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House of Assembly - Fifty-Second Parliament, Second Session (52-2)
2012-02-15 Daily Xml
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Answers to Questions

BIRTHING SERVICES

24 Dr McFETRIDGE (Morphett) (1 June 2010) (First Session).

1. Which GPplus Emergency Hospital will provide birthing services in the country areas?

2. Which organisation has deemed it necessary to have four doctors present to care for mother and baby in situations of high risk caesarean births and does this include the anaesthetist?

3. How many doctors are deemed necessary at normal or elective caesarean births not including the anaesthetist?

4. How many doctors are deemed necessary for a normal birth at a public hospital?

5. How many births were there at public hospitals in 2005, 2006, 2007, 2008 and 2009, respectively, and in how many cases did the anaesthetist administer an epidural for pain relief or for other reasons?

6. How many births were there in 2005, 2006, 2007 and 2008, respectively, attended by a Government midwife only and did these occur outside of hospitals?

The Hon. J.D. HILL (Kaurna—Minister for Health and Ageing, Minister for Mental Health and Substance Abuse, Minister for the Arts): I have been advised of the following:

1. At January 2012, the following country hospitals currently provide birthing services:

Barossa (Tanunda), Berri, Ceduna, Clare, Crystal Brook, Cummins, Gawler, Jamestown, Kangaroo Island, Kapunda, Loxton, Millicent, Mount Barker, Mount Gambier, Murray Bridge, Naracoorte, Peterborough, Port Augusta, Port Lincoln, Port Pirie, Quorn, Victor Harbor, Waikerie, Wallaroo and Whyalla.

2. The SA Maternal & Neonatal Clinical Network advises that a health unit providing Level 3-6 Perinatal Services (as per the Perinatal Service Delineation included in the Standards for Maternal & Neonatal Services in SA 2010) must have at least three medical officers with appropriate perinatal services credentials available 24-hours per day, seven days per week, to attend a caesarean section delivery. This includes the anaesthetist.

3. The SA Maternal & Neonatal Clinical Network advises that the workforce requirements for elective caesarean section deliveries are the same as for an emergency caesarean section delivery, meaning that a health unit providing Level 3-6 Perinatal Services (as per the Perinatal Service Delineation included in the Standards for Maternal & Neonatal Services in SA 2010) must have at least three medical officers with appropriate perinatal services credentials available 24-hours per day, seven days per week, to attend a caesarean section delivery. Excluding the anaesthetist, there must be at least two medical officers with appropriate perinatal services credentials attending an elective caesarean section

4. The SA Maternal & Neonatal Clinical Network advises that there is no professional practice guideline that dictates the necessity to have a doctor at a normal birth. Women in established labour require 1:1 care by a qualified midwife, including third stage labour.

5. Births and epidural use at SA public hospitals

2005 2006 2007 2008
Number of births 13,315 13,704 14,399 14,611
Number of women giving birth 13,097 13,490 14,194 14,384
Number of epidurals given 3,595 3,717 3,944 4,032
% of epidurals/number of women giving birth 27% 28% 28% 28%


Source: Pregnancy Outcomes Data, SA Health

6. All public hospitals require that a midwife be present at any delivery. The delivery attendees are written up in the Birth Register, which incorporates information as to whether and which doctor(s) were present at the delivery. However, this information is recorded in hard copy only and is not available for electronic reporting by the hospitals.

Some of the government-employed midwives at the Women's and Children's Hospital perform births outside of the hospital, in accordance with the 'Policy for Planned Birth at Home in South Australia', which was endorsed for implementation on 1 February 2009.

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