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Rural maternity units: how will they have a future?

Andrew F Pesce
Med J Aust 2008; 188 (2): . || doi: 10.5694/j.1326-5377.2008.tb01524.x
Published online: 21 January 2008

After a decade of closures, a flexible approach is needed

About one in three Australian women give birth outside metropolitan areas. Historically, most of these women have been cared for by general practitioner obstetricians and midwives in local hospitals. However, in recent years it has been difficult to recruit and retain midwives and doctors with the necessary skills to adequately staff many rural maternity units providing traditional models of care. Whenever any essential component of obstetric, anaesthetic, paediatric or midwife infrastructure has become unavailable, maternity units have been closed, and women in the area are required to travel to the nearest maternity centre instead. It is estimated that more than 130 Australian rural maternity units have closed since 1995.1


  • Westmead Private Hospital, Sydney, NSW.



Competing interests:

I am currently the Chairman of the National Association of Specialist Obstetricians and Gynaecologists.

  • 1. Rural Doctors Association of Australia. Maternity services for rural Australia. Canberra: RDAA, Feb 2006.
  • 2. Scherman S, Smith J, Davidson M. The first year of a midwifery-led model of care in Far North Queensland. Med J Aust 2008; 188: 85-88. <eMJA full text>
  • 3. Queensland Health Information Centre. Perinatal statistics — Queensland 2004. Tables: hospital, birth centres and planned home births information. http://www.health.qld.gov.au/hic/peri2004/FACILITY.pdf (accessed Nov 2007).
  • 4. Hodnett ED, Downe S, Edwards N, Walsh D. Home-like versus conventional institutional settings for birth. Cochrane Database Syst Rev 2005; (1): DC000012.
  • 5. Berglund A, Lindmark G. The usefulness of initial risk assessment as a predictor of pregnancy complications and premature delivery. Acta Obstet Gynecol Scand 1999; 78: 871-876.

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