A former Orange paediatrician says the unused birthing suite at Parkes Hospital is not fit for purpose and doesn't have adequate blood supplies in case something goes wrong.
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The issue came to light amid ongoing calls to reopen the birthing suite at Parkes Hospital.
The hospital opened in 2015, but its maternity ward closed in 2019 forcing expectant mums to travel to Orange, Dubbo and Forbes to give birth.
Member for Orange Phil Donato asked health minister Ryan Park on what progress is being made to reopen the crucial service in Question Time on October 17.
Mr Park said the health department is working to recruit staff to get the birthing service up and running again but it has been challenging to attract the talent.
However, Paediatrician Dr Jo Rainbow, who was working at Orange Hospital and was involved when the issue of the Parkes birthing suite was raised, said there is more to the issue.
"I'm amazed it's still being discussed because Parkes is not fit for purpose, that's the bottom line," Dr Rainbow said.
"They have built the delivery suite for $70 million but they have forgotten that the standards for delivery suites have changed and you now must have a blood bank that has adequate supplies to support ladies who are giving birth.
"That will be an investment of another $1 million."
Low risk does not equal no risk
The plan for the Parkes birthing unit was to only do low-risk deliveries, however, Dr Rainbow quoted the old adage "low risk does not equal no risk".
"The trouble is even low-risk deliveries can have this life-threatening complication called a postpartum haemorrhage, pph for short, and five per cent of those cannot be predicted, you cannot anticipate what's going to happen," she said.
"Unfortunately it even happens in low-risk deliveries."
Mother's life on the line
Dr Rainbow cited the case of Forbes mother Nicole Blinco whose low-risk delivery became a life-threatening ordeal.
"She was a low-risk delivery, had a pph, needed eight litres of blood, was basically intubated at Forbes because she was so sick and woke up in Orange [Hospital]," Dr Rainbow said.
"When I say she needed eight litres of blood, in addition to that, when you give so much blood to people, you then have to give other blood products because then the blood gets too runny.
"She was very lucky that Forbes [Hospital] had enough to keep her alive sufficiently to get to Orange."
Why staff don't want to work there
Dr Rainbow warned Parkes didn't have the same provisions as Forbes and that was contributing to the reason Western NSW Local Health District cannot attract staff to work at the birthing unit.
"Parkes is not fit for purpose because they haven't invested in an adequately stocked blood bank ... you need more staff, so no doctors will work there because they know it is not safe," she said.
"It's not 'oh, we can't recruit doctors' which is what they keep traipsing out, it's no doctors will work there because we know it's not safe.
"It was going to be a midwifery run service. A midwifery-led service is fantastic but you need a backup plan just in case these low-risk deliveries go wrong.
"Parkes has got the attitude that we, the doctors, were against them doing deliveries, that's not the case at all. We have a fantastic midwifery-led service based at Orange but from time to time you need medical backup for when it all goes pear shaped and they haven't got that in the plans."
Back-up plan needed
Dr Rainbow also raised issues with what happens if an emergency caesarean is needed or a baby needs to be resuscitated.
"They were honestly expecting the GPs at Forbes to drop what they were doing and zoom over to Parkes to do a caeser, assuming they're not in the middle of a caeser or resuscitating a baby and there's someone available," she said.
"All the GPs in Forbes said 'we're not doing that, that's not safe' so then they started recruiting and of course once they found out there's no blood bank then no body will do it.
"The other issue is, say, something goes wrong and the baby needs to be shipped out, they said, 'we'll call NETS [Newborn and Paediatric Emergency Transport Service]' but we'll tell you in Orange, NETS is not readily available and who's going to resuscitate the baby and keep the baby alive until NETS get there?
"They wanted us, the paediatricians here in Orange to drop what we were going to do and zoom out there to help them. That again is presuming we're not busy resuscitating babies in Orange."
How the situation can be remedied
She said if they get a blood bank Parkes would have a better chance of recruiting an obstetrician.
"I think the decision to get the midwifery led service in Parkes, although laudable, and it's what the community wants, it's not going to fly unless they've got sufficient back up plan for if something goes wrong," Dr Rainbow said.
"If something goes wrong with deliveries it goes wrong very, very quickly.
"There is a blood bank in Parkes, it just doesn't have enough blood. It needs a massive expansion, it needs staffing, it needs more donations, it needs everything.
"They need to reconsider the investment that they've made, and that means reinvest in the blood bank, employ more staff to run the blood bank and then they have to train the midwives adequately to support the service."
Health district's response
The Central Western Daily approached the Western NSW Local Health District, which runs the Parkes Hospital, for comment.
We asked if the birthing unit meets current delivery standards, if there is provision for on-site blood supplies if something does go wrong when a woman gives birth and if the NSW Government is considering an upgrade to the blood service for the maternity unit.
A statement provided by a spokesperson from the health district said the hospital does maintain the infrastructure and amenities to support the required level of birthing services under the Lachlan Midwifery Group Practice model, in line with clinical standards.
The spokesperson backed the Minister's statement that a shortage of appropriately skilled workers was preventing the unit from reopening and until that happens birthing will continue at Forbes Hospital.
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"Despite our significant recruitment efforts, the district continues to face challenges recruiting the required workforce to safely reinstate birthing services at Parkes Hospital, due to the ongoing shortage of midwives and specialists being faced by all jurisdictions across Australia," they said.
"In line with Parkes Hospital's current service capability as a non-birthing site under the NSW Health Maternity and Neonatal Service Capability Guideline, the provision of on-site blood and blood products to support planned birthing services is not required.
"This is not an underlying cause of the ongoing suspension of birthing services.
"Parkes Hospital maintains a supply of on-site blood and blood products to support patients in emergencies and when clinically required."
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