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Four options for location of primary birthing unit in Central Otago released ahead of Public Meeting in Cromwell

Issue date:

Options for the location of a new primary birthing unit in Central Otago have been released in preparation for a public meeting in Cromwell to gain community feedback.

The meeting will be held on Thursday 23 July, from 4pm, at Cromwell Presbyterian Church, 10 Elspeth Street, Cromwell, and the full Options Paper can be found at https://www.engage.southernhealth.nz/maternity 

The meeting will be streamed live via Zoom. Please note Zoom numbers are limited. If you can't access the meeting, check back later and we will post a recording of it. Click the link to join: https://zoom.us/j/91767788317 The meeting password is: 543102. People may also email questions beforehand to Maternity@southerndhb.govt.nz Southern DHB has worked alongside the Central Lakes Locality Network to engage with stakeholders and local communities to develop options to meet the need for primary birthing facilities.

Mary Cleary Lyons, General Manager, Primary and Population Health, Southern DHB said the public meeting will share feedback received from the public consultation so far, and present options around the configuration of maternity services in the area for people to consider.

During the consultation process, over 300 responses to an online form have been received, and meetings have been held with stakeholders including midwives, primary care, St John and Māori communities.

Participants were asked their views on the most important issues to consider when deciding on a location for a primary maternity facility, with the following priorities identified:

  • 24/7 midwifery availability at birthing facilities
  • Rapid access to urgent transport, especially a helicopter
  • Equity of travel times and access to primary birthing facilities for all parts of the region
  • Co-location with other health services
  • Needs to take account of future population growth
  • Quality of the whole pathway of maternal care
  • Respectful treatment of Māori patients and whanau
  • Charlotte Jean Maternity Hospital is highly valued by women and the community.

Based on this feedback, the proposed four options are being presented for consideration at the public meeting.

Option One:

  • Locate a single new facility at Cromwell
  • Decommission Charlotte Jean Maternity Hospital
  • Supplemented by Maternal and Child Hubs in Wanaka, Alexandra and Ranfurly
  • Emergency birthing facilities in Lawrence

Option Two:

  • Locate a single new primary birthing unit in Clyde at Dunstan Hospital
  • Decommission Charlotte Jean Maternity Hospital
  • Supplemented by Maternal and Child Hubs in Wanaka and Ranfurly
  • Emergency birthing facilities in Lawrence

Option Three:

  • Locate a new Primary Birthing Unit in Wanaka AND
  • Retain the current unit in Alexandra (Charlotte Jean)
  • Supplemented by Maternal and Child Hubs in Ranfurly and Cromwell 
  • Emergency birthing facilities in Lawrence

Option Four:

  • Locate a new Primary Birthing Unit in Wanaka AND
  • Relocate the current unit in Alexandra (Charlotte Jean) to be co-located with Dunstan Hospital in Clyde
  • Supplemented by Maternal and Child Hubs in Ranfurly and Cromwell
  • Emergency birthing facilities in Lawrence

“We have sincerely appreciated the consideration that has been given to this question, and the thoughts our communities and stakeholders have shared with us. It is a complex issue and there are a variety of possible solutions, each of which offer opportunities as we weigh up the priorities involved.”

“All of the scenarios represent an increased investment in primary maternity services in this area, and we are pleased to be working with women, families and health care providers to provide this important care.”

In addition to the public meeting on 23 July, people can provide feedback online https://www.engage.southernhealth.nz/maternity

Feedback from the public meeting and online will be used to formulate a report with recommendations to the Southern District Health Board for its October meeting.

ENDS

For further information, please contact: Southern DHB Senior Communications Advisor Eirwen Harris Mitchell, on 027 8364 718 or email: eirwen.mitchell@southerndhb.govt.nz

Frequently Asked Questions about the Location of a new Primary Birthing Unit in Central Otago

Why has the provision of primary maternity services in the Southern District been changing in recent years?
Southern DHB has the largest geographical area of all New Zealand’s DHBs, and a population that is widespread. 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.

What does the new system mean for pregnant women in Southern?

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, who now receive special payments to provide LMC care to women in remote areas. Through the maternal and child hubs, we are also covering the cost of room rentals and other equipment and supplies for rural LMCs (costs 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.

Are there rules around where a Primary Birthing Unit should be located?
Yes. Southern DHB is required to provide or fund primary maternity facilities for urban or rural communities with a catchment of:

  • 200 pregnancies per annum where the facility is 30 minutes from a secondary service,
  • 100 pregnancies per annum where the facility is 60 minutes from a secondary service.

