms.
Serving the Southland region
Two birth rooms and four queen-size postnatal rooms. Partners are encouraged to stay.
Hospital Maternity Care
If you have medical complications in pregnancy it will be recommended that you birth in hospital where you can receive input from the specialist and/or neonatal team in addition to your LMC midwife. If you have an uncomplicated pregnancy you can also birth at a base hospital under the care of your LMC midwife and supported by the staff midwives.
Southland Hospital Maternity Service is part of Southland Hospital in Invercargill. Queen Mary Maternity Centre is located on Level 2 of Dunedin Hospital. Both hospitals have specialist antenatal clinics Monday to Friday. Certified lactation consultants are on staff to help women establish breastfeeding. After giving birth women can choose to stay at the base hospital or transfer to a primary maternity unit close to home for post-partum recovery.
Southland Hospital has a Neonatal Intensive Care Unit (NICU) providing level two neonatal and intensive care to babies born prematurely (from 30 weeks gestation) and for newborn babies to three months of age who require intensive care.
Dunedin Hospital’s Neonatal Intensive Care Unit (NICU) provides tertiary level (highly specialised) care to babies born prematurely (from 23 weeks gestation) and for newborn babies to three months of age who require intensive care.
To view some sample scenarios click here.
Talk to your midwife about what’s right for you
Talk to your midwife about what’s right for you. If you need input from a specialist doctor, they will give you advice about where to plan to have your baby.
Birth outside of hospital is a safe option for healthy women having straight-forward pregnancies. Women who plan to birth at home or in a local Primary Maternity unit are more likely to have a normal vaginal birth and are less likely to need pain relief.
If you need specialist care during labour and birth, most likely you will be advised to birth at a base hospital. Common reasons this is recommended include: carrying more than one baby, going into labour early, or having a medical condition such as high blood pressure or diabetes.
If you birth in hospital, you may wish to plan for a postnatal stay at a Primary Maternity unit close to home.
How to find a midwife:
• Go to https://findyourmidwife.co.nz/
• Ask your GP or Practice Nurse
• Ask for recommendations from friends and whānau.
All eligible women are entitled to maternity care at no cost.
If you have been unable to find a midwife call:
• 03 470 9858 (Otago)
• 03 218 1949 Ext. 48523 (Southland)