Maternity crisis: mums and midwives call out for help

Thousands of Victorians have signed a petition pleading for the state government to invest more in maternity care.

Melbourne Greens MP Ellen Sandell said hundreds of women had reached out to her with stories of poor maternity care. She is now calling for the State Government to invest more into fixing the system.

“Women are being failed by an underfunded system at its breaking point,” Ms Sandell said.

The hospitals and midwives are doing their absolute best, but there simply aren’t enough resources for maternity care in Melbourne right now.

“I can’t help but think, if it was men who gave birth, would maternity care be given more money and attention?”

Melbourne midwife Bridie Ryan knows all too well the pressure of the job. Image supplied.

Ms Sandell’s petition, which was tabled in Parliament last week, has 3099 signatures from mothers and midwives who are all calling for additional investment in maternity services. 

Victorian midwife Bridie Ryan knows all too well the pressures felt by hospitals, nurses and midwives, as well as expectant parents.

Ms Ryan said a Covid-19 baby boom had heightened these pressures, and with Victoria experiencing a midwife shortage, the cracks in the maternity sector were widening.

“Everywhere is overbooked and understaffed … that pressure has been felt on every level,” Ms Ryan said.

“The frustration has come from parents and midwives because the parents feel neglected, and as midwives, we feel pressure when we’re already pushed.”

We want to spend time with mothers, have more one-on-one care, but there’s no time for that.

Ms Ryan said hospitals were pressuring midwives to get new mothers home straight away because they can’t cope with the demand. This strategy isn’t ideal.

“I guess it’s a disheartening feeling, knowing that I’m in a system and a hospital that’s so under the pump, understaffed and not supported,” Ms Ryan said.

“This is flowing down to us in group practice … there’s a lot of pressure that if the women don’t go home, the hospital won’t have beds for others.”

With over 270 Victorian midwifery job listings on Seek.com, Ms Ryan said midwifery needed to be made more desirable.

“It’s not an overly well-paid job, for the hours and unpaid overtime that we do. It’s a very physical and emotionally demanding job,” she said.

“We don’t have a lot of funding or recognition from Medicare.”

Jen Hocking warns about the retention rate for midwives. Image supplied.

The state Budget has dedicated millions toward providing more graduate placements for midwifery students, however, this hasn’t addressed the concerns put forward by those still working in the sector.

The Australian College of Midwives Victorian chair Jen Hocking, who is also a midwifery academic at the Australian Catholic University, said there hadn’t been a difference in course enrolment, but retention in the profession had decreased.

“The course I teach at ACU has a huge demand. We have about 1500 applications but only take 70 to 100 students in first year,” Ms Hocking said.

“So, there is no problem with attracting people to midwifery. What we do know from our research is that retention in the profession is decreasing, so that means a lot of people leave after five years.”

An industry under pressure: midwife retention is decreasing due to dissatisfaction with the standards of care. Picture by Christian Bowen on Unsplash

Ms Hocking said a major factor affecting retention rates was the dissatisfaction midwives felt about the standards of care they were delivering to their patients.

“There’s a shortage of staff, so hospitals are busy, meaning it’s difficult for midwives to maintain the standards of care they wish to deliver as a professional,” she said.

“Being satisfied about what they’re offering is what keeps people doing their jobs.

“People don’t go into midwifery for the money. It’s a job for life, and it’s really about having capacity to offer the care that you want to offer, and that’s the first concern for midwives.

“There is a great deal of evidence to say we should be offering more continuity of care to women and have more midwife-led programs in our health services.”

The continuity of care model leads to fewer complications and better outcomes for mother and babies, but the current system means many are missing out. Picture by Polina Tankilevitch from Pexels

The continuity of care model means mothers have the same midwife throughout the birthing experience, building a relationship with a carer (midwife) and enabling the mother to develop confidence.

Midwifery students are taught the values and practises of the continuity model however, once they enter the workforce those teachings become irrelevant, leading to job dissatisfaction and parents who feel neglected.

Ms Hocking said the continuity of care model leads to fewer interventions, fewer infections and better outcomes for mothers and their babies.

While most health services in metro Melbourne offered the continuity of care model, the demand for these services was not meeting the need, she said.

“Everyday women miss out on being able to get that model of care and instead need to partake in the mainstream hospital of care, which is midwifery based, but there is no continuity of care,” Ms Hocking said.

Institutions are large inflexible animals so when we introduce new care models, there’s a lot of changes that have to occur, and institutions don’t cope with that.

“Hospitals are built on industrial models, and they are designed to bring a lot of women through and to provide safe care to them throughout their pregnancy and birth.”

As a midwife, Ms Ryan said she had experienced the inability to deliver the gold standard of care because of the policies and management of institutions.

“It does come down to funding because we can’t keep up with the demand of what’s happening when we’re confined to certain restrictions within a hospital setting,” Ms Ryan said.