blacktown maternity tour

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First baby born in new women’s health wing at baby booming Blacktown

‘Perfect’ was how mum Sheela Kharel described Blacktown Hospital’s new birthing unit today, after her baby boy made history as the first arrival in the unit this afternoon.  

The new birthing unit is one of many women’s health services opening this week in Blacktown Hospital’s new building, a key part of the $700 million expansion of Blacktown and Mount Druitt Hospital.

It includes birthing rooms with en-suites and a range of items to support birthing such as ledges, ropes and baths.

Located on level 6 of the new building, the unit also includes a maternity assessment centre for early diagnosis and management, which is directly adjacent to newborn care, which also opened today.

Newborn care includes a mixture of single and four-cot rooms, all with recliners or carer zone beds,  a parents’ retreat and a shared outdoor courtyard.  

Second-time mum Sheela said she was thrilled to be the first to experience the new birthing unit.  

“I’ve never seen any hospital like this. Everything is no new and advanced,” Sheela said.

“I desperately wanted to have a water birth with my first baby and today I did it – I’m so proud of that!

“It’s a huge achievement. To see that women love what we’ve designed, and the way it supports their individual birthing experience, makes it all worthwhile. I couldn’t be prouder of our team.”

Newborn care nurse unit manager Therese Freeman said the move into their new unit today couldn’t have been smoother.

“The parents are well and truly settled in and they’re just astounded by the design, the light, and the services available to them,” Therese said.

“They think it’s just beautiful.”

Today the hospital also opened its new perioperative services complex, with three urgent surgeries already conducted early in the day, and a total of about ten expected by the end of the day.

Divisional nurse manager of surgery and anaesthetics Cesare Aguilar said the move into the new hospital building went ‘really well’.

“The equipment worked well and we’ve had a lot of support from the IT and technology providers.”

For more information about the $700 million Blacktown and Mount Druitt hospitals’ redevelopment, visit: http://www.bmdhproject.health.nsw.gov.au/

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Blacktown Hospital maternity ward still facing challenges, three years after Jennifer's baby was delivered stillborn in 2019

A Western Sydney maternity ward was significantly understaffed and vulnerable to overnight medical emergencies when several infants were stillborn or died shortly after birth, documents obtained by the ABC have revealed.

Key points:

• Six babies died unexpectedly at Blacktown Hospital over the course of two years 
• In late 2020, midwives protested and 20 obstetricians threatened to resign over understaffing and resourcing concerns 
• The Western Sydney Local Health District has since hired 19 midwives and five nurses are being trained in midwifery

Jennifer Fonua found special significance in the fact that her sixth child, whom she planned to call Thalia, would be born at the same hospital as her five older siblings. 

So when she was admitted to Blacktown Hospital in April 2019, she said was comfortable and at ease with the staff.

"The midwives and the nurses there, they cared for me. When I went for my baby check-ups, they were always there for me, they knew me," she recalled.

Ms Fonua had been admitted three days ahead of a planned caesarean.

She said she was feeling well and was looking forward to meeting Thalia, but had noticed the baby hadn't been moving as much over the previous few days.

They started monitoring the baby's heartbeat, and just before midnight doctors decided she need an emergency caesarean within an hour.

The heartbeat monitor, called a CTG, was removed when Ms Fonua was taken to get ready for theatre, but then she waited more than two hours after another urgent case was given priority.

"I was a little bit concerned because I knew at this point my daughter's heartbeat was dropping, but I trusted them to do right by me," she said.

"They did say they were going to put me back on the machine to monitor her heart, so I was OK with that.

"However, once they went to check her heart, that's when they didn't find her heart [beating]."

Around 3:30am, Thalia's death was confirmed.

"It was one of the hardest things to hear, because for me it was a few minutes ago I heard her heartbeat, like a bunch of horses racing … the galloping," Ms Fonua said.

"And then I remember crying and saying, 'Bring me my partner. I need my partner. I need him here right now.'

"They put me into theatre. I remember it was so silent, no one was speaking … and you knew that it wasn't right."

She was delivered stillborn an hour later.

An investigation into Thalia's death, called a root cause analysis, found the CTG shouldn't have been removed, and the medical team didn't fully appreciate the baby's worsening condition.

"The insufficient CTG monitoring resulted in a missed opportunity to detect deteriorating fetal condition and expedite delivery," the investigation found.

Four deaths prompt district-wide review 

By the time an internal review into the Western Sydney Local Health District's (WSLHD) maternity services was commissioned in mid-2020, a total of four babies had died unexpectedly in the space of 18 months, including Thalia Fonua.

