Wednesday, December 5, 2007

More about length of post natal hospital stay

The subject of how long women should stay in hospital after the birth of a baby has arisen again after the sad death of a baby who went straight home after her birth and died shortly after. Carolyn McIntosh has written a very thoughtful post about this and I have nothing to add except my sincere condolences to all involved.

Carolyn has brought up one interesting point for discussion, which is the role of the primary birthing unit. A news piece on our national news suggested that primary birthing units are one answer to the shortage of post natal beds in large tertiary hospitals. I would certainly agree that primary birthing units are key to maternity services in New Zealand and else where; not just as a source of post natal care, but also as a strategy to reduce medical intervention in birth which leads to outcomes such as cesarean section.

We have been lobbying for a primary birthing unit in Dunedin for some years. I understand there is medical support for one that is attached to the hospital, but midwives in Dunedin believe it should be a 'stand alone' facility. This enables midwives to have complete control over the running of the unit and leaves them free to promote normal childbirth without interference.

I am sorry that I do not have time to go into this in any greater depth. I am writing this in Singapore, so I do not have any access to references that back up my claims. However, if you are interested in knowing more about this argument, please let me know and I will be happy to continue the discussion. Meanwhile, keep an eye on Carolyn's blog because I think she is going to look at this issue on greater depth.

Image: RNS Maternity Ward and cots - - RNSH


Sarah Stewart said...

The other thing I didn't say on this post is that opening more primary birthing units in the future doesn't address our immediate midwifery shortage. However, having midwives work in primary units that really facilitates midwives' skills and knowledge may improve job satisfaction and thereby increase recruitment and retention. However, employment conditions such as shift patterns still need to be addressed.

Carolyn McIntosh said...

Thanks for linking my blog here Sarah. I do hope that something positive does come out of this. Dunedin desperately needs a place where women can go to birth which is not a hospital. As we know it is so important for women to feel comfortable and relaxed in a birthing environment. I believe our senses are more affected by a hospital environment than we actually recognise. How do women manage to relax and get into that deep almost hypnotic state, so essential for an intervention free birth, in a busy hospital with all sights sounds and smells of the place? Providing a wee section cordoned off as a supposed "primary birthing unit" is not the answer. A birthing unit needs to be a completely separate building managed and staffed by midwives, a homely and inviting place where women can get into that quiet space for birth to occur spontaneously.