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Demand for maternity services is up as much as 20% in some parts of Victoria, prompting fears the system is ‘at breaking point’

HealthDemand for maternity services is up as much as 20% in some parts of Victoria, prompting fears the system is at breaking point
Despite experts arguing a Covid-19 baby boom is unlikely, those on the maternity frontline say some hospitals are already under a strain because of a spike in births.
Madeline Kaio and her husband, Chris Williams, always thought they would have kids eventually, but when Australia locked down last year it was the first time they ever seriously considered starting a family.
My husband and I were working from home and we sort of thought, Why not?, she says.
Lockdown highlighted how important family is so we thought wed start our own.
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Kaio says the Victorian pair spent months training for and dreaming about the birth of their daughter, but right from the start of her labour things started going terribly wrong.
I went into labour at 2am … we called [the hospital] a bunch of times throughout the day, and this is where we sort of came into the issue, that there was nobody that could look after us and there were no rooms so I had to sort of stay at home until there was something available or Id be sitting in the waiting room, she says.
By 11 oclock we were like, nah, screw it, were going in, this is, I dont know whats happening. This doesnt feel right.
With all the delivery beds full, Kaio says the hospital put her in a shared room.
It was really unfortunate because the woman that was in the room with me was introducing her newborn with a toddler, so I was like over my dead body am I making noise. I was labouring while this beautiful moment is happening.
When she was taken to a proper delivery room she says the staff checked her temperature for the first time to find she had a fever of 39.1C.
Twenty minutes after that we were going in for an emergency caesarean section … It was terrifying as we didnt know if we were both going to be OK, she says.
Its like, was that always gonna happen? Or if we had been able to get into a room, or had been seen quicker would it have been picked up?
In the end, baby Esteé spent five days in a special care nursery, and Kaio was hospitalised for 11 days with a serious infection affecting the placenta and her body.
Mother and bub are now both back in full health, but Kaio says she is terrified to consider how things might have ended if they hadnt defied the hospitals directives.
If my temperature was 39, her temperature was a couple of degrees higher. So I was essentially boiling, she says.
Madeline Kaio with newborn baby Estée. Photograph: Madeline Kaio
We really dont want to think about what would have happened I have a feeling if we had stayed home any longer she wouldnt have made it.
But Kaio and Williams are far from the only parents to have experienced the strain on Australian maternity systems in recent months.
Last week the Victorian health minister, Martin Foley, responded to questions in parliament over dozens of anecdotal reports compiled by the Greens MP Ellen Sandell that Victorias maternity system was at breaking point, by saying this pressure was due in part to soaring birth rates across the state.
We are in fact at the moment going through a massive baby boom in Victoria, at record levels, including the Royal Womens, he said.
This is backed up by provisional data provided to the state government from health services that shows, compared to the same time last year, demand for maternity services has increased as much as 20% in some areas.
If my temperature was 39, her temperature was a couple of degrees higher. So I was essentially boiling
Despite the federal government predicting fertility rates in Australia will drop to an all-time low of 1.59 babies per woman this year, an analysis of Medicare data published in the Medical Journal of Australia also indicates Australia could soon be experiencing a wave of new births.
The number of Medicare item numbers recorded for the five antenatal serology tests usually ordered for pregnant women on their first pregnancy check-up have risen by around 8.9% compared to the early months of last year, says the papers co-author and clinical microbiologist Len Moaven.
Well June [2020] there was a clear bounce of 25.4% and presumably part of that was pregnant women may be waiting to go down to get a test done and then this goes backwards, and now this 8% or 9% is what the background figure is right now. It doesnt seem to be abating.
The paper states the usual fluctuation in these billing levels across the years is only around 3%.
Accounting for miscarriages, Moaven predicts an additional 20,000 babies have been born so far.
But Dr Aude Bernard, a demographer with the University of Queensland, urged people to be cautious when it comes to declaring a Covid baby boom as spikes could be caused by a number of factors and may not actually represent an increase in the net number of babies born.
I think most of us demographers agree that were not expecting a baby boom. If you look at historical evidence from recessions the GFC and other economic downfalls. Theyre typically associated with this fall in fertility, she says.
If anything, perhaps Covid could just change the timing If you were in early 2020, you would think of having a baby and you saw what was going on, you were like wait a second something is not great, so maybe well wait until the end of 2020 and then the babies are coming now.
Anecdotal evidence is that even before Covid, we were at capacity. [Health systems] dont have a lot of flexibility
Other developed nations including the US and European and Nordic countries appeared to be recording a drop in birth rates. Although Australia experienced considerably more stability during the pandemic, it would remain an outlier if it were to buck the trend.
Australia generally records birth rates based on birth registration data, which creates a time lag, meaning it can be difficult to officially access changes within the last 12 months.
But medical professionals on the frontline say the increase has been dramatic. One junior midwife who asked to remain anonymous, told Guardian Australia she resigned from her full-time role at a prominent health service because the extreme workload made her feel ethically compromised, and unable to properly care for her patients.
Its a career Im extremely passionate about but it just got way too much. Honestly, it was quite traumatising, and it was just getting to the point where I was having to participate in things that I just didnt agree with, she says.
Although she is new to the field she says senior midwives were constantly telling the juniors that this was the craziest theyve ever seen and that this isnt normal.
She says she would never have felt she had to quit were it not for the boom in births, starting towards the end of last year.
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Its a hard job, but there was enough that fulfilled me, but [now] it was just wearing me down and having so many these days where you just feel like youre failing yourself and youre failing the families that you care about, she says.
Bernard notes that, although these spikes may not actually constitute a net increase in the fertility rate or population over time, if statistics from Victoria and other pockets of the country are to be believed and births have temporarily spiked then systems need to be put in place to accommodate the new wave of babies.
In my personal experience of having children, that anecdotal evidence is that even before Covid, we were at capacity. [Health systems] dont have a lot of flexibility for bigger growth, she says.
So even if we just have a small increase because people have postponed having kids you need to accommodate for these children. They will go to school, there will be a flow-on effect.
A Victorian government spokesman confirmed the pandemic had a lasting impact across Australia, which included increased demand on maternity services.
The Victorian budget 2021-22 delivered $3.7bn over four years to support our hardworking midwifery and medical workforce to meet increased demand at our busy hospitals, he said in a statement.
Several maternity wards in Victoria have been opened or expanded in recent years and in 2019 $50m was put towards training nursing and midwives to build the workforce.
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