What is a Primary Birthing Unit?
A Primary Birthing Unit, sometimes called a Primary Maternity Unit, is a home-away-from-home environment and is a good option where women with uncomplicated pregnancies can have a planned birth. Women are cared for by their LMC midwife, supported by the maternity unit staff.

The unit might be a stand-alone facility, or part of a base hospital – e.g. Southland Hospital or Dunedin Hospital.

Stand-alone Primary Birthing Units do not offer maternity services such as epidural, Caesarean section or medications to induce/augment labour.

If you are birthing at a stand-alone Primary Birthing Unit and develop a complication during labour or after you have your baby, you will transfer to one of the base hospitals (in Invercargill or Dunedin) for medical care. Staff are well trained to assist with complex deliveries and also provide comprehensive postnatal care.

There are six Primary Birthing Units in Southern: Oamaru Hospital Maternity Centre in Oamaru, Clutha Health First Maternity Centre in Balclutha, Charlotte Jean Maternity Hospital in Alexandra, Lakes District Maternity Unit in Frankton, Gore Hospital Maternity Unit in Gore and Winton Maternity Centre in Winton.

What is a Maternal and Child Hub?
A Maternal and Child Hub is a SDHB-funded facility where women can go for antenatal and postnatal support. Women might also have a consultation with a medical specialist through teleconferencing facilities at a hub.

A Maternal and Child Hub is not a replacement for a Primary Birthing Unit. Instead it provides an additional layer of support for women in areas that are further away from other maternity facilities.

While planned births do not take place at Maternal and Child Hubs, they do have midwifery equipment and are accessible to LMC midwives in case of a rapid birth.

There are Maternal and Child Hubs in Wanaka, Ranfurly, Te Anau, Lumsden and Tuatapere.

So why does Central Otago need to consider the location of a Primary Birthing Unit?
Central Otago’s growing population has been growing rapidly. Southern DHB is required to locate a Primary Birthing Unit in an area where there are 100 pregnancies per annum and the facility is more than 60 minutes away from a secondary service.

What are the important considerations for choosing where to locate a new Primary Birthing Unit?
We asked stakeholders, including midwives, other health professionals and members of the community, what they considered the most important considerations when choosing a location for a Primary Birthing Unit.

They identified the following criteria:

  • 24/7 midwifery availability at birthing facilities;
  • Rapid access to urgent transport, especially a helicopter;
  • Equity of travel times and access to primary birthing facilities for all parts of the region;
  • Co-location with other health services;
  • Needs to take account of future population growth;
  • Quality of the whole pathway of maternal care;
  • Respectful treatment of Māori patients and whānau.

What are the options for locating the new Primary Birthing Unit in Central Otago?

The proposed four options for consideration at the Public Meeting on 23 July are:

Option One:

  • Locate a single new facility at Cromwell
  • Decommission Charlotte Jean Maternity Hospital
  • Supplemented by Maternal and Child Hubs in Wanaka, Alexandra and Ranfurly
  • Emergency birthing facilities in Lawrence

Option Two:

  • Locate a single new primary birthing unit in Clyde at Dunstan Hospital
  • Decommission Charlotte Jean Maternity Hospital
  • Supplemented by Maternal and Child Hubs in Wanaka and Ranfurly
  • Emergency birthing facilities in Lawrence

Option Three:

  • Locate a new Primary Birthing Unit in Wanaka AND
  • Retain the current unit in Alexandra (Charlotte Jean)
  • Supplemented by Maternal and Child Hubs in Ranfurly and Cromwell
  • Emergency birthing facilities in Lawrence

Option Four:

  • Locate a new Primary Birthing Unit in Wanaka AND
  • Relocate the current unit in Alexandra (Charlotte Jean) to be co-located with Dunstan Hospital in Clyde
  • Supplemented by Maternal and Child Hubs in Ranfurly and Cromwell
  • Emergency birthing facilities in Lawrence

When is the Public Meeting? And where?
The meeting will be held on Thursday 23 July, from 4pm, at Cromwell Presbyterian Church, 10 Elspeth Street, Cromwell, and the full Options Paper can be found at https://www.engage.southernhealth.nz/maternity

Can I give my feedback online?
Yes, you can. People can provide feedback online https://www.engage.southernhealth.nz/maternity

What next?
Feedback from the Public Meeting and online will be used to formulate a report with recommendations to the Southern District Health Board for its October meeting.

Has COVID impacted on this consultation?
Yes. Southern DHB began consulting over the location of a new Primary Birthing Unit for Central Otago in early February 2020. The work was put on hold during the COVID crisis, as everyone was deployed to helping with the public health response. Our consultation is now back underway.

We have received over 300 submissions. Thank you to all those submitters for making the time to participate and share your thoughts.