Lismore is suffering from a lack of options for those looking to increase their family size.

There are currently no private obstetricians that are providing birth services through Lismore Base Hospital, and there is a general shortage of midwives experienced across the state, exacerbated in Lismore with the QLD border, giving better career opportunities.

Planning a family comes with so much love and uncertainty. A lot of time goes towards making sure the pregnancy is well managed and planning the ideal scenario when your pregnancy comes to full term.

If enhanced care is required or desired, the options in Lismore are scant. There are private gynaecologists and obstetricians; however, none practise in hospitals.

Dr Addenbrook, one of Lismore’s private obstetricians, confirmed that there are currently no options available for women to give birth with a private obstetrician at Lismore Base Hospital.

 “I am still offering private antenatal care in Lismore (but not care in labour or for birth). I am still offering private consultations and surgery for gynaecology as well.”

Private paediatrician Dr Chris Ingall points out that it is difficult to attract younger talent to regional areas, and many specialists opt to work a shift at a public hospital rather than have to coordinate a private business where they are on call.

Dr Ingall explains the difference between public and private care.

“In the public system, you attend the midwifery antenatal class. If there were any problem with the pregnancy, they would consult the doctor, basically the midwives, who would be looking over that pregnancy.”

Private care ensures you know your team, and they know about your journey, taking you through it with continuity of care. 

“In the public system, when you came into labour unless you contracted your own private midwife, then you wouldn't know whose face was going to pop around the corner to help you deliver. 

“So there's that loss of continuity of care in the public system; you might get the registrar, or you might get a consultant if things go wrong. It's a very safe system, but it's just not a personal one.”

The closest private hospital is in Queensland at John Flynn or Pindara.

"Your child can be admitted to that hospital, and your paediatrician, who you saw in the rooms that day, will be the doctor whose name is on the end of the bed, and the same with your pregnancy.”

Dr Ingall also speaks to the difficulty of hiring short-term.

”When you don't employ to a position, whether it's a nursing position or a doctor position, then you get a locum. And the moment you get a locum in, you increase risk.

“How much safer is it to have someone who knows the patient and knows how they were on Monday and on Wednesday, that they look worse. Whereas, if you didn't see them Monday and you're just going by what the patient's family might be saying, we're not happy with healing, but to articulate that it's her colour might be missed.

“The perfect system is one where there's ownership and continuity of care.”

Healthy North Coast 2023 report says that midwifery has decreased 34% (254 midwives) since 2013 in the North Coast region, which is consistent with the declining birth rate (from 2.31 to 2.07), which is higher than in the state of NSW (from 1.95 to 1.72). Many areas have below-average midwife numbers, and Kyogle doesn't have any at all.

A spokesperson for St Vincent’s Lismore said, “We acknowledge there is a shortage of services in our area. St Vincent’s has no intention or plan to implement a maternity service.”

Midwifery figures are particularly low in Lismore. Many midwives in the Northern Rivers region opt to work a little further north, where the pay and conditions can see up to a 40% increase.

New South Wales has the lowest number of midwives per capita in the country, with only 104 midwives per 100,000 population. There are 6,600 practising midwives in the state.  

NSW Nurses and Midwife Association Assistant General Secretary and midwife Michael Whaites said the recruitment and retention issues in midwifery require urgent attention, particularly by federal and state governments and employers in NSW.  

"This national workforce report reinforces what we already knew – increasing numbers of midwives are looking to exit the industry due to work-related issues including burnout, understaffing, not feeling valued and poor skill mix," Mr Whaites said.

NSW Nurses and Midwives said that Lismore Base Hospital is understaffed by more than 100 nursing and midwifery staff members. They currently employ 60 agency staff.

The government spent more than $24 million on agency nurses and midwives in Northern NSW Local Health District last financial year – the highest of all Local Health Districts.

For further reading, find these resources;

Nursing and Midwifery report by their board

Healthy North Coast Trends Report