An audit of Queensland maternity inpatient wards has found single midwives are being left to care for up to 20 mothers and babies at a time.  

Queensland Nurses and Midwives’ Union (QNMU) Secretary Kate Veach said a second Count the Babies (CtB) audit of public and private hospitals has revealed dangerously high numbers of mothers and babies being allocated to individual midwives.    

Ms Veach said the findings, released today, revealed workloads and conditions in Queensland maternity inpatient wards were increasingly unsafe and unacceptable. The audit was conducted across 47 hospitals on May 5 and findings sent to Queensland Health (QH) and the federal government.  

“The QNMU’s second Count the Babies audit has revealed single midwives are being left to care for up to 20 mothers and babies at a time,” Ms Veach said.    

“Almost 50% of midwives involved in the audit said mothers in their care had complex needs and required high levels of care.  

“This simply is not safe. Midwives are deeply concerned for the wellbeing of Queensland mothers, babies and their colleagues who are experiencing unsafe workloads and burn out.   

“We call on the state government to fix the maternity crisis.”   

The audit findings come as the QNMU and the Australian College of Midwives (ACM) call on the state government to commit appropriate funding to Queensland midwives and midwife led models of care such as Midwifery Group Practice (MGP).  

The state budget included $42 million in maternity funding – however the state government is yet to announce how much funding will be allocated to midwives and successful models such as MGP. Funding has been allocated to train GPs in obstetrics medicine and other medical training initiatives.  

QNMU member and Midwife Ashleigh Sullivan said the QNMU and its 71,000 midwife and nurse members were determined to make positive change.   

“The QNMU’s second Count the Babies audit has revealed 11% of midwives are being allocated up to 20 women and babies at one time,” Ms Sullivan said.    

“A further 27% of midwives have reported being left to care for up to 18 mothers and babies at a time.     

“Queensland midwives have repeatedly told health authorities, politicians and the media that conditions in Queensland maternity wards are not safe. Today we’re calling on the state government to commit appropriate funding for midwives and midwife led models of care in Queensland.”    

The QNMU and ACM are calling for appropriate funding to support and expand MGP, the introduction of midwifery ratios in QH maternity inpatient wards, public funding for home births and a midwifery workforce plan to address existing and future staff shortages. The QNMU continues to campaign for the introduction of ratios, including in maternity, in federally regulated private hospitals state-wide.   

The QNMU and ACM are also calling for the introduction of a Queensland Chief Midwife and a Commonwealth Chief Midwife to hear and progress midwifery issues.   

Ms Veach said the Queensland Chief Midwife should report directly to the Director-General and be the professional lead for clinical governance and evidence-based midwifery-led workforce planning. The Commonwealth Chief Midwife should report directly to the Federal Health Minister and should be the professional lead for clinical governance and evidence-based midwifery-led workforce planning.    

“Just as Chief Medical Officers act as the professional leads for medical issues impacting Queensland and Australia, Chief Midwives would provide leadership to highlight and advance important midwifery issues and concerns,” Ms Veach said.  

“It’s high time midwives were heard on issues impacting women, babies and this invaluable workforce.”    

As part of the QNMU and ACM’s call for an immediate midwifery funding commitment, QNMU billboards with the slogan You Can’t Fix Maternity Without Midwives! are now live in Townsville, Rockhampton and Bundaberg. The billboards aim to highlight the lack of midwifery funding to fix the state’s maternity services. 

Summary of QNMU and ACM state government funding asks:     

• Midwifery Group Practice: Support and expansion of midwife led MGP to provide continuity of care, with midwives working with mothers and babies during pregnancy, birth and post birth. They also enable women, particularly those in rural and remote areas, to give birth where and when they want to. MGPs can operate without an obstetrician, while ensuring one is available if required. Evidence shows continuity of care models such as MGP result in a 24% reduction of pre-term births and a 16% reduction in pregnancy and neonatal loss, improves perinatal mental health and is more cost effective to Government than standard care Continuity of carer | Clinical Excellence Queensland(health.qld.gov.au)  
• Ratios: Introduction of midwifery ratios in Queensland Health facilities to ensure safe levels of mothers and babies are allocated to a single midwife in Queensland Health (QH) facilities   
• Home birth: Publicly funded home birth services to allow skilled midwives to provide maternity services for women where and when they are required – particularly in rural and remote areas. Queensland remains one of the last states to introduce this publicly funded option   
• Midwifery leadership:  Midwives must have midwifery leadership at all levels, including executive, and must maintain contemporary midwifery practice and knowledge. This supports long-term workforce sustainability, multi-disciplinary co-ordination and patient safety. This includes calls for a Queensland Chief Midwife and a Commonwealth Chief Midwife to hear and progress midwifery issues. 

The QNMU is also calling for a Federal Government overhaul of funding models so newborn babies receive appropriate funding and are counted in midwifery workloads.  

The QNMU’s CtB second audