Australian primary maternity units: Past,present and future |
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| Authors: | Amy R. Monk Sally Tracy Maralyn Foureur Lesley Barclay |
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| Affiliation: | 1. The University of Sydney, Sydney Nursing School (M02), NSW 2006, Australia;2. The Royal Hospital for Women, Centre for Midwifery and Women''s Health, Level 1, Barker Street, Randwick, NSW 2031, Australia;3. The University of Technology, Faculty of Health, Centre for Midwifery, Child and Family Health, PO Box 123, Broadway, Ultimo, NSW 2007, Australia;4. The University of Sydney, The University Centre for Rural Health, PO Box 3074, Lismore, NSW 2480, Australia;1. School of Psychology, The University of Adelaide, North Terrace, Adelaide, SA 5005, Australia;2. Women''s and Children''s Hospital, 72 King William Road, North Adelaide, SA 5006, Australia;3. Flinders Medical Centre, Flinders Drive, Bedford Park, SA 5042, Australia;4. School of Medicine, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia;1. School of Nursing and Midwifery, La Trobe University, Bundoora 3086, Australia;2. Judith Lumley Centre, La Trobe University, 215 Franklin St., Melbourne 3000, Australia;3. The Royal Women’s Hospital, 20 Flemington Road, Parkville 3052, Australia;1. School of Nursing and Midwifery and Paramedicine, Curtin University, Bentley, Perth, Western Australia 6102, Australia;2. Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia 6009, Australia;3. King Edward Memorial Hospital, Subiaco, Western Australia, Australia |
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| Abstract: | Primary maternity units are commonly those run by midwives who provide care to women with low-risk pregnancies with no obstetric, anaesthetic, laboratory or paediatric support available on-site. In some other countries, primary level maternity units play an important role in offering equitable and accessible maternity care to women with low-risk pregnancies, particularly in rural and remote areas. However there are very few primary maternity units in Australia, largely due to the fact that over the past 200 years, the concept of safety has become inherently linked with the immediate on-site availability of specialist medical support.The purpose if this paper is to explore the various drivers and barriers to the sustainability of primary maternity units in Australia. It firstly looks at the historical antecedents that shaped primary level maternity services in Australia, from the time of colonisation to now. During this period the space and management of childbirth moved from home and midwifery-led settings to obstetric-led hospitals. Following on from this an analysis of recent political events shows how Australian government policy both supports and undermines the potential of primary maternity units. It is important that researchers, clinicians and policy makers understand the past in order to manage the challenges facing the development and maintenance of midwifery-led maternity services, in particular primary maternity units, in Australia today. |
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| Keywords: | Childbirth Place of birth Midwifery History Politics |
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