I am currently receiving quality prenatal care with the Wheatbelt Midwifery Group Practice (WMGP) in Northam. This is an excellent service for which I am very grateful. It is on a share-care arrangement with Midland St. John of God Midland Hospital (SJOG).
My issue is this: I am not considered ‘eligible’ to deliver my baby in Northam. Instead I have to travel a further hour into Midland to deliver. I am in the category of ‘Grand Multiparous’ (6 or more births), and based on this, I am considered ‘high risk’ and do not meet the inclusion criteria to birth in Northam. I don’t believe that medical research in developed countries can confirm that grand multiparity to be necessarily any higher risk than lower parity.
I live over an hour drive from Northam which makes a trip to Midland a two hour drive. In order to meet the ‘shared care’ arrangement, I must travel to Midland for booking-in, midwife and obstetrician appointments though-out the pregnancy. This is inconvenient, time consuming, expensive and particularly frustrating when I could otherwise have access to experienced care through the WMGP and be spared the extra hour travel for appointments and during labour in order to get to Midland SJOG.
I feel I am being discriminated against without sound medical reasoning. To be blanket labelled ‘high-risk’ simply on the basis of parity and thus be excluded from the right to birth in Northam without an assessment of personal health and previous obstetric history, I believe is wrong.
My understanding is that the midwives at the WMGP have guidelines to adhere to, and this is not within their authority to change.
What can I do to be risk assessed based on my past history and present health and not simply on the basis of parity in order to be considered eligible for birth in Northam with the WMGP?
Responses to this story
Response from Sean Conlan, Regional Director, WA Country Health Service - Wheatbelt last week
Thank you for sharing your story regarding the Wheatbelt Midwifery Group Practice (WMGP). I am very sorry that you feel a sense of discrimination in relation to not being able to have your baby at Northam Hospital and would like to assure you that it is not our intention to make you feel this way.
As you correctly mention, the WMGP includes the shared care of expectant mothers with metropolitan obstetric services. So that we can ensure the safety and wellbeing of both women and their babies, the WMGP has carefully developed criteria, based upon the King Edward Memorial Hospital Clinical Guidelines for Obstetrics.
We understand the complexities of being a busy mum and wanting to stay as close to home as possible. However, as you highlight in your story, women who have had more than five births are at a greater risk. This risk could relate to the possibility of postpartum haemorrhage (PPH). As the WMGP does not have 24/7 theatre support in Northam, it is considered to be much safer for you, and your baby, to birth at Midland Hospital.
We would really like to talk with you about how we can best support you prior to your delivery. Please feel free to contact Ms Marie Hill who is the WMGP Clinical Midwifery Manager. Marie can be contacted on 0437 911 095 and is very happy to meet and talk about your concerns.
Again, thank you for sharing your story with us.