Every year, more than 3000 pregnant women on the Central Coast, seeking publicly funded healthcare, have only one option of where they can give birth. Central Coast Local Health District (CCLHD) maternity services themed complaints have not historically related to birthplace, however following the closure of the midwife-only led Wyong stand-alone birth centre, complaints rose by 400% from 2020-2021. Some of these complaints were taken directly to local members of parliament, requiring CCLHD to respond to women's dissatisfaction.
This project aims to meet the needs of more women living on the Central Coast, by providing alternative publicly funded birthplace options. This means moving from the current single option to at least two options for well women, by December 2023.
Initiation began with the primary goal of designing a women’s centre for the Wyong hospital site. This scope changed following advice from the district’s chief executive, encouraging us to look instead at alternative models of care for birthing women. Solutions were designed based on the diagnostics gathered, consultation and brainstorming with stakeholders both within and external to the health service, in addition to a literature review. Solutions identified and priority voted, were for a publicly funded homebirth model, a Wyong Hospital obstetric led birth unit, and/or a stand-alone birth house. For the purpose and scope of this project, home birth was the agreed solution. Implementation of the new model of care; homebirth, is underway, considering a CCLHD risk forecast and implementation history assessment results.
A project plan has been developed, with endorsement currently currently being finalised with the CCLHD executive team. Equipment has been provided and midwives have been attending education and simulation training. Midwives have been supported to attend homebirths with the neighbouring service at Belmont Birthing Services within Hunter New England Local Health District.
A full evaluation will be undertaken, both post pilot and again at a milestone of 12 months, measuring the following outcomes:
- uptake by well women of the alternative birthplace option
- satisfaction of women utilising the alternative birthplace option as measured by CCLHD midwife consumer experience survey
- a 50% reduction in the number of complaints per year relating to birthplace, utilising consumer feedback data between March 2020-March 2022, compared from June 2023 - June 2024
- adverse events as reported through monthly maternity services safety and quality meetings and perinatal morbidity and mortality meetings
- a lower fiscal and environmental impact based on reduced costs and waste from women receiving their antenatal, birth and postnatal care in the community compared to the women of the same risk who birth in the current birth option.
View this project's poster from the Centre for Healthcare Redesign graduation April 2023.
