'High risk' pregnancies account for 70 per cent of births at Bendigo Health, inquiry hears

Bendigo Health director of obstetrics and gynaecology Nicola Yuen, deputy director of nursing, women's and children's services Fiona Faulks and Mamta co-ordinator Amanda Hewett at the inquiry in Bendigo on Tuesday. Picture: ADAM HOLMES
Bendigo Health director of obstetrics and gynaecology Nicola Yuen, deputy director of nursing, women's and children's services Fiona Faulks and Mamta co-ordinator Amanda Hewett at the inquiry in Bendigo on Tuesday. Picture: ADAM HOLMES

SEVENTY per cent of pregnancies handled by Bendigo Health since the opening of the new hospital have been described as “high risk” as gestational diabetes and obesity become increasingly prevalent in the region.

The figure took the health service by surprise, as it predicted 50 per cent of its pregnancies may be high risk before moving into the new maternity unit.

High risk pregnancies require an increased level of care and monitoring, placing a further strain on resources in the maternity ward.

The figure was highlighted during a parliamentary inquiry into perinatal services, which held a hearing in Bendigo on Tuesday.

Bendigo Health director of obstetrics and gynaecology Nicola Yuen told the parliamentary inquiry into perinatal services that high risk pregnancies risked “poor perinatal outcomes”.

“The acuity of patients has changed quite dramatically over the last 12 to 18 months,” she said.

“We were expecting approximately 50-50 mix between normal and high risk.

Related coverage: Pressure grows on Bendigo hospital's maternity unit

“In fact, on review of those statistics it seems it’s more like 70 per cent high risk, and 30 per cent low risk.

“So there’s a significant increase acuity that we’re seeing. Obviously those women require more visits during pregnancy.”

Bendigo Health is required to accept pregnant women from across the region with body mass indexes of greater than 40, but the health service concedes the effects on a baby from an obese mother remain unknown.

The new Bendigo hospital accepts high risk pregnancies from across the region - which now account for 70 per cent of births.

The new Bendigo hospital accepts high risk pregnancies from across the region - which now account for 70 per cent of births.

The requirement has resulted in a higher than expected number of “high risk” pregnancies at Bendigo Health since the opening of the new hospital.

Dr Yuen said research into the impact of high BMI in pregnant women was ongoing.

“BMI has been one of the major restrictive factors for smaller hospitals to care for women,” she said.

“The impact of obesity in pregnancy is still very much a developing area for obstetrics. It’s still very much an area where the evidence is still being discovered.”

The health service has been accepting “a significant amount” of high risk pregnant women from Deniliquin and surrounding areas. Dr Yuen said the travel factor for these women was “challenging”.

Bendigo Health also outlined issues in transferring women to Melbourne whose level of risk was beyond the hospital’s capability. A lack of beds in metropolitan hospitals meant there were often delays.

The health service was further questioned about issues in attracting and retaining midwives.

Related coverage: Gift cards offered for staff to find new midwives for Bendigo Health

Bendigo Health deputy director of nursing, women's and children's services Fiona Faulks said there was difficulty in retaining midwifery graduates who move to Bendigo from interstate and Melbourne.

But she said the introduction of a midwifery-nursing double degree at La Trobe University was helping to make inroads into the staff shortage.

“We now have 20 students in every year from the Bachelor of Nursing/Bachelor of Midwifery,” Ms Faulks said.

“It’s really key for regional services to have local people trained in midwifery because then they stay in our unit.

“The diploma model was not going to be able to sustain us long-term.”

The parliamentary inquiry is examining the Victorian health system’s ability to deal with high risk pregnancies, the disparity between rural, regional and metropolitan hospitals, and access to a qualified workforce.

It will release its report in March next year.