Claim midwives' ideology hinders bids to stop falls

Ideological opposition from midwives makes it difficult to instigate change to hospital practices to reduce the incidence of neonatal falls, a junior paediatrics trainee says.

Dr Matt Hale, of the Dunedin Hospital Neonatal Intensive Care Unit, conducted a two-year audit of neonatal falls at Dunedin Hospital and found the rate appeared to be higher than in overseas studies.

Addressing delegates yesterday, he said he did not know whether the finding was statistically significant, however, as the number of cases identified (six) was very small.

There was a lack of literature about neonatal falls internationally, and in New Zealand he had found no research.

The falls had largely not resulted in injury, but there was potential for serious harm, and significant trauma for parents.

One mother had refused to hold her baby for three weeks after a fall, he said.

Most occurred during the night, when mothers had fallen asleep in their beds while breast-feeding.

It was difficult to engage midwives on the topic, he said, as they did not want to discourage practices that enhanced breast-feeding.

Midwives were ideologically opposed to measures they thought separated mothers and babies, he said.

Placing rails around beds was an option, but introduced a potential suffocation risk so had to be well designed.

Hospitals needed to carefully consider any behaviour that might be seen to encourage co-sleeping.

''We should be modelling good behaviour,'' he said.

In some instances overseas, parents in wards were warned of potential fall dangers, although there was a risk of information overload with too many messages at a sensitive and stressful time.

More research was needed, he said.



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