National Women's Annual Clinical Report 2010

2.2.4 Antenatal and Postnatal Wards
There are 83 antenatal and postnatal beds at National Women’s for women and
babies requiring secondary and tertiary care. All primary postnatal stays where
the mother and baby are well are transferred to Birthcare Auckland, who hold the
contract to provide these services.
2.2.5 High Risk Medical Service (including Diabetes Service)
The High Risk Medical and Diabetes services are provided from an outpatient
clinic located on level 9 in the Auckland City Hospital (ACH) support building. This
facility is also used by Newborn Services, including the Child Development Unit,
where NICU admissions are followed after discharge to assess long term
outcome.
The High Risk Medical and Diabetes services provide antenatal and postnatal
midwifery community visits to patients at home as well as in Starship Hospital and
on the postnatal wards at ACH. Two ADHB pool cars are available to assist this
service.
2.2.6 Community Services
Community clinics are held at Green Lane Clinical Centre, along with antenatal
clinics in 14 General Practice facilities in the ADHB catchment area.
Community midwifery clinics and postnatal home visits provide continuity of
midwifery care during the antenatal and postnatal period with labour and birth
midwifery services provided by core midwives in Labour and Birthing Suite.
Clinics staffed by publicly funded obstetricians are held four times a week at Green
Lane Clinical Centre seeing women under the care of community midwifery care
and reviewing secondary referrals from private LMCs.
Clinics staffed by obstetric physicians are held two times per week.
A midwifery staffed Walk in Centre acts as a first point of contact and triage for
some pregnant women. These women access the centre by phone or by turning
up, either with or without an appointment, and are made aware of their choices for
maternity care. If presenting with an acute problem, they are referred to obstetric
care as necessary.
The Vulnerable Pregnant Women’s multidisciplinary team provides a midwifery
lead weekly forum for midwifery, maternal mental health and health social workers
to plan and coordinate clinical and social care for a client group of pregnant
women described as vulnerable. This forum grew out of an urgent need to
coordinate the care of women with complex social needs, at times placing them
and their babies at high risk. This risk inevitably involves statutory child protection
services, adding a further layer of complexity. The increased coordination of
service has resulted in outcomes such as; less traumatic uplifts of new born
babies from the hospital; increasing numbers of babies remaining in their parents
care with intensive social service support in place at the time of birth; increasing
numbers of babies being placed in kin care without the disruption to attachment
inherent in protracted foster placements and reduced interdisciplinary and
interagency conflict.
11