Maternity Health Care in Australia - Term Paper Example

Maternity Health care in Australia (Insert Name) (Institution Affiliation) The Australian maternity services are of substantial high quality, low prenatal and maternal mortality and the health care outcomes compares favorably with the international standards (Leslie & Storton, 2007). The Australian maternity service plan is to centre the maternity care on women and reflect the needs of every woman within a sustainable and safe quality system. All women in Australia are expected to access to high quality, culturally competent and evidence based maternity care in a range of setting in their neighborhood. The ultimate provision of such maternity care will thus contribute to closing the wide gap between the health outcomes of Aboriginal and Torres Strait Islander people and the non-indigenous Australians (Rumbold, Bailie, Si, Dowden, Kennedy, Cox, & Connors, 2011). The provision of such maternity care would however require highly trained and qualified primary health professionals including the registered nurses, to provide maternity care to all women in Australia. Currently in Australia there is an expectation that the universal health care system provides all women equal access to maternity and midwifery services during the antenatal and postnatal periods. However, there is increasing evidence that this is not always the case. In addition, workforce issues are increasing the requirement for registered nurses to provide some maternity care in some health services in Australia (Kruske, Kildea, & Barclay, 2006). This paper compares and contrasts the findings of the current evidence that is related to the major factors impacting the women’s access to maternity and midwifery services as well as the factors that impact on the ability of women to access maternity and midwifery services in Australia. In addition the paper Identifies and explains the professional issues related to registered nurses providing maternity care in the Australian health care system. Despite the Australian maternity care being among the safest in the world, some sectors of the population especially the Aboriginal, remote and rural communities and the Torres and Strait Islander usually experience substantial social disadvantage and health inequality (Single, & Rohl, 2009). These groups have limited provision of quality and reliable maternity care which eventually leads to less favorable outcomes for mothers and babies and also that are faced with restricted birthing choices. Maternity care in Australia is currently coordinated based on the availability of health services that often prioritize the service needs over the needs of the women. Compared to the non - indigenous Australians living in the cities, the Aboriginal and Torres Strait Islander women especially who lives in the remote rural areas are being denied proper access to high quality maternal care from qualified maternal health expertise. The maternal care received by this group is also fragmented and in many occasions, it does not meet their cultural needs. There is a great need for improvement Aboriginal and Torres Strait Islander maternal health outcomes within the maternity services community which is a high priority for the Australian national Government. A culturally competent workforce which also consists of the registered nurses is recognized as a priority reform area in closing the wide gap in Indigenous life outcomes (Riggs, Davis, Gibbs, Block, Szwarc, Casey, & Waters, 2012). The development of individual and organizational cultural competence is essential to ensure all Aboriginal and Torres Strait Islander people using a health service are treated in a respectful and safe manner that secures their trust in the capacity of the service to meet their needs. The current evidence shows that the women in Australia have experiences significant decrease in the rates of mortality. The evidence further shows a decrease in prenatal deaths to around 10.3 prenatal deaths per 1000 births. When these rates are compared to those in other OECD nations, the maternal and prenatal mortality rates in Australia remains relatively low (Gordon et al, 2012). However, the Aboriginal and Torres Strait Islander women are an exception. These women continue to receive poorer maternal and prenatal outcomes which are mostly characterized by higher rates of preterm birth, prenatal deaths and a substantial proportion of babies with low birth weights compared to the non-indigenous Australians living in non-remote parts particularly in the cities. In 2012 alone, approximately 1.1% of the Torres Strait Islander and Aboriginal mothers experienced prenatal deaths (Fenwick, Butt, Downie, Monterosso, & Wood, 2006). This percentage is quite high compared to around 0.5% of non Torres Strait Islander and Non Aboriginal mothers who suffered from the same. This is primarily due to the barriers experienced by these marginalized groups in accessing quality maternity services (Barnes, & Rowe, 2007). Also, women from a linguistically and culturally diverse background are at a greater risk due to the psycho –social disadvantage. Cultural issues remain major issues that impact the access of women in Australia to maternity services. Compared to the non-indigenous Australians, pregnant indigenous or Aboriginal women often access antenatal care with less frequency and later in pregnancy than their counterparts. This has proved to be one of the greatest risk factors that have led to poor birth outcomes among the Aboriginal and Torres Strait Islander women (Leslie & Storton, 2007). Furthermore, Aboriginal and Torres Strait Islander are more likely to smoke than the non- indigenous Australians thus increasing the rate of prenatal and maternal mortality. In terms of maternal health outcomes, women residing in the rural areas have higher neonatal deaths as compared to those living in the cities whereas women residing in remote areas have higher foetal deaths rates than their urban counterparts. This can be attributed to the fact that rural and remote women have restricted access to quality maternal care which arises from the diminished availability of rural or remote maternity units, general practitioners and obstetricians as well as mid wives. While it is generally accepted that women should have access to safe maternity care, consistent with their assessed level of risk, as close as possible to where they live, the options available to women differ according to where they live Another major factor that is impacting the access to the maternal services within Australia is the shortage of maternity workforce. The provision of quality maternity care primarily depends on well distributed, highly skilled, professional and robust maternity workforce (Barnes, & Rowe, 2007). Currently, the maternity care sector is experiencing severe shortages in the workforce and the situation is expected to persist due to the ageing of the maternity professionals and the general workforce. In addition, there has been an acute shortage in general practitioners, obstetricians and anesthetists especially in the remote and rural area which has significantly impacted on the ability of rural women to access maternity services. The access to midwifery care, which is reasonably distributed on