Abstract
ObjectiveTo describe characteristics and outcomes of women birthing within GP‐obstetrician (rural generalist) supported rural (level 3) obstetric units in Queensland.DesignRetrospective descriptive study.Setting21 GP‐obstetrician supported birthing units in Queensland.ParticipantsWomen (n = 3111) birthing from January 2017 to December 2017.Main outcome measuresPatient, pregnancy and labour characteristics and key maternal and neonatal outcomes routinely recorded in the Queensland Perinatal Data Collection and Queensland Hospital Admitted Patient Data Collection were compared to Queensland public hospital aggregate data.ResultsWomen birthing in rural maternity units were significantly more likely to be Aboriginal or Torrs Strait Islander (16% v 9%), < 20 years old (7% v 4%), term deliveries (96% v 91%), achieve spontaneous onset of labour (67% v 51%), and birth (71% v 60%) (p<0.001) compared with all Queensland public hospitals. They were significantly less likely to be nulliparous (36% v 40%), use pharmacological analgesia (65% v 69%), or have continuous electronic fetal monitoring in labour (54% v 66%) (p<0.001). Neonatal outcomes were comparable; with no significant difference in stillbirth rate between rural units and all Queensland public hospitals (4.8 v 7.3 per 1000 births). Precipitate delivery was the most common labour complication (36% v 33%) (p<0.001).ConclusionGP‐obstetrician (rural generalist) supported rural birthing units in Queensland provide important access for low and medium risk women to deliver locally, with strong indicators of quality and safety.
Highlights
Thirty per cent of Queensland's population is dispersed throughout rural and remote areas and deserve safe and highquality birthing services as close to home as possible.[1]
This paper identifies patient characteristics and key birthing outcomes of GP-obstetrician level 3 maternity units by service volume (
The majority of mothers delivering in rural units had low-risk characteristics, some characteristics known to be associated with increased pregnancy risk were higher than for Queensland public hospital averages
Summary
Thirty per cent of Queensland's population is dispersed throughout rural and remote areas and deserve safe and highquality birthing services as close to home as possible.[1] The tendency towards centralising health services in many developed nations, including Australia, has resulted in rural and remote maternity unit closures. In Queensland, from 1992 to 2011 there was a net reduction of 36 maternity units (28%), effectively increasing the distance to birthing units for rural [Correction added on 17 January 2020, after first online publication: Funding information has been corrected.]. Families.[2] Closures were linked to issues of rurality, medical and midwifery workforce shortages, safety and quality concerns, perceived higher costs[2] and disconnected localised planning and reactionary decision-making.[3] This trend has been met with local community protest and concern.[4]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
