Former midwife concerned about staff shortages in Bathurst maternity unit

With around a decade of experience, the former midwife, who spoke to the Western Advocate on the condition of anonymity, understands the challenges the maternity unit is facing.

She is among 15 midwives who have resigned from the hospital's maternity unit in the last 18 months, saying her decision to leave came down to safety.

"For me, it was just the endpoint of going, 'Management aren't listening to us. I don't want to be the midwife that is going to go down when something goes wrong'," she said.

"I've always thought of myself as an advocate for women, but I also need to think of myself and I don't want to work in a place where it's not safe, where you're not supported, and where people's lives are at risk."

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A spokesperson for the Western NSW Local Health District (WNSWLHD) has denied there is a safety risk, telling the Western Advocate that "staffing levels are maintained at a level which is safe for mothers and their babies".

A decade ago, the midwife would have agreed.

When she started on the unit, she found herself in a "a well-staffed, well-supported environment" that could meet birthing numbers and acuity of patients at the time.

She loved her job and she enjoyed coming to work, as did her colleagues.

But she said things began to change around three years ago, well before the start of the pandemic, when the acuity of patients increased.

Around the same time the hospital introduced the Bathurst Midwifery Group Practice program, which the midwives initially thought would be "a really positive thing for the maternity unit".

The program aimed to offer families a better experience by assigning one midwife to provide continuous care throughout pregnancy, during labour and after birth.

However, the former midwife who spoke to the Advocate said the four staff employed for the program came from the maternity unit and they were not replaced.

She said this was when the staffing problems really began.

"I've never seen burnout to what I have in the last two years, so it just cascaded to the point that you had midwives that were continually working double shifts, so much overtime, and with that burnout comes increased conflict in the unit. So many other issues arise from that burnout," she said.

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She said some of the most experienced midwives have resigned as the pressure became too much, and those positions have largely been unable to be filled.

She alleged that, prior to her resignation, the unit was deemed to be approximately 14 full-time equivalent midwives short.

She fears that it will take a maternal death for things to change, which is why she is speaking up now.

She, along with other midwives, are calling for the maternity unit to be closed until such time appropriate staffing can be offered.

"It's not ideal, no one wants to see it come to this, but for the safety of the women in this town what needs to happen is they need to close the birthing facility at Bathurst until they can get a full complement of midwives," she said.

The WNSWLHD spokesperson did not directly respond to whether or not the suggestion to close the unit would be considered.

The provision of maternity services in rural and regional NSW has been deemed as complex, and the health district is working with the NSW Clinical Excellence Commission to examine its network of maternity services to ensure they are sustainable and meet the future needs of all its communities.

According to the WNSWLHD spokesperson, Bathurst's maternity unit currently has 10 vacancies.

"There are currently 26.68 full-time equivalent midwife roles at the Bathurst Health Service. There are currently 10 vacancies with eight of these temporarily vacant while staff are on maternity leave. Casual or agency staff are employed to fill these vacancies," they said.

"In addition, in many cases midwives who have moved on from their roles at the Bathurst maternity service during the past 18 months have chosen to remain part of the services' midwifery casual nursing pool."

The spokesperson also noted the results of the most recent maternity services survey undertaken, which reported that 95 per cent of respondents rated their care during labour and birth at Bathurst Hospital as very good or good.

General secretary of the NSW Nurses and Midwives' Association, Brett Holmes, has supported the former midwife's story and called on the WNSWLHD to act.

"We are extremely concerned about the ongoing short-staffing occurring within Bathurst Base Hospital's maternity services," he said.

"We are aware a number of senior midwives have resigned or reduced their hours of work due to burnout and fatigue from unreasonable workloads. This has led to other skill mix issues for the remaining midwives and at times, led to unsafe working conditions.

"Despite concerns being raised by midwives about staffing shortages and regular overtime requests being placed upon them, Western NSW Local Health District has not introduced any practical immediate or longer-term solutions.

"The association is calling on the local health district to hold meaningful discussions with midwives at Bathurst to address their concerns and release the findings of a Birthrate Plus review conducted in the second half of last year into local midwifery staffing levels."

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