HOSPITAL patients overflowing from emergency departments are clogging up beds in maternity wards, while pregnant women are being transferred to distant hospitals to deliver their babies because of a lack of resources.
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Maternity units at NSW hospitals were so overstretched in the run-up to Christmas that seven women were transferred from Sydney to Newcastle on a single day.
Some neonatologists say the high number of transfers is symptomatic of a system that has no ‘‘surge capacity’’, and also means women are being hurried out of hospital before they are ready to make room for new arrivals.
Mothers who deliver their babies at Liverpool Hospital are sometimes forced to wait for beds in the maternity unit to be vacated by patients overflowing from the emergency department, they say.
‘‘They don’t actually quarantine beds for the mothers,’’ a doctor said.
Thirty-one pregnant women were transferred to Newcastle’s John Hunter Hospital in December, prompting concerns about the state’s ability to cope with the rising number of premature deliveries.
Most transfers happen when a woman has a complication or prematurity risk that cannot be adequately handled at her local hospital. There are an estimated 1350 transfers in NSW every year.
It is safer to transfer premature babies to hospitals with neonatal intensive-care units in utero than to wait until they are born.
Pregnancy and Newborn Services Network adviser Daniel Challis said a hotline, set up in 2013 for clinicians to get high-level advice and ensure all transfers were strictly necessary, took 320 calls in the first 12 months.
‘‘On occasion the capacity of individual intensive care or high-dependency units can be reached, which may necessitate the transfer of women or babies out of their local network or further from home than is ideal,’’ Dr Challis said.
John Hunter is the main obstetric unit in northern NSW for women who have complications with their pregnancy and whose babies may need a neonatal intensive-care unit.
It delivers about 4000 babies a year and 25 women are transferred there each month on average.
Newcastle doctors have requested the government build nearby accommodation for women with high-risk pregnancies.
The high demand for neonatal beds has caused tensions among medical specialties. Obstetricians would like to prioritise beds for women with high-risk pregnancies who are about to deliver, but neonatologists are reluctant to move out premature babies who have been long-term residents at the hospital.
The general rule is last in, first out. But John Hunter obstetrics director Henry Murray said this was unsafe: ‘‘We believe when a baby is stable we should be able to send it to a lower-level neonatal unit to allow the higher-risk ones to remain in the hospital.’’
Maternity beds could also be freed up by creating a better system for midwives to look after babies at home and by lowering the caesarean rate, Dr Murray said.
The NSW government funded three additional neonatal intensive care cots in July 2014 and plans to add 11 intensive care cots to John Hunter by 2017.
Labor MP Andrew McDonald, a paediatrician, said neonatal cots were an ongoing problem.
‘‘They run them at bare necessity, which gives them no surge capacity,’’ Dr McDonald said. ‘‘I don’t think there would be any neonatal paediatrician in NSW who didn’t want more beds.’’
Health Minister Jillian Skinner said the overwhelming majority of women delivered in the hospital of their choice: ‘‘In a limited number of cases, women transfer to another hospital to ensure both the mother and baby receive the best possible care in the most appropriate setting.’’