Women and babies could die due to midwife cuts at Sydney's RPA hospital, staff warn
Hospital staff say 20 full-time equivalent roles have been removed from across the women and babies service at Royal Prince Alfred (RPA) hospital in Camperdown, including five from the midwifery group practice (MGP), effective from Tuesday.
The New South Wales Nurses and Midwives' Association (NSWNMA) said that while no jobs will be lost, vacant positions that are currently advertised will now not be filled and fewer casual staff will be brought in.
The changes will mean fewer midwives will be rostered on to each shift in the labour ward and birth centre to assist mothers giving birth at RPA.
'So currently in the birth unit, you would have eight midwives on a day shift, 10 midwives on an afternoon and eight on the night [shift],' the NSWNMA president, O'Bray Smith, said. 'With the new changes, you will have six midwives [on each of the three shifts]. This is not safe.'
The union said nine beds in the maternity ward would also be cut, with Smith warning this would mean 'women will be pushed out faster than they already are'.
Speaking at a rally outside RPA on Tuesday, Smith said reducing the number of midwives assisting women during birth will mean that not all women will receive the one-to-one care during active labour and two-to-one care during delivery, which is considered safe practice.
'Midwives are already at breaking point,' Smith said. 'They know that women aren't getting the care they deserve in NSW. This is really going to make things a lot worse. Every single shift, a mother or a baby could die as a result of not having enough staff. This is about saving lives, having safe staffing. The midwives are absolutely terrified of what could happen here.'
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Jessica Rendell, a midwife at RPA since 2021, the staffing changes were 'a slap in the face'.
'It's just really unsafe having such limited [number of] midwives,' she said, speaking to Guardian Australia in her capacity as an NSWNMA member. 'It's such a joke that they're cutting our staffing and numbers. It's not like we're sitting around doing nothing. We are run off our feet every single day.
'If you ask any of the girls working today, have they had a break? Have they eaten? And they probably haven't … We're exhausted, honestly we've had enough. The government is making it so hard to enjoy coming back to work every day, because it's just so stressful coming into work and knowing that you might not be able to help your woman in an emergency.'
Rendell said she knew a number of midwives who were looking to leave positions in NSW Health for jobs in other states where the pay is higher and staff-to-patient ratios are better.
The NSW health minister, Ryan Park, told reporters on Tuesday: 'I want to make it clear, no one in RPA is losing their jobs.' He said midwives were being 'redeployed in other parts of maternity services' due to 'a slight reduction in birthrates at RPA'.
Park added that the state government used a model called Birthrate Plus to determine the level of staffing in birthing and maternity services, a model that he said had been endorsed by the NSWNMA.
The union previously endorsed the Birthrate Plus model, but has for a number of years called for its review and the implementation of 1:3 staff ratios.
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The NSWNMA has raised concerns about the reduction in the number of midwives who will work across the MGP program, which allows a woman to see the same midwife throughout her pregnancy, during delivery and postnatal follow-up care.
The number of midwives assigned to MGP will drop by at least five, the union said, despite a huge demand for the service and the fact that the recent NSW birth trauma inquiry recommended 'the NSW government invest in and expand midwifery continuity of care models, including midwifery group practice'.
The Aboriginal MGP, a dedicated program to assist Indigenous women to give birth in culturally safe ways and to improve outcomes for Indigenous women and their babies, will also be merged with the general MGP program.
The two dedicated Aboriginal MGP midwives say they anticipate being asked to pick up extra patients from the general service, diverting their focus from Indigenous women.
'It's been integrated. It's no longer a protected Indigenous space,' , one of the Aboriginal MGP midwives, Paige Austin, said, speaking to Guardian Australia in her capacity as a NSWNMA member. 'Those women lose us, and they lose our time and everything that we give to them extra on top of MGP.'
News of the staffing changes was shared on the mothers' group that Charlotte Wesley and Bridget Dominic are part of, and they both turned out in the rain on Tuesday to show support for the RPA midwives who had assisted them to deliver their babies – George and Roonui – just three months ago.
'The midwives showed up for us so we really want to show up for them,' Dominic said.
'I do think that these cuts could lead to deaths of mothers and babies. But further than that, we shouldn't just be aiming for alive mothers and babies; we want happy and healthy [mothers and] babies who contribute to happy healthy communities.'
RPA was contacted for comment.
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