Health Care: Maternity Services — Speech in the Federation Chamber 24/06/2024

Hansard 24/06/2024  House of Representatives

Mr LLEW O’BRIEN (Wide Bay) (18:32): I move:

That this House:

(1) notes that the reduction in the provision of maternity services in rural Australia:

(a) has increased significantly since the 1990s due to closure of rural maternity services and centralisation of services to metropolitan areas;

(b) greatly increases the chances of a woman having her baby outside of appropriate maternity services;

(c) increases the risk of complications for both mother and baby; and

(d) places increased financial and time costs on the woman and family; and

(2) calls on the Government to:

(a) remove the structural barriers and address any outstanding funding recommendations to primary maternity care as outlined in the Medicare Benefits Schedule’s report of Participating Midwives Reference Group, and the Senate Community Affairs References Committee’s inquiry into the universal access to reproductive healthcare, both of which included recommendations for supporting rural maternity services; and

(b) ensure funding agreements with the states and territories enforce the provision of adequate rural maternity services through the Rural Birthing Index, and provide direction for the types of state-based maternity services that should be operating in rural communities.

Welcoming a baby into the world should be a joyous time for parents, but, if you’re one of the seven million Australians living in rural and regional areas, chances are you’re a long way from maternity services and have every chance of giving birth in the gravel on the side of the road.

Since the early 1990s, the number of babies born before arrival has increased by 50 per cent nationally and doubled in Queensland, alarmingly. Over half of rural maternity services, or more than 130—including in Maryborough in Wide Bay—have closed during the same period. These closures disproportionately impact smaller services, putting much longer distances between maternity services. Despite the ‘bigger means better’ safety mantra, smaller, much-needed rural maternity services where they are available have been proven to be as safe as large facilities in metropolitan areas. There is little evidence that maternity service closures are entirely a result of these workforce shortages, but once they close it’s rare and more difficult for them to reopen.

The closure of rural maternity units puts greater financial burden and psychological stress onto families. These families are hit by higher travel and accommodation costs. They are forced to leave their local support systems and their employment, and their other children are forced to leave school at a critical time. According to the Australian Institute of Health and Welfare, rural babies are more likely to be born prematurely, facing lifelong health challenges. But the most tragic consequence is the one we can’t ignore: more rural and remote mothers and babies don’t come home at all.

Our nation’s rural families are the lifeblood of our country and our economy. However, despite contributing so much to our economy, for them there’s little in return in the way of health care and maternity services. A recent report by Nous Group’s health and ageing practice found that there was a $6.55 billion shortfall in healthcare funding between rural and urban Australians. Disappearing local maternity care exacerbates the rural-urban health gap. Rural Australians begin experiencing health disadvantage before they’re even born. Despite shrinking levels of maternity services, endorsed midwife numbers have increased across rural and regional Australia, and they continue to fill in gaps for rural families by providing much-needed antenatal, birth and postpartum care, often travelling long distances to deliver these services.

But there are outstanding structural barriers that must be urgently addressed by government to help more rural families. The federal government provides significant funding to all our states and territories for hospital services, including maternity services. This funding needs to go to rural towns to ensure we have the services that these families rightly deserve. The Australian rural birthing index is a tool created to ensure adequate services are available to expectant mothers in these regions. It’s up to the Albanese Labor government to hold state and territory governments to account by tying funding to the rural birthing index to improve outcomes in regional areas and to not let their Labor mates in Queensland off the hook as they slash rural maternity services.