THE state’s busiest maternity hospital is on track to deliver 5500 babies this year, despite being built for only 4000, raising fears for patient safety.
During one 24-hour period last week, staff at Royal Prince Alfred Women and Babies in Camperdown delivered 25 babies in a unit designed for 14 a day.
Women in labour are regularly transferred to other hospitals and those who live outside the geographical area serviced by RPA Hospital are told to go elsewhere.
RPA Women and Babies director Dr Andrew Child said the unit had reached critical mass. He said October was the busiest month the unit had experienced since opening its doors in 2002.
Dr Child said it was being forced to put up the "house full" sign, with at least two patients a month transferred to other hospitals – usually Canterbury Hospital, about seven kilometres away. The Sun-Herald was told three patients were diverted to Canterbury during the past fortnight.
At other times, women who booked into the labour ward had been moved to the birth centre for low-risk deliveries. Staff say some women have refused to be transferred.
"Canterbury Hospital is a very good hospital and it’s geared to do childbirths," Dr Child said. "I wouldn’t say the patients are happy about it [being transferred] but they understand it’s better to go to a hospital where they will get the right attention than to be in a situation where they will be among five patients being seen to by one midwife."
One midwife raised concerns about patient safety given the large number of women going through the unit.
A woman who recently underwent a caesarean delivery at RPA Women and Babies said she felt pressured to leave early so her bed could be made available to another woman.
But Dr Child said the hospital would cap patient numbers before safety was compromised.
"We are considering capping our numbers," he said. "Obviously, we have to think about safety and I think the point we are at now is critical. We’ve already introduced a geographical limit with our bookings. If you live outside those particular postcodes, we’ll have to say no.
"Some days we’ll deliver 24 babies. Other days it’s only six. When we have more than 20 babies in a day, it really does put the heat on," he said.
Pat Brodie, professor of midwifery practice and development at the University of Technology, Sydney, said the demand at RPA Women and Babies highlighted the need for more federal funding for university places and clinical education programs.
The hospital should also look at more innovative models of care and more efficient and flexible ways of rostering midwives to work.
"Even in times of extreme activity there, the midwives can be very creative in finding ways to ensure safe care," she said. "But when you add another few emergency caesars to a dozen births already in train, they simply can’t be in two places at once."
Staff said stretched resources had also caused some mothers in recovery after a caesarean delivery to be separated from their child, thereby delaying the first breastfeed.
Australian Breastfeeding Association president Margaret Grove said: "Ideally, it shouldn’t be happening and every effort should be made to make sure it doesn’t. Even just from a bonding perspective – we’re talking about that first little while when mum and baby are getting to know one another."
Dr Child said the problem had arisen because the baby boom wasn’t forecast when the decision was made to close the old King George V Hospital and replace it with RPA Women and Babies.
"When KGV closed, we were delivering about 3600 babies a year," Dr Child said. "In the past six years, we have gone from 3600 a year to 5500 a year. You have to remember, going back to 10 years ago when the new maternity hospital was being planned, all the indicators suggested that the birth rate was going down.
"Since then, a number of factors – the baby bonus, economic prosperity – have resulted in this unforeseen increase in the birth rate. That said, the increase in the number of births at RPA is much higher than the average."