Temporary maternity ward for Middlemore Hospital to deal with postnatal bed demand

Counties Manukau DHB general manager Nettie Knetsch said the maternity ward's monthly capacity was at 85 to 90 per cent, with three to five days a month when overall capacity was "not sufficient". Photo / Michael Craig

Plans are underway for a new maternity ward in Auckland to help cater for the growing number of women who are leaving hospital before they are ready because of a shortage of beds.

Counties Manukau District Health Board has received signoff for a 24-bed ward at Middlemore Hospital which is hoped to be ready for new mothers from April.

General manager Nettie Knetsch said the hospital's current maternity ward was at capacity up to five times a month and more beds were needed, particularly for mothers who had complex births or babies with extra needs.

Knetsch said there were six areas of concern that required extra postnatal care including breastfeeding difficulty, postoperative recovery, ongoing medical problems, psychological problems, babies with special needs and geographical isolation.

Although a lot of those women were staying three days or longer after birth, not all were, Knetsch said.

"Some of these women really should have stayed in hospital longer but bed capacity has been insufficient," Knetsch told the Herald.

Under Ministry of Health guidelines, all women had the right to 48 hours' hospital care after giving birth.

Knetsch said the current maternity ward's monthly average capacity was 85 to 90 per cent.

"However, we usually have three to five days each month when the overall capacity on those days is not sufficient," Knetsch said.

"Women have longer wait times to go from birthing and assessment up to a postnatal bed or delays in transfer to one of our primary birthing units for their postnatal stay," Knetsch said.

New Zealand College of Midwives chief executive Alison Eddy said bed availability at maternity wards was a nationwide problem.

"I don't know enough about this proposed ward but I know finding bed space is a constant struggle and certainly having that extra support would help provide better support," Eddy said.

The new ward will be housed in an existing part of the hospital known as Ward 21 until a new Women's Health building is completed in about five years. It will operate in addition to the 45-bed existing maternity ward.

The new ward would primarily be used for antenatal care while the existing ward would become primarily focused on postnatal care with dedicated transitional care
capacity for babies and their mothers and high-risk cases.

Knetsch said part of the growing demand for beds came from a increasing rate of complex births, which meant mothers couldn't deliver at any of the three primary birthing units in Counties Manukau. Those units don't have surgeons or operating theatres.

At a meeting last week, a board member said those rates were "extraordinarily high" and it was a piece of work the DHB would like to take to the Ministry of Health.

Caesarean-sections are also fall into the complex birth category. About 30 per cent of women giving birth at Middlemore Hospital are getting a C-section - 245 more from 2014 to June last year.

Overall births in theatre were up 18 per cent over this time period.

More babies were being born premature, induction of labour was increasing and epidurals were a lot more common, Knetsch said.