Birthing unit to be on site

Chris Fleming. Photo: ODT files
Chris Fleming. Photo: ODT files
The new Dunedin Hospital will have a primary birthing unit alongside its maternity ward, the Southern District Health Board has confirmed.

The news is a partial victory for midwives, who wanted a unit but had hoped it would be a stand-alone facility separate from the hospital.

Most New Zealand cities have a primary birth centre for women expected to have trouble-free natural births.

A possible Dunedin unit was proposed in the SDHB’s region-wide review of maternity services, but the decision was deferred until plans for the new Dunedin Hospital were finalised.

The hospital’s indicative preferred preliminary site masterplan included a primary birthing unit in its scope of intended services, with the proviso it was subject to review by the SDHB.

Board chief executive Chris Fleming confirmed a unit for the new complex’s acute services building, sited alongside maternity.

There was clear evidence of better health outcomes in a primary birthing unit, and there was little debate over building one, he said.

"The issue was would it be a stand-alone unit, i.e. off-site, and if it were on-site would it be separate from the secondary maternity unit or alongside."

Planning to date was that the unit would be alongside maternity but that was unconfirmed, he said.

"It is modelled on the Hawke’s Bay model ... there is a one-way door there between primary and secondary ... it is deliberately not used as an overflow facility, you are either a primary birth or a secondary birth."

The four-year average pregnancy figure for Dunedin is 1598; an estimated 30% of those were estimated as being appropriate for a primary unit birth.

The size of the unit, as well as the number of beds in the main maternity unit, are still being debated.

The final master site plan for the hospital is unconfirmed, a situation likely to delay presentation of the detailed business case for the new hospital to Cabinet.

However, planners, after consultation with the project’s clinical leadership group, had confirmed a unit would go ahead, Mr Fleming said.

New Zealand College of Midwives Dunedin representative Maureen Donnelly said what the DHB called a primary birthing unit and what midwives thought one was were not quite the same thing.

"It will be part of a ward in a hospital, it’s not going to be something separate ... we would have liked a stand-alone unit but no, it is going to be on the same floor," Ms Donnelly said.

"It’s better than what we have got now ... but it’s hard to say yes when they are rebuilding the whole hospital and we are only getting a tiny little part of it."

Midwives had wanted a ground floor space with outdoor access, but had been told the ground floor was prioritised for other facilities, Ms Donnelly said.

Their other concern was that if the unit had a small number of beds, women who had just given birth would be required to vacate their room for a woman in labour.

"At the moment if women have a normal birth they are allowed to stay in the room they birthed in, but if someone else comes in they will be asked to leave," she said.

"It’s going to become the thing, you come in and go home shortly afterwards for post-natal care."

Mr Fleming said the siting of the unit alongside maternity meant services would be immediately available to mothers and babies.

"It is fair to say there are still some who gave a view that the primary birthing unit should be completely stand-alone and off-site; there is nothing stopping any parties out there developing primary birthing units. There are units which are not DHB-owned."

"We believe the development of an appropriately configured facility that would enable some back-up and infrastructure for each other but which would be operated as two separate units is a good balance."
 

Add a Comment