A retrospective, descriptive study of maternal and neonatal transfers, and clinical outcomes of a Primary Maternity Unit in rural Queensland, 2009–2011

• Published in: Women and birth : journal of the Australian College of Midwives Vol. 28; no. 1; pp. 30 - 39
• Main Authors: Kruske, Sue, Schultz, Tracy, Eales, Sandra, Kildea, Sue
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.03.2015
• Subjects: Adult; Australia; Continuity of care; Continuity of Patient Care - organization & administration; Female; Health Services Accessibility; Health Services, Indigenous; Humans; Infant; Maternal Health Services - methods; Midwifery; Midwifery group practice; Nursing; Oceanic Ancestry Group; Outcome Assessment (Health Care); Patient Transfer - statistics & numerical data; Pregnancy; Quality of Health Care - organization & administration; Queensland; Retrospective Studies; Rural Health Services; Rural maternity care; Rural Population - statistics & numerical data; Time Factors; Transfer; Transportation of Patients - statistics & numerical data; Young Adult; Australia; Queensland; Continuity of care; Midwifery; Transfer; Rural maternity care; Midwifery group practice
• ISSN: 1871-5192; 1878-1799
• DOI: 10.1016/j.wombi.2014.10.006

A widely held view in maternity services in rural Australia is they require 24-h on-site surgical and anaesthetic capability to be considered safe. This study aimed to provide a detailed description of three years of activity (2009–2011) of a rural maternity unit approximately 1h from the nearest surgical service. We describe the reasons for transfer to and from the unit, transfer times and the clinical health outcomes of all women (all risk status) and their babies. This retrospective study utilised contemporaneously, purposefully collected audit data, routinely collected data and medical chart review. Data were analysed based on the model of care that women were allocated to at the time of booking. The PMU provided care to twice as many young women (13.3% MDH vs. 5.1% QLD) and almost five times as many Aboriginal and/or Torres Strait Islander women (27.5% MDH vs. 5.7% QLD). A total of 506 women booked to receive care through a midwifery group practice (MGP), and 377 (74.5%) gave birth at the local facility as planned. Clinical outcomes for women and babies birthing both at the PMU and those transferred were comparable or better than other published data. The results challenge the notion that birthing services can only be offered in rural areas with onsite surgical capability. More PMUs should be made available in rural areas, in line with national and state policy and international evidence.