As more and more of the Loddon-Mallee’s “high risk” women are sent to Bendigo Health to give birth, the flow-on effect is causing overcrowding in the maternity ward’s special care nursery.

The hospital is now reviewing its approach to the problem, but staff shortages mean there could be little room for improvement.

Bendigo Health outlined the pressure being placed on its maternity ward in a submission to the state government’s inquiry into perinatal services.

It stated births have increased 15 per cent in three years, with 15 per cent of those from gestational diabetic women.

A further 25 per cent of women have a BMI greater than 35.

Bendigo Health found this is placing pressure on other areas of the maternity ward, including the Special Care Nursery which has experienced occupancy greater than 90 per cent for the whole of 2017.

“These high risk women naturally have a cascade effect on the demand and admissions to the Special Care Nursey with similar data collected in this space,” the submission reads.

As a level 5 maternity and level 4 neonatal unit, the hospital must accept high risk women from across the region to give birth.

But this is also putting a strain on services.

“Due to staffing challenges across the perinatal services in Bendigo Health, this remains a difficulty for the organisation with limited staff and beds available during the times of increased acuity and demand,” the statement reads.

“When requested, Bendigo Health exacts the escalation process in an attempt to accept women and neonates.

“However, this is not always possible and the Perinatal Service Division is currently revising strategies to improve its response to this situation in the future.”

The $630 million Bendigo hospital started operating in January this year.

The new maternity ward boasts 25 single rooms for new mothers, an increase of nine from the old hospital. It also has seven birthing suites, an increase of three.

The Special Care Nursery also increased in capacity, from eight cots to 15.

In August last year, Bendigo Health stated the new maternity ward was being built to accommodate future demand.

Yet a lack of available staff has caused problems for the new ward in its first six months.

Bendigo Health described this as a “constant challenge for… managers”.

“This is due to the small number of staff available in the region and the retention of staff who frequently use the positions to propel them into high level perinatal positions in metropolitan areas,” the submission reads.

“Due to the current staffing issues in meeting safe patient ratios across the women’s and children’s service, many units are using casual staff on a daily basis.

“This significantly dilutes the pool available to other areas in the division due to the number of shifts they are being utilised for in order to cover the basic roster resulting in less staff available to cover short notice leave such as sick leave and increases in acuity.”

Bendigo Health has refused multiple requests for transfers from the Royal Children’s Hospital to its birth suite and special care nursery, due to them both operating close to capacity.

Its Assessment Clinic is also being plagued by staffing concerns.

Assessments now operates for limited day shift hours, with women having to instead present to the Birth Suite at other times.

“Assessment Clinic are also not governed by ratios which again causes significant confusion and safety issues for staffing,” the submission reads.

The state government launched the perinatal services inquiry in 2015, but has been extended a number of times to allow for more submissions.

It aims to investigate the health and wellbeing of mothers and babies across Victoria during the perinatal period.

One aim is to find out the disparity between rural and metropolitan hospitals.

The disparity could be even greater for Indigenous mothers.

In its submission to the inquiry, the Loddon Mallee Aboriginal Reference Group found the lack of any Koorie Maternity Services in Bendigo could place Indigenous mothers at an increased risk.

“Koorie Maternity Services provide an excellent model of care but they do not exist in all local areas,” the submission reads.

“Lack of funding for maternal child health nurses and lactation specialists employed directly by Aboriginal community controlled organisations, together with structured modes of maternal child health service delivery, is a major concern.”

Bendigo Health clinical director obstetrics and gynaecology Nicole Yuen said the hospital had the capacity to look after high acuity babies and mothers.

"Bendigo Health maternity services have expanded since the move into the new hospital and we are supporting an increased number of births,” she said.

“We have had 839 mothers welcome 850 new babies in the new hospital.

“We have an ongoing commitment and responsibility to support and collaborate with regional hospitals as the leading maternity service for the Loddon Mallee region.”