November 11, 2003

The Royal Hospital for Women, Randwick

These last two days have been spent facilitating a workshop for midwives from the South Eastern Sydney Area Health Service in Sydney. There are three maternity hospitals in this region: The Royal Hospital for Women at Randwick; St George Hospital at Kogarah; and The Sutherland Hospital in Caringbah.

This program was the first of three that I have been asked to present - one at each campus. This Area Health Service is arguably the most progressive in NSW and they are actively pursuing a number of major midwifery initiatives, including making homebirths an option for women choosing to give birth with midwives employed by the hospitals. This will be a first for NSW and many on the group I worked with today are eagerly awaiting the start of this exciting program.

This workshop was at Randwick, and next month I will be at Sutherland Hospital. I was disappointed that so few of the Royal’s midwives chose to attend - I wonder why they chose not to come? In this hospital rotation through the whole maternity unit is not compulsory and there are some midwives who have worked in one area (post natal or “delivery suite”) for many years. I believe that this is a poor policy for a number of reasons: it encourages stagnation and entrenched attitudes and practices; it de-skills midwives at a time when flexibility in the workforce is of paramount importance and it may breed an arrogance that is dangerous - “we are experts at what we do and don’t need to update/revise/review”.

A midwife who is only competent in one area of her practice is a liability to an organisation and runs a severe risk of being supplanted by a person with better skills and is cheaper to employ. For example, a midwife who just works in post natal wards could be replaced by a lactation consultant and an enrolled nurse (or other less expensive personnel). However, if she has skills in labour ward, the prenatal clinic, early discharge program, birth centre and team midwifery she is an asset that is very valuable in these days when the need to staff all areas is essential.

I have also heard that some of the obstetricians that work at the Royal are difficult, wanting control over what is said in prenatal classes, the number of epidurals they can order and insisting on dictating some aspects of the midwives work practices. Perhaps this is the reason that midwives are unwilling/unable to remind themselves of what normal birth is all about?

Posted by andrea at November 11, 2003 06:01 PM

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Hi Andrea,

Could you please recommend a midwife/obstetrician in Southern Sydney. I hope to give birth at St George Hospital mid next year.

Thank you.

Posted by: Anelise on November 12, 2003 10:56 AM

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Hi Andrea, i'm expecting our 5th baby around sept. i have had 3 chn at Sutherland hospital and 1 at Sydney South West Private.i have had P.E with all my pregnancies,on meds at 30 weeks with the last 2 and inductions for all 4.my last baby was delivered at 35wks.i'm just hoping you can recommend an obstetrician that specialises in P.I.H.Thinking of having the baby at Royal Hospital For Women.tnanks,melissa

Posted by: melissa on January 9, 2004 12:18 PM

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Posted by: blackjack on January 19, 2004 10:31 AM

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I plan to have a baby next year and currently am a bit puzzled as to my options: public versus private hospital; insurance versus no insurance. It seems that the consequence of getting a policy that includes obstetrics, is being about $5000 out of pocket for obstetrician fees which the policy does not cover. I would like to get more information on what it means to go public at say Royal Hospital for Women in Randwick, but not being pregnant yet, I am not in contact with the system. How bad are the queues at outpatients? Are the stats better for those babies who are delivered by a selected obstetrician in a private ward? Can you have an elective caeserian as a public patient? What would be the best way to get some of these questions answered? Any help much appreciated.

Posted by: maggie on April 2, 2004 01:36 PM

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I am having a baby at the end of January and have tried to get into pre-natal classes but am having trouble getting into any. I am hoping that you can point me in the right direction.
Many thanks
Fiona

Posted by: Fiona on September 25, 2004 03:08 PM