That review, which was obtained by Greens MLC Cate Faehrman through the NSW Parliament, found Blacktown Hospital was understaffed and the overnight roster included no senior medical staff, leaving it exposed to emergencies overnight.

"The midwifery workforce has significant deficits with ongoing vacancies … the recruited workforces is relatively junior and inexperienced," the review stated.

"The overall senior medical staffing of the service at Blacktown is suboptimal … the medical workforce appears to be organised around individual clinicians rather than organised for safety."

General secretary of the NSW Nurses and Midwives Union Brett Holmes said midwives were working under enormous pressure.

"The reality is they were trying to run a service 28 midwives short of what was needed to do a minimum," he said.

"That leaves an enormous burden on that midwife because they're looking after up to 12 mothers … and 12 babies.

"There still is a very heavy reliance on junior midwifery staff.

"They're developing their skills, but until you have sufficient numbers of midwives there and not rely so much on registered nurses to backfill the midwives, those midwives won't be able to continue to develop the full range of skills that that would be normally expected of them."

In a statement, a spokesperson for the WSLHD said they had hired 19 midwives, a birthing suite midwifery unit manager, and a clinical nurse educator to support after hours.

The statement said five nurses are being upskilled in midwifery, and seven more nurses were filling in while recruitment for the rest of the promised 28 midwives continued.

An additional night shift registrar has also been added to the roster.

NSW Health Minister Brad Hazzard said in a statement he was pleased with the progress made by the hospital so far.

"I instructed NSW Health to ensure more midwives were employed and changes made in the medical staff to ensure that structures and processes were in place to address the issues raised in the Resilience Review," he said.

"I am pleased to see progress on that front with the recruitment of an additional 19 midwives and other staff in key positions that are a major boost for the hospital's maternity service."

Midwives struggling under workloads

In late 2020, midwives walked off the job and 20 obstetricians threatened to resign in response to their ongoing concerns about lack of staff and resources.

At the time, the WSLHD was already in possession of the internal review which echoed many of the issues raised by workers, including the understaffing of the maternity ward.

Another two babies died in unexpected circumstances in the months following.

The review also found that clinical midwives struggled to attend morbidity and mortality meetings — where incidents like Thalia Fonua's death might be reviewed — because of their workload.

It stated a long list of recommendations formed in direct response to root cause analysis investigations, like the one undertaken into Thalia Fonua's death, still haven't been actioned.

A WSLHD spokesperson said safety huddles and clinical handovers had been established in all maternity wards to address safety concerns, as part of the response to the review.

"WSLHD follows a rigorous process to ensure we identify, investigate and learn from any incidents that occur in our hospitals," the spokesperson said.

"All unexpected deaths in our hospitals are thoroughly investigated with a Root Cause Analysis which, if required, comes with recommendations for implementation.

"A review of all local obstetrics and gynaecology policies and procedures has been completed in WSLHD."

Medical negligence barrister and registered nurse Ngaire Watson said the internal review showed a lack of accountability and ability to learn from mistakes.

"The report indicates that there have been root cause analyses conducted after serious incidents, but the findings from these are not being fed back into the system so that they can change what's happening within the system — so the problems keep getting repeated," she said.

"I think it would be very distressing for midwives not to be able to participate and feedback into a system when they are the ones ... who actually know what's happening at a patient care level.

"They're working in an environment where they're swimming against the stream.

"They're in a very difficult situation where they're trying to provide care in an environment where it's very difficult to do that, and within a system that's not really listening to what they're saying."

A WSLHD spokesperson said all 18 recommendations made in the internal review have been accepted by the district, with 12 completed and the remaining six expected to be finalised early this year.

Almost three years on, Jennifer Fonua is frustrated that there are still unresolved issues at Blacktown Hospital, and that other families have had to experience what she has.

"[Thalia] would be three in April. I'm still waiting for things to be changed," she said. 

"I've seen since my daughter's death in April 2019 [that] nothing has changed, more babies' deaths have arisen.

"I now live with mental illness, I live with depression, I live with anxiety.

"But I push myself every day because they need their mum. My children need their mum."

Watch this story on 7.30 tonight on ABC TV and ABC iview

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Which hospital should I book to have my baby?

Latest Posts , Pregnancy

I will start answering this question by writing about my personal experiences as an obstetrician in private practice.

When I started in private practice, I had appointments at the San Hospital (Sydney Adventist Hospital), Baulkham Hills Private Hospital (now relocated to Bella Vista and called Norwest Private Hospital), Hornsby Hospital and Blacktown Hospital.

I cancelled my Blacktown Hospital very soon after starting my practice. Considering the increasing disasters being reported in Blacktown Hospital maternity department and the inadequate quality of care many maternity patients receive at Blacktown Hospital, I am incredibly pleased I do not have an appointment there. I quit Hornsby Hospital sometime later. Again, this was because of concerns I had about the inadequate quality of care many public patients received.

Currently, because of increasingly financial pressures on households there are more pregnant women opting out of private and into public care. I suspect for many who have experienced private pregnancy care in the past, this is a temporary financially driven decision. Many who have never experienced private pregnancy care I suspect they assume the quality of public pregnancy care and hospital facilities will be the same as private pregnancy care and private hospital maternity facilities. This is not the case. When they realise this, it is probable many will go private when their finances improve. I have had many women switch from public to me for private care during their pregnancy, even though they are not insured, as they we not coping with the poor quality of care they were receiving as public patients.

I quit Baulkham Hills Private Hospital when we moved to Wahroonga to live. As well, as my rooms were in Hornsby, and I was getting more bookings for the San Hospital.

Years later a colleague asked me to cover him while he was on holidays. He confined women at both the San and Baulkham Hills Private Hospitals. That meant I needed to be reappointed to Baulkham Hills Private Hospital.

With the population growth in northwest Sydney, I was getting more patients from that area of Sydney, many of whom wanted to be confined at Baulkham Hills Private Hospital. I started to accommodate their requests and started admitting my own patients to Baulkham Hills Private Hospital. Then Baulkham Hills Private Hospital relocated to Bella Vista. A new hospital was built and was called Norwest Private Hospital. It was a very popular decision. I decided to sell my office in Hornsby and buy my current office on Norwest. As well, we had relocated to Hills District to live. My maternity booking numbers at Norwest Private Hospital grew dramatically.

The San then built a new maternity department in the top two floors or the new Clark Tower. This provided better quality rooms and overall better facilities.

Then the San next introduced with HCF the Swaddle programme. That meant than patients with HCF would not be out of pocket for hospital (except fund excess, if any), doctors, scans, and pathology (as long as there were no extras required). It was very appealing. A woman would save about $7000 in having a baby privately. Leon Clark (who Clark Tower is named after) was the previous CEO of the San Hospital and a personal friend once said to me: “someone has to have a very good reason to drive past their local maternity hospital”. Saving $7,000 was a particularly good reason. Women would travel considerable distances to have their babies at the San for the financial savings.

The Swaddle programme proved not to be financially viable for HCF and so has ended. There is no longer a good reason for a woman to drive past their local maternity hospital. Some who live outside the San Hospital area will go back to the San after Swaddle as they had an enjoyable experience there, but for others they will book next pregnancy at their local maternity hospital. For most women living in northwest Sydney that would be Norwest Private Hospital. I am seeing that in my patient bookings. With my office being in Norwest, now there are now more booking at Norwest Private than the San.

Both hospitals provide very good facilities and good quality care, so it is a personal preference and geographical location in deciding where to go to have your baby. You can check out both maternity departments online. As well you can visit both and have a look around.

The maternity tour links are:

• Norwest Private Hospital Maternity tour https://norwestprivatehospital.com.au/maternity/virtual-tour
• San Hospital Maternity tour https://sah.wistia.com/medias/ma1waxf8rt

I attend both hospitals. There are good paediatricians (sometimes the same) at both and good anaesthetists (mostly not the same) at both.

In both hospitals you can be confined from 33 weeks gestation. If you need to be confined before 33 weeks, you will be transferred to a public hospital where they have a suitable neonatal intensive care unit (NICU). This is uncommon and is not a reasonable reason to book at public hospital. Indeed, I know of a woman who booked at a public hospital and needed to be delivered before 33 weeks. That public hospital’s (where she booked) NICU was over full and so she was transferred to another public hospital for confinement.

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• Health Problems

Blacktown Hospital’s ‘maternity crisis’ continues after sixth baby dies in two years

One of Sydney’s busiest hospitals is reeling and a young couple are devastated after the sixth death of a baby in two years.

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One of Sydney’s busiest hospitals is reeling and a young couple are devastated after a newborn baby on Sunday became the sixth infant to die unexpectedly in the space of roughly two years.

The latest death of a baby at Blacktown Hospital in western Sydney comes months after midwives walked off the job in protest, and some 20 obstetricians threatened to quit, if staffing issues were not resolved.

But according to the nurses’ union and the hospital, the ward was fully staffed over the weekend at levels agreed to with state health officials during crisis talks in the wake of the previous death late last year.

“Can I just extend my heartfelt condolences to the family of that little baby,” NSW Premier Gladys Berejiklian said on Wednesday.

“The Minister for Health Brad Hazzard and the health agencies will undertake all the required investigations.”

Opposition health spokesman Ryan Park told the ABC that he would be speaking to the relevant unions to better understand how the “absolute tragedy” happened and that the community would be demanding answers.

But Mr Park said he acknowledged staffing levels at the hospital had improved.

In November, NSW Health Minister Brad Hazzard said he was ordering a full review into the procedures at the hospital in the wake of the fifth newborn death since mid-2019.

Mr Hazzard’s office did not respond to a request for comment on Wednesday about the latest death or the status of the hospital review.

WARD WAS ‘FULLY STAFFED’

NSW Nurses and Midwives’ Association general secretary Brett Holmes told news.com.au in a statement on Wednesday that “some significant progress has been made at Blacktown Hospital, but every death is an enormous tragedy, and our sympathies go out to the family and the staff who feel these tragedies as they occur”.

“Our members have told us staffing over the weekend was within the agreed levels that we have worked with Western Sydney Local Health District, since our industrial dispute last year,” Mr Holmes said.

“Last year there was agreement by the LHD to increase the number of midwives by 15 and they’re very close to the recruitment of those midwives, albeit many of those are beginning practitioners.”

He added, “The LHD is continuing to work constructively with us, in trying to restore Blacktown Hospital to the best possible care delivery that can be provided to the local population.”

After the fifth baby died in November, the union demanded the state government step in to “address the crisis in the maternity ward” with additional midwives .

In a statement on Tuesday about the latest tragedy, Blacktown Hospital said since October last year it had hired 15 additional midwives, three senior medical officers and four junior doctors, with “more appointments still to be made”.

“At the time of the incident on March 12, the ward was fully staffed, which included full medical and midwifery coverage,” a Blacktown Hospital spokeswoman said.

“The death of a baby is a tragedy. Our thoughts and deepest condolences are with the family, who are receiving bereavement support at this incredibly difficult time.”

But the union in December last year warned that the while the promised 15 extra midwives was “a step in the right direction”, it was concerned “it will not be enough to address the very high workloads our members currently face”.

From 2015 to 2020, births at Blacktown Hospital increased by 52 per cent, while staffing only rose by 11 per cent, union figures showed.

“Not only are they burning out with fatigue, many of the midwives have been traumatised by tragic deaths and believe the staffing issue has become untenable, putting their professional registrations at risk,” Mr Holmes said last year.

Multiple investigations are now underway into the latest death – a so-called root cause analysis (RCA), which is conducted by NSW Health’s Clinical Excellence Commission, and an internal probe by the hospital.

“The hospital general manager and the women’s and children’s nurse manager have met with the family and assured them a root cause analysis is underway,” the hospital spokeswoman said.

“All RCAs are referred to NSW Health and the Clinical Excellence Commission. In addition, an internal investigation into the infant’s death has also commenced. Western Sydney Local Health District follows a rigorous process to ensure we identify, investigate, and learn from incidents that occur in our hospitals.”

The spokeswoman added that a dedicated operating theatre had been opened at the hospital to provide “improved access for emergency caesarean sections”.

YOUNG PARENTS GRIEVING

The Sydney Morning Herald today revealed further details of the baby boy’s death.

According to the newspaper, the couple aged in their 20s arrived at the hospital on Friday evening. The mother was just over 38 weeks pregnant.

She was induced on Saturday morning as a precaution due to a pre-existing medical condition and laboured through the day, but just after midnight the baby’s heart rate suddenly dropped.

Staff attempted and failed to deliver the baby with forceps, before performing an emergency caesarean section. The baby died between midnight and 2am on Sunday, the newspaper reported.

“They never expected such a thing to happen,” a friend of the couple told The Sydney Morning Herald . The friend also said the parents believed everything was OK during the process and the staff did not seem worried.

Last year, one doctor told The Australian they thought the death of a newborn at the time was “avoidable”. “The infant missed out on the opportunity for an emergency caesarean section,” the doctor said. “There are clear system factors involved.”

The Australian reported that death occurred following a 39 weeks pregnant mother going into labour. It was reported she felt unwell when taken to hospital and that the baby had a normal heartbeat in the morning. However, that afternoon clinicians checked and could not find a heartbeat.

Speaking to The Guardian in November, a senior obstetrician from the district said Blacktown was one of the fastest growing areas in the country and demand for services had grown as a result.

“The complexity of the cases has increased,” he said.

“There’s a high Indigenous and non-English speaking community, and changes have occurred around maternal transfer procedures so Blacktown is taking a higher load of more complex obstetric cases. So you have a perfect storm of all these things happening and there have not been the staffing enhancements needed to keep pace with that.”

He added, “Blacktown serves a high-needs population and it’s important it has a strong and viable public obstetrics and gynaecology department. That’s what everyone agrees women deserve.”

[email protected]

– with NCA NewsWire

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