MATERNITY SERVICES

Chronicle (Levin), 22 April 1947, Page 2

MATERNITY SERVICES

Rising Birthrate Brings Difficulties The grim position of maternity hospitais and services in the Palmerston i>forth Hospital Board district was placed hefore the hospital hoard yesterday in a report by the Medical Supermoendent, lvir. J. H. North. He stressed the vu-gent necessity for provision of additional beds in the board 's maternity instxtutions and referred to the difficulties of the private and public maternity hospitals in finance and staffing as mentioned in the report of the committee 'of enquiry into Maternity Hospital Staffiing which was promoigated some time ago.

Reviewing the maternity services ol: the board 's* district he stated that the temporary home at Feilding met only a portion oi' tlie.necds of tliat district. A total oi 42 iiatients from Feilding and surroundiug districts was admifted to the Palmerston .North District Maternity Home in the past twelve months i and a number to private maternity liomes in Palmerston North. In Palmerston North the position liad been very ditticult. There were a number of private maternity liomes in the city including one large home which previously liad 25 to 30. beds. This latter home liad reduced its beds to 18 in January, transf'erring up to 14 pat- . ients each month to the Districit Maternity Home. Ile understood that other! liomes were contemplating the terminafiou of wtheir leases. The District J Maternity Home had been planned as aj twelve-bed home and to meet the difficulties during 1946 additional beds had j been provided by using the ante-natal ciinic and also opening beds in the Mc--Iiardy Ward and Ward 11 of the main! hospital. Mr. North submitted the following iigures indicating the number of cases admitted during the past seven months to the District Maternity Home: Sep- j tember 1946 26, October 36, November 38, December 32, January 1947 38, Pebruary 50, March 51. Bookings already made for the following months, allowing known transfers from private maternity liomes are: April 1947 44, May 43,'june 33, July 44, August 40, Sep.tember 37, October 29, November 22. The actuai admissions were likely to be six to ten more than the bookings indicated up to the end of Septeihber, he said. Por some years the Palmerston North District Maternity Home had had a liiuitation placed on the number of bookings, 22 being the limit set for •"each month.. This allowed for some un- ' bO'oked patients and transfers from other maternity homes. Since January lt had been necessary to increase the bookings as no alternative accommodation in private hospitals was available and there had been a large number of unbooked cases from private maternity homes. The largest had sent 11 to 14 patients eacli month.- The number of confinements for February had been 50 and 51 respectively. The bookings for the next few months showed that this figure was likely to be maintained. The Health Department standard for maternity homes was 18 cases per bed por yeaic At the rate of 50 cases per month '38 beds would be required. If leases for other maternity homes were not renewed a greater number of beds would be required at the -hospital. The difficulties in mceting the requirements for maternity patients at the Palmerston North District Maternity Hospital at the present time were very considerable. In addition to the provision of beds, tlieatre facilities were entirelv iuadequate for the number of confinements occurring at the maternity home. The theatre facilities there were designed for a 12-bed home and at present there were over 25 patients, tliis mimber nccasionally reachitig abovc -30. To provide the extra beds the McHardv Ward and parts of Ward .11 liad been used for patients from the maternity liome after their confinement. Al.l confinements took place in the one labour room in the maternity hospital. This meant transf'erring patients from tlie niaternity home to the main hospital where they were nursed largely by mi rses without maternity training. The position was unsatisfactorv even as a temporary expcdient but an immediate solution of the problem was not possible. If t.he District Maternity Hoine's commitments were maintained at 50 or more cases each month, it would be necessary, as a temperory measure, to alter one of the main hospital wards, probably one of the military ones. ' The position would be watched over carefullv for the next month or tfwo and temporary alterations of this tvpe may become urgently necessary. * "lt is evident that the board must plan for permanent considerable additions to the District Maternity Home," he continued. " Practically no relief will be obtained from the proposed homes in Feilding and Levin. The board has been able to carrv on until the crisis in January last only by seyerely limiting bookings at the District Maternity Home. Large 'nnmbers of cases. have been refused admission each month, provided the sister-in-charge obtained a bed for them in anv private maternity home. Many patients who are refused bookings olrject to the navment of private maternity home fees but our problem would be impossible at nresent without limitation "in tlris way. "But, as a' policv of the foture, it is doubtful if a limitation of bookings in this way should be maintained. The Committee of Enquirv's report does not support limitation of bookings by hospital boards. Tt would appear on the present position of maternity aecommodation in the city, that the board should provide a district mntornity home of at least 80

beds. This would entail remodellin'i : completely Ihe nursery and theatre facilities, the provision of a promaturo nurserv and, in addition, more tlian i doubling the patients' aecommodation. I If there is furMier closure of maternity , homes in the citv the board will necd to provide for ahuost 50 beds. The present position is most difficult and un- ' satisfactorv and the board must realise the difficulties under which we are at present, carrying out maternity work in Palmerston North. | "I would recojnmend that the provisi ion of additional maternity accoinmoda- | tion should be planned now so that our i home ean be expanded to 30 beds and . later to 50 beds if necessary. This work : obviously cannot be proceeded with at ! once but preliminary planning should | be undertaken as soon as possible. In the meantirae the use of one of the gen ' eral wards must. be continued and it t may well be necessary in the near ; future to carrv out alterations to a , ward, ward 1 would probably be hnost ! satisfactorv to convert into a full i maternity unit. The district should be I fairly completely covered when the ' Feilding and Levin Maternity Homes j are erected and the above recommendecl additions at Palmerston North, are agreed to and completed. " I Speaking to the report the mapagi-ng , secretary, Mr. A. J. Yhillipps, stated ' that the position was far more serious i tlian the report suggested. "I ask the ! board to give uS pennission to make the j alterations to ward 1 if necessary," he said. i Following discussion of the report it ] was adopted aml the. medieal superini tendent and managing secretary given | full power to in ike alterations to the | ward if required. A copv of Mr. North 's report is to he sont to the i Health Department.