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Novel midwifery program supports private patients

The Mater Hospital midwife Cristina Silva with a p
Photo: The Mater Hospital midwife Cristina Silva with a pregnant woman
A pioneering midwifery-led program is supporting pregnant women’s emotional wellbeing in private sector maternity services.

Sydney’s The Mater Hospital Pre-admission Midwife Appointment Program provides women in the third trimester of their pregnancies with a free 45-minute appointment, with a specially trained midwife, to discuss pregnancy, birth and early parenting.

The initiative focuses on women’s emotional wellbeing - screening for depression, anxiety and associated risk factors as well as domestic violence screening.

It also promotes self-awareness of emotional wellbeing, along with validation and assistance for any concerns or social stresses in the women’s lives.

Statistics show perinatal depression affects up to one in 10 women during pregnancy, and almost one in seven women in the first year after birth.
While most public hospital maternity units provide psychosocial assessment and depression screening as part of routine antenatal care across Australia, implementation in the private sector has lagged behind.

The Mater is one of the few private hospitals in the nation to provide this type of self-funded service, which offers access to all women scheduled to give birth at the hospital.

The initiative enables the program’s team of 10 midwives to provide holistic multidisciplinary care to patients, providing support from the pregnancy to the birth of the baby and into the postnatal period.

The program, which began in October, has been such a success, it recently won a $10,000 national Team Excellence Award at the 11th HESTA Australian Nursing and Midwifery Awards.

Antenatal midwife coordinator Sarah Tooke, a registered nurse and midwife, says it’s imperative private patients have the same opportunity as public patients - to access a midwife.

“In the private system, patients don’t necessarily see a midwife until after they have their baby, unless they are lucky enough to have an obstetrician who has a midwife in the rooms,” she says.

“We sort of went…our patients shouldn’t be paying and missing out on a service that public patients are getting.”

The hospital partnered with The Gidget Foundation, a not-for-profit organisation that promotes emotional wellbeing for expectant and new parents. It tapped into the results of the foundation’s pilot study, which found clinically significant antenatal depressive symptoms in a sample of women accessing private obstetric care - highlighting the importance of antenatal depression screening for all women.

The hospital, a facility of St Vincent’s Health Australia (SVHA), worked with the foundation, particularly chairman and obstetrician Dr Vijay Roach, board member Catherine Knox, psychiatrist Professor Bryanne Barnett and CEO Arabella Gibson, to develop and implement the initiative.

Midwives involved in the program completed workplace training on domestic violence screening, with the program utilising SVHA’s own screening tool for family and domestic violence, while midwives also attended two training days with Professor Barnett.

In addition, a summary and referral system was developed to ensure the right support for at-risk women, with referrals to a range of pathways including obstetric social worker and midwife Deb De Wilde, the Gidget Foundation, a lactation team, discharge planning team, and the patients’ own psychological services.

“We made the program a little bit more holistic so that it has a big focus on emotional wellbeing screening - looking at those risk factors for anxiety and depression but also screening for domestic violence,” Ms Tooke says.

“Also, it just gives women the opportunity to have a chat with the midwife and ask questions, and talk about previous experiences if they had a traumatic time with feeding or a bad birth experience - just validating that.”

While the program is still in its infancy, Ms Tooke says participation has increased from an average of 35 per cent of patients to between 50 and 75 per cent of patients.

“We hope to get that up a little bit higher but the biggest focus so far has just been on successful implementation,” she says.

“What we’re really going to look at this year is doing some formal research so we can make sure we are giving the women what they want and continuing to improve what we’re offering.”

Ms Tooke says prize-money from the HESTA Award will go towards funding the qualitative research, as well as ongoing education in perinatal mental health for midwives, training for more midwives to join the team, and a postnatal follow-up appointment for patients identified with key risk factors.

The prize-money will also fund an interpreter to help meet the needs of the hospital’s high proportion of Chinese patients.

Ms Tooke, who also runs a private childbirth and parenting education business, says while feedback from women participating in the program has been overwhelmingly positive, midwives are also reaping the rewards of the service.

“I just love being able to talk to the women and actually having time to talk to them, and just developing that relationship and that trust,” she says.

“I suppose being off the ward, you just get away from that crazy, busy stuff, and you actually feel like a real midwife.

“Even though you’re not there delivering babies, you feel like you’re doing your job properly because you have the time to actually sit back and be with a woman and validate experiences and just listen.

“I think that just by getting that support in place, it can really make this time in women’s lives much more positive.”

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Karen Keast

Karen Keast is a freelance health journalist who writes news and feature articles for HealthTimes.

Karen regularly writes for some of Australia’s leading health news websites and magazines.  In a media career spanning 20 years, Karen has worked as a senior journalist in newspapers and television. She has covered the grind of daily news and worked as a politics reporter at countless state and federal elections.

Since venturing into freelance writing five years ago, Karen has found her niche in writing about the health sector for editors, businesses and corporations.

Karen has interviewed the heads of peak health organisations in Australia and overseas, and written hundreds of news and feature articles covering the dedicated work of health professionals who tread the corridors of hospitals and health services, universities, aged care facilities and practices, day in and day out.

Follow Karen Keast on Twitter @stylemywords