Primary Maternity Units in rural and remote Australia: Results of a national survey.

Kruske, S; Kildea, S; Jenkinson, B; Pilcher, J; Robin, S; Rolfe, M; Kornelsen, J; Barclay, L

Primary Maternity Units in rural and remote Australia: Results of a national survey.

Kruske, S

Kildea, S Jenkinson, B Pilcher, J Robin, S Rolfe, M Kornelsen, J Barclay, L

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Publisher:: ELSEVIER SCI LTD
Publication Type:: Journal Article
Citation:: Midwifery, 2016, 40, pp. 1-9
Issue Date:: 2016-09

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Field	Value	Language
dc.contributor.author	Kruske, S https://orcid.org/0000-0002-2317-3954
dc.contributor.author	Kildea, S
dc.contributor.author	Jenkinson, B
dc.contributor.author	Pilcher, J
dc.contributor.author	Robin, S
dc.contributor.author	Rolfe, M
dc.contributor.author	Kornelsen, J
dc.contributor.author	Barclay, L https://orcid.org/0000-0002-9345-3468
dc.date.accessioned	2022-08-15T01:48:16Z
dc.date.available	2016-05-07
dc.date.available	2022-08-15T01:48:16Z
dc.date.issued	2016-09
dc.identifier.citation	Midwifery, 2016, 40, pp. 1-9
dc.identifier.issn	0266-6138
dc.identifier.issn	1532-3099
dc.identifier.uri	http://hdl.handle.net/10453/160170
dc.description.abstract	BACKGROUND: Primary Maternity Units (PMUs) offer less expensive and potentially more sustainable maternity care, with comparable or better perinatal outcomes for normal pregnancy and birth than higherlevel units. However, little is known about how these maternity services operate in rural and remote Australia, in regards to location, models of care, service structure, support mechanisms or sustainability. This study aimed to confirm and describe how they operate. DESIGN: a descriptive, cross-sectional study was undertaken, utilising a 35-item survey to explore current provision of maternity care in rural and remote PMUs across Australia. Data were subjected to simple descriptive statistics and thematic analysis for free text answers. SETTING AND PARTICIPANTS: Only 17 PMUs were identified in rural and remote areas of Australia. All 17 completed the survey. RESULTS: the PMUs were, on average, 56km or 49minutes from their referral service and provided care to an average of 59 birthing women per year. Periodic closures or downgrading of services was common. Low-risk eligibility criteria were universally used, but with some variability. Medically-led care was the most widely available model of care. In most PMUs midwives worked shift work involving both nursing and midwifery duties, with minimal uptake of recent midwifery workforce innovations. Perceived enablers of, and threats to, sustainability were reported. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: a small number of PMUs operate in rural Australia, and none in remote areas. Continuing overreliance on local medical support, and under-utilisation of the midwifery workforce constrain the restoration of maternity services to rural and remote Australia.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	ELSEVIER SCI LTD
dc.relation.ispartof	Midwifery
dc.relation.isbasedon	10.1016/j.midw.2016.05.004
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1110 Nursing, 1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services
dc.subject.classification	Nursing
dc.subject.mesh	Australia
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Female
dc.subject.mesh	Health Services Accessibility
dc.subject.mesh	Humans
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	Midwifery
dc.subject.mesh	Obstetrics
dc.subject.mesh	Pregnancy
dc.subject.mesh	Rural Health Services
dc.subject.mesh	Rural Population
dc.subject.mesh	Surveys and Questionnaires
dc.subject.mesh	Humans
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Obstetrics
dc.subject.mesh	Midwifery
dc.subject.mesh	Pregnancy
dc.subject.mesh	Rural Population
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	Rural Health Services
dc.subject.mesh	Health Services Accessibility
dc.subject.mesh	Australia
dc.subject.mesh	Female
dc.subject.mesh	Surveys and Questionnaires
dc.title	Primary Maternity Units in rural and remote Australia: Results of a national survey.
dc.type	Journal Article
utslib.citation.volume	40
utslib.location.activity	Scotland
utslib.for	1110 Nursing
utslib.for	1114 Paediatrics and Reproductive Medicine
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access	*
dc.date.updated	2022-08-15T01:48:15Z
pubs.publication-status	Published
pubs.volume	40

Abstract:

BACKGROUND: Primary Maternity Units (PMUs) offer less expensive and potentially more sustainable maternity care, with comparable or better perinatal outcomes for normal pregnancy and birth than higherlevel units. However, little is known about how these maternity services operate in rural and remote Australia, in regards to location, models of care, service structure, support mechanisms or sustainability. This study aimed to confirm and describe how they operate. DESIGN: a descriptive, cross-sectional study was undertaken, utilising a 35-item survey to explore current provision of maternity care in rural and remote PMUs across Australia. Data were subjected to simple descriptive statistics and thematic analysis for free text answers. SETTING AND PARTICIPANTS: Only 17 PMUs were identified in rural and remote areas of Australia. All 17 completed the survey. RESULTS: the PMUs were, on average, 56km or 49minutes from their referral service and provided care to an average of 59 birthing women per year. Periodic closures or downgrading of services was common. Low-risk eligibility criteria were universally used, but with some variability. Medically-led care was the most widely available model of care. In most PMUs midwives worked shift work involving both nursing and midwifery duties, with minimal uptake of recent midwifery workforce innovations. Perceived enablers of, and threats to, sustainability were reported. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: a small number of PMUs operate in rural Australia, and none in remote areas. Continuing overreliance on local medical support, and under-utilisation of the midwifery workforce constrain the restoration of maternity services to rural and remote Australia.

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http://hdl.handle.net/10453/160170