- In short: A Tasmanian mother has shared her traumatic birth story, saying services at the North West Private Hospital were substandard
- What's next? The Tasmanian government has brought forward plans to return maternity services in the north-west to the Tasmanian Health System
For new mother Shayla Marshall, birthing her son was a lonely and traumatising experience.
Ms Marshall birthed Carter as a public patient at Tasmania's North West Private Hospital (NWPH).
She said she waited in the assessment room for five hours.
"There was blood all over the assessment machines, like the heart-rate monitor," she said.
"It was just someone else's blood there.
"I was put in the labour ward, and there was blood all over the floor and all over the bed and on the wheels … from someone else that had obviously given birth prior."
Ms Marshall said she was pushing for an hour and a half before she was given an episiotomy to safely birth Carter, who was in a posterior foetal position.
Post birth, she said, she was quickly stitched up and transferred to the maternity ward.
"They just left me. I didn't have any care," she said.
"I didn't know how to breastfeed. My nipples were bleeding.
"I didn't know anything, and then I felt useless to my baby.
"I just felt like they kind of put me to the side because they were so short-staffed.
"I felt alone, like I didn't want to be a mum."
Ms Marshall said it was three days before a midwife showed her how to breastfeed.
Days after leaving the hospital, the mother and baby were scheduled to have an at-home appointment with a midwife.
But Ms Marshall said it was cancelled due to staff shortages, and they had to travel to the hospital instead.
"Here I am, I can hardly sit down, let alone carry a capsule, so if I didn't have my mum to take me to the hospital … I wouldn't have been able to go, and we wouldn't have been able to get checked over," she said.
Mothers across the north-west have shared stories of not enough staff on the floor at the private hospital, no continuity of care and having to drive across the state to give birth.
Hospital changes from December
Maternity services in the north-west differ from the rest of Tasmania.
The NWRH provides antenatal care, but the private hospital provides birthing services to both public and private patients.
Maternity services moved to the private hospital in 2016 because the public hospital did not have adequate facilities.
Now the government has brought forward plans to return them to the Tasmanian Health System (THS) by nearly a year.
From December, the public system will deliver all services, including inpatient, birthing clinics and midwifery services.
Premier and Health Minister Jeremy Rockliff said it would significantly improve care in the region.
"The most important thing is the continuum of care for mothers and their babies," he said.
"The continuum of care in public hands, rather than the fragmentation of maternity service in both public and private, provides a greater level of security, support, care, health and safety for our mothers and babies."
He said the transition would create job opportunities, and offered private staff the opportunity to go public with their existing entitlements.
Mr Rockliff expected it would also help attract staff.
Hospitals North West chief executive Paula Hyland said in the meantime, the hospital would work with expectant mothers, their families and GPs to help them understand the changing arrangements.
Services will remain the same until December.
More staff from interstate needed
The transition follows calls from the Australian Medical Association's (AMA) Tasmanian branch, which said the region's maternity services were no longer safe and the state government needed to take them over.
The AMA's Tasmanian vice-president, Annette Barratt, previously called the private-based maternity services "inefficient, ineffective and dangerous to mothers and children".
Today, Dr Barratt welcomed the date being brought forward.
"It means that the women in north-west Tasmania know that they're going to have a public-funded, quality service from maternity, which is what we have been asking for," she said.
Dr Barratt said the government now needed to attract staff from interstate, which meant a competitive enterprise bargaining agreement and pay parity.
She said the region needed at least three more obstetricians.
Dr Barratt said the transition would help mothers feel safe.
"It's lack of staff, not the lack of quality of the staff — the staff are doing the best they can — but we don't have sufficient numbers, and that is partly because of the uncertainty of employment with the private system," she said.
Nursing union welcomes 'positive news'
Tasmanian branch secretary of the Australian Nursing and Midwifery Federation (ANMF) Emily Shepherd said it was good news for mothers and babies.
"Ultimately, it means you have got the same service provider, the same staff working under the same systems, talking through the same systems and sharing of information right across the north-west region," she said.
Ms Shepherd said the December time frame gave enough time to establish service delivery and models of care.
She said it was encouraging that the government was trying to bring midwives over to the public system.
"That then gives us a bigger pool of midwives across a consolidated service to be able to deliver maternity services in a more coordinated way," she said.
Ms Shepherd said it would also make the NWRH a more desirable place to work for interstate nurses.
"Most public maternity services include the full breadth and depth of service delivery, not just one piece of maternity practice, so it allows that full comprehensive scope of practice to be carried out by the midwives," she said.
"I do think there still will need to be efforts in terms of recruitment and thinking about how we actually grow our own midwives here in Tasmania, particularly in the north-west."
Labor spokesperson Anita Dow welcomed the announcement but said service provision should never have reached the point of being deemed unsafe.
"The premier must now ensure there is focus on workforce culture and retention, offering career pathways for midwifery services so that mothers can receive the care they deserve," she said.
But the announcement is cold comfort to Ms Marshall.
"I think they were very understaffed, and that's the reason I didn't get the care that I should have," she said.
"There's just not enough staff … I don't think it's going to make a difference."
The North West Private Hospital has been contacted for comment.
