KEY POINTS:
The shortages of midwives and maternity beds may increase the risk of mothers being sent home too early after giving birth, the Nurses Organisation says.
"The whole maternity service is under pressure," the group's professional services manager, Susanne Trim, said yesterday. "Both with the increasing birth rate, the midwifery shortage and the relatively static number of beds."
Miss Trim was speaking after the list of Wellington Hospital's woes grew with the release of information about 23 medical mishaps in the past two years that had led to death or serious harm to patients. That came after:
* Nurses Organisation members in the hospital's emergency department said in a letter to management that patient safety was being compromised daily.
* The death last Friday of a baby the day after her mother went home from hospital less than six hours after the birth. It was the woman's first birth and followed a 30-hour induced labour.
The circumstances around the early discharge are disputed. The cause of death had not been stated yesterday and the Wellington coroner was yet to decide whether to hold an inquest.
The hospital says it was the decision of the woman's independent midwife for her to go home, but the baby's parents said they were unaware they could have stayed longer if they had wanted.
But the midwife said the couple knew they could stay longer and she would not have discharged the family if she thought the woman was not well enough to leave.
The newborn's death has highlighted the Capital & Coast District Health Board policy of encouraging women to go home straight from the delivery suite if they and their baby are well - but not if there were complications or it was a first birth.
The scheme was about to be sweetened with a $100 supermarket voucher, but the hospital ditched that idea after critics called it a bribe and Health Minister David Cunliffe said it was not Government policy.
Maternity and parent groups have condemned the nationwide practice of sending most women home after a post-natal hospital stay of around 48 hours, caesarean patients are allowed longer.
"I think truncated stays in maternity care is buying trouble in terms of breast-feeding, bonding and attachment, and simply recovery from what for most women is a very demanding, not to mention painful, process," said Parenting Council chairwoman Lesley Max.
"If help with breast-feeding is not available at the time that milk is coming in, which is on the third day, that can't be a good thing."
While there was no direct evidence linking early hospital discharge and a "troubled, traumatic start", to child abuse, "it's an assumption one could make".
But midwifery experts say there is no evidence that going home early causes problems for mother or baby, as long as they are well and have supportive family or friends at home.
"What evidence there is does support early discharge as being advantageous for most women," said College of Midwives chief executive Karen Guilliland.
Around a fifth of women who gave birth in hospital went home early. The problem was that with too few maternity beds and the shortage of midwives, women were "rushed and pushed and feel harassed" and some went home early who should not.
- NZPA