a per capita basis, is also affected by the vastness of the region and distance. Furthermore, provision of maternity health care requires suitable and well developed physical infrastructure. For the maternity programs to be successful especially in the rural areas, women must be accommodated in accessible, culturally secure and welcoming environments. Rural and remote women in Australia are currently being restricted access to high quality maternity services due to the inadequate transport systems (Fenwick, Butt, Downie, Monterosso, & Wood, 2006). A number of infrastructures are recommended in order to improve the access to medical services among the women in the rural areas. These include drop in clinics, transport systems and provision of outreach services such as the royal flying doctors. The existing Aboriginal and Torres Strait Islander health workforce is currently poorly utilized and this influences the attraction of Aboriginal and Torres Strait Islander people to work in mainstream facilities. Although the Maternity care services have a coordination that is far from ideal, the Australian mental healthcare is among the best in the world. The poor coordination that lenders it inaccessible to a number of women is due to the fact that the services are developed separately by each Territory and State, and by various independent general practitioners, private obstetricians and other non-governmental organizations (Leslie & Storton, 2007). The primary role of the Commonwealth government within the national maternity health strategy is to ensure coordination of the major issues in system and structural reforms of the maternal health care system. Also, Australia has a well-developed community midwifery service which is complemented by well-organized ambulatory services. While the Australian maternity care system delivers quality services to majority of the pregnant women in the country and has positive outcomes, the access to these services is not uniform since some groups experience poorer access and consequently poor outcomes (Barnes, & Rowe, 2007). Apart from the maternity care services, rural population experiences higher level of difficulties in accessing the other health care services. Similarly, the poorer access and outcomes for Aboriginal indigenous mothers and babies have been identified by many Australians as the most pressing national issue. Majority of people residing in rural areas experience a number of health inequalities. A variety of these inequalities are exacerbated by problems with accessing the health services. The Aboriginal and people in the rural areas demonstrate higher prevalence of chronic diseases, higher consumption of alcohol, higher smoking rates and higher rate of obesity which increases the chances of prenatal deaths (Barnes, & Rowe, 2007). A key principle underlying much of Australia’s maternal health care system is universal access to good quality health care regardless of ability to pay. The private sector remains an important part in provision of health services (Leslie & Storton, 2007). The health care system is family centered, has shared responsibility between the Commonwealth and States; promotes wellness, comprehensiveness, strengthen prevention and above all provides hope for the future generation by recognizing the broader environmental and social issues impacting the system. The government policies have ensured safety, accountability and transparency through community engagement, ethical system, culture of innovation and reflective improvement, responsible spending and public voice. In the current Australian maternal health care system, registered nurses are essential for the provision of high quality maternity care and services throughout the pregnancy period, birth and even postpartum period (Dahlen, Schmied, Tracy, Jackson, Cummings, & Priddis, 2011). The maternity nursing skills which registered nurses have should be recognized as the core part of the general list nursing skills especially in the rural and remote areas. Recently, registered nurses have been highly described as multi specialist when they practice in remote and rural settings. The registered nurses care for pregnant women during birth and labor pains which demands complex skills, knowledge, experience and high degree of responsibility in order to maintain proficiency. The set of skills of the maternity nurses is no different from that of the registered nurses but at times they include tasks that are aimed at safe guarding women during pregnancy and in the process of giving births. In low volume units especially in the remote or rural settings, a registered nurse may be the only professional person in the hospital with a laboring woman who has the required expertise to evaluate the progression with physicians and other practicing nurses on call (Boxall, & Flitcroft, 2007). This requires the registered nurse to have the confidence to make intricate decisions concerning the labor periods and call for reinforcement as required when a pregnant woman develops a complication. Registered nurses and rural midwives in Australia at times face a number of challenges including professional isolation, difficulties in obtaining sufficient locum coverage in the face doctors and general practitioners and unsustainable workloads. Issues of surgical backup and transport are often amplified in home deliveries which form an important component of registered nurse practice particularly in community health service. Due to the greater demand for low risk maternity services among the Aboriginal women living in the rural areas, the is a greater need to increase the number of registered nurses providing maternity services to assist the registered Aboriginal midwives, registered midwives and traditional midwives. This will help in improving access to maternity services among the Aboriginal and Torres Strait Islander women in Australia. The role of the registered nurses in the current Australian maternity health care system is restricted to assisting the general practitioner in caring for the pregnant women. Therefore, remuneration for maternity care providers should reflect the unique challenges and increased professional responsibility faced by the registered nurses especially in rural settings (Barnes, & Rowe, 2007). Remuneration models should facilitate inter- professional collaboration in order to eliminate professional isolation that is faced by the registered nurses in the line of duty. In conclusion, Rural and Aboriginal maternity health care services are under stress and many remote and rural communities across Australia have limited access to quality maternity health care services. Rural and indigenous or aboriginal women who travel to access better maternity care usually experience high levels of stress, increased cost and sometimes adverse outcomes due to the inadequate transport systems. Lastly, the registered nurses who provide maternity services usually face professional isolation and are always criticized as they are only professionally obligated to assist the general practitioner. References Barnes, M., & Rowe, J. (2007). Child, youth and family health: Strengthening communities. Churchill Livingstone. Boxall, A. M., & Flitcroft, K. (2007). 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