Statement from Chris Fleming, CEO, Southern DHB, concerning Wanaka primary maternity services
Statement from Chris Fleming, CEO, Southern DHB
There are a number of points in this story that need clarification and correction.
Firstly, there is a maternal and child hub set up and running in Wanaka. In the interim, this is housed within the Wanaka Lakes Health Centre. It includes a clinic room, where consultations are held, plus access to emergency equipment is the emergency equipment including a resuscitaire and continuous foetal monitoring (CTG). The CTG was brought to the clinic room to support the rapidly progressing birth there. There is also access through the after-hours service to the emergency triage space when needed.
The DHB is paying for all the costs associated with this. This has been set up late 2018 and is well utilised by the midwives.
This interim hub is a first step, to enhance support for the midwives who were working there.
Longer term we are moving to a facility in Gordon Rd, which we are fitting out for this purpose. It will be better configured for delivering primary maternity care, including two clinic rooms, and an emergency treatment room appropriate for birth if needed.
Prior to the implementation of the Integrated Primary Maternity System of Care, the midwives would only have had access to their own equipment.
The Save our Midwives group has been campaigning for a primary birthing unit in Wanaka.
However, it is clear that a primary birthing unit would not have been recommended in this situation as women with previous history of Caesarean section are advised to birth in hospital (not a primary maternity facility) due to additional risks of subsequent births. Any births anticipated to require access to specialist care, epidurals, assistance such as forceps, blood transfusions, or access to a theatre such as for a Caesarean section are recommended to occur in secondary unit in Dunedin or Invercargill.
It is not feasible to establish a 24/7 secondary care hospital in Wanaka, with the required roster of four general surgeons, anaesthetists, obstetricians, midwives, plus any other services that would be deemed necessary.
This is why access to secondary care for those living at some distance from these services depends on forward planning between the woman and her midwife, supported by emergency services – including PRIME responders and transport services, and the emergency equipment available at the interim hub - that can assist when things do not go according to plan.
The LMC midwife has made clinical decisions in response to the situation she was faced with, and we acknowledge her skill in managing a rapidly evolving situation and ensure the safe birth and care of the mother and baby. We congratulate the family on their new arrival.