Welcome to CANA

CANA reviews plans for obstetric theatres in the new Mater Mothers Hospital, Brisbane. Report by Cas McCullough

Debby Gould and I met with Janelle Laws, the building coordinator for the new Mater Mother’s Hospital in Brisbane on Monday 5 March to discuss the set up of obstetric theatres and recovery areas for women having caesarean sections. It was a great meeting and we discussed several issues including how to meet the needs of mothers who lose a baby after a caesarean, how to make the theatres and recovery areas look less clinical, how to provide for fathers to be immediately present and stay with the newborn when the mother needs to be put under a General Anaesthetic, how to arrange the room and equipment to facilitate skin-to-skin caesareans, and how to facilitate keeping the baby within reach or view of the mother during measuring and weighing.

To make the theatres and recovery areas less clinical, Debby and I suggested that the walls be painted and themed similarly to the birth suite rooms with artwork (such as a simple stylised wall mural or watermark) painted onto a feature wall. Janelle later discussed this idea with the art team for the new hospital and management and received a positive response to this idea.

Janelle said that the hospital will aim to accommodate for grieving families (ie. Those who lose a neonate or have a stillborn baby) by allowing them to use a separate room for recovery so they are not in recovery with other mums and newborns. She suggested two possibilities: a birthsuite just at the corner of the recovery area which is fairly isolated from other rooms, and the two assessment rooms. We look forward to confirmation of this idea by MMH management.

It was also suggested that fathers might be able to view the births of their babies through the neonatal resuscitation area in the case of general anaesthetic being used. We suggested that keeping fathers within view of the baby at all times and allowing them to have skin-to-skin contact while the mother is in recovery could aid in minimising separation issues the mother may have after the birth and improve bonding.

Other concerns we raised related to staffing issues. We stressed the importance of birth suite midwives going with the women into theatre (if desired by the mother) to provide emotional support during the operation and help the mother establish breastfeeding in recovery if possible.

After our discussion Janelle took Debby and I on a tour of the new hospital and showed us where the new recovery area was going to be. This area will not be combined with general surgery recovery areas but will be a separate area just for mums and their families. Newborns will stay with the mother so long as there are no complications requiring the baby to be monitored in special care or intensive care nurseries.

It is wonderful to have the opportunity to provide input into the more technical aspects of the new MMH and we look forward to the opening next year.

Debby and Cas new Consumer Reps on the MMH Clinical Governance Stakeholder Advisory Committee. Report by Cas McCullough

On 6 March, Debby Gould and I attended their first Clinical Governance Stakeholder Advisory Committee meeting at the Mater Mothers’ Hospital in Brisbane. What is this committee for? The committee meets once a month to discuss and update policies for maternity care. This means that Debby and I get to review policies alongside the midwives and obstetricians at the MMH and ensure the consumers (ie. Women and their families) have a voice in the policy development process.

This a huge step forward by the MMH and getting consumers onto this committee and the neonatal committee (which Melissa Fox from Maternity Coalition and Juanita Simmonds from the Childbirth Education Association will attend) was a process that involved months of negotiation between Maternity Coalition, CANA, the Childbirth Education Association and the MMH.

We would like to thank the MMH for including consumers on the maternity and neonatal committees and look forward to developing a close working relationship to meet the needs of women and their families who give birth at the MMH.

We’d also like to encourage women in other parts of Australia who have an interest in improving their local maternity services to contact us about how to approach their local hospitals. We have found through our experiences with the MMH that many of the decisions about maternity care are driven by women in the community who become vocal about their needs.

Campaign against the Birth After Caesarean Research Trial

In January CANA’s parent organisation Maternity Coalition received a letter from the National Health and Medical Research Council stating that the NHMRC has investigated MC’s concerns regarding the Birth After Caesarean (BAC) Trial.

The letter gave the researchers’ responses to our concerns which were:

■  The ethics of randomly assigning healthy women with uncomplicated pregnancies to major surgery (Caesarean Section).
■  The accuracy and reliability of information being given to participants.
■  The quality of care being offered to women in the vaginal birth after caesarean (VBAC) group.
■  The conduct of recruiters and,
■  The administration of the trial at participating centres.

In MC’s letter to the Federal Minister for Health in August last year, we asked:

■  Was the feedback detailing major ethical concerns from the consumer group CARES-SA passed on to the Human Research Ethics Committee that initially approved the trial?
■  If so, why were these concerns dismissed and why were other collaborating sites apparently not made aware that concerns had been raised before giving their stamp of approval to the trial (we had received a letter stating that “no concerns were raised” from one site).
■  If not, why not?
■  Given that CARES-SA was invited to give feedback on behalf of consumers, why weren’t they kept informed about the progress of the trial and the funding of the trial?
■  Which other birth consumer groups, if any, were consulted with by the Women’s and Childrens Hospital’s HREC in relation to the ethics and consumer perspective of women this trial is targeted at?

The response we have received from the NHMRC still fails to address most of these questions. Instead MC once again received a letter justifying that the consultation process with consumers was adequate. Without allowing for or asking for our response to the researchers in this regard MC was informed that the investigation was now closed. Well, it might be for them but it certainly isn’t for the thousands of women who will be affected by this federally funded research trial.

The BAC trial is now winding up but the Government still needs to be called into account for this research and other studies like it. As consumers of birth care we need to call on the Government to establish stricter protocols and guidelines for research on healthy pregnant women and their unborn babies.

Campaign Quick links

Recent Activities