Access and outcomes of general practitioner obstetrician (rural generalist)-supported birthing units in Queensland
- PMID: 31903661
- PMCID: PMC7328769
- DOI: 10.1111/ajr.12593
Access and outcomes of general practitioner obstetrician (rural generalist)-supported birthing units in Queensland
Abstract
Objective: To describe characteristics and outcomes of women birthing within GP-obstetrician (rural generalist) supported rural (level 3) obstetric units in Queensland.
Design: Retrospective descriptive study.
Setting: 21 GP-obstetrician supported birthing units in Queensland.
Participants: Women (n = 3111) birthing from January 2017 to December 2017.
Main outcome measures: Patient, pregnancy and labour characteristics and key maternal and neonatal outcomes routinely recorded in the Queensland Perinatal Data Collection and Queensland Hospital Admitted Patient Data Collection were compared to Queensland public hospital aggregate data.
Results: Women birthing in rural maternity units were significantly more likely to be Aboriginal or Torrs Strait Islander (16% v 9%), < 20 years old (7% v 4%), term deliveries (96% v 91%), achieve spontaneous onset of labour (67% v 51%), and birth (71% v 60%) (p<0.001) compared with all Queensland public hospitals. They were significantly less likely to be nulliparous (36% v 40%), use pharmacological analgesia (65% v 69%), or have continuous electronic fetal monitoring in labour (54% v 66%) (p<0.001). Neonatal outcomes were comparable; with no significant difference in stillbirth rate between rural units and all Queensland public hospitals (4.8 v 7.3 per 1000 births). Precipitate delivery was the most common labour complication (36% v 33%) (p<0.001).
Conclusion: GP-obstetrician (rural generalist) supported rural birthing units in Queensland provide important access for low and medium risk women to deliver locally, with strong indicators of quality and safety.
Keywords: access; maternity; obstetrics; risk; rural.
© 2020 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.
Conflict of interest statement
Dr Tennett was the recipient of a $5000 research grant from the Rural Generalist Pathway (Queensland Health) to support the undertaking of this study. The authors have no conflicts of interest to declare.
Figures
References
-
- Queensland Treasury . Population Growth Highlights and Trends, Queensland Regions, 2015 edition. Brisbane City, QLD: Queensland Government Statistician’s Office; 2015.
-
- Kildea S, McGhie AC, Gao Y, Rumbold A, Rolfe M. Babies born before arrival to hospital and maternity unit closures in Queensland and Australia. Women Birth. 2015;28(3):236‐245. - PubMed
-
- Longman J, Pilcher JM, Donoghue DA, et al. Identifying maternity services in public hospitals in rural and remote Australia. Aust Health Rev. 2014;38(3):337‐344. - PubMed
-
- Dietsch E, Shackleton P, Davies C, Alston M, McLeod M. 'Mind you, there's no anaesthetist on the road': women's experiences of labouring en route. Rural Remote Health. 2010;10(2):1. - PubMed
-
- National Rural Health Alliance . Rural and Remote Health. 2017. https://www.aihw.gov.au/reports/rural-health/rural-remote-health/content.... Accessed June 27, 2019.
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
