News

New maternity framework for best care at Mildura Base Hospital

Mon, 09 Jan 2017 06:51:00

A new State-wide framework is being implemented for maternity services at Mildura Base Hospital to ensure the safest possible maternity and neonatal care for mothers and babies.

The annual self-assessment assists in planning for the broad range of women and new babies requiring care at MBH against a standardised capability framework developed by the Department of Health and Human Services.

MBH Director of Nursing Janet Hicks said the new framework would involve some changes to the management of care for women and babies with potentially higher complexity needs.
“The maternity capability frameworks were developed through extensive consultation with clinicians, health service program managers and policy makers and focus on the core requirements for safe care at each level,” Ms Hicks said.
“They are one way for hospitals to determine the services they can safely provide,” she said.
“For MBH and other health services across the State, the framework ensures that safe and high quality maternity and newborn services are provided in a planned and sustainable way.”
Ms Hicks said although rural and remote hospitals maintain a degree of flexibility around decisions on the appropriate care for mothers and babies, the framework supported by evidence based care recommendations determined what level of service could be provided by hospitals and health services.
“For most women, there is no change to the safe care we provide at MBH,” Ms Hicks said.
“However, the framework responds to research in relation to mothers that are clinically defined as obese that demonstrate these mothers and their babies have worse outcomes, including a higher risk of infant death,” she said.
The Victorian Consultative Council on Obstetric and Paediatric Mortality and Morbidity found that obesity in pregnancy is increasing and women with a Body Mass Index higher than 40 carried a higher risk of their baby dying – double that of a woman of normal weight.
“Obviously some complications can arise suddenly and labour can progress quickly, so in these cases where plans can be put in place early, the women need to be close to a Neonatal Intensive Care Unit where their babies can have the best-possible support,” Ms Hicks said.
“Neonatal Intensive Care Units are located in Melbourne, Bendigo and Adelaide, so for the welfare of the mother and baby, women with a high BMI will be individually assessed and potentially referred to these specialist hospitals to have their babies.
“It can be difficult if you want to stay close to home but it’s important to listen to your maternity team's advice and plan for your baby to be born in the safest place. 
“Antenatal care will still be provided here in Mildura, and we are establishing referral pathways and shared care arrangements with specialists and hospitals to enable transfer back for postnatal care as soon as possible post the birth if everything has gone well for you and the baby.
The Victorian Patient Transport Assistance Scheme (VPTAS) is available to rural patients who have to travel for specialist care by subsidising their travel and accommodation costs. This includes travel to receive specialist antenatal care from an obstetrician.
Ms Hicks said the formal referral pathways for women requiring higher levels of care means that women and families will have access to the safest care as close to home as possible.
“Excellent maternity care is delivered by a team working together, not just one person,” Ms Hicks said.
“Recent State-wide service reviews have confirmed MBH has the skills, staff and equipment to safely deliver babies for the majority of the 900 women a year who give birth at MBH,” she said.
“For women who potentially require a higher level of care for childbirth, these formal referral pathways mean that, most importantly, they are getting access to the care, services and specialists to provide the best outcome possible for their baby,” she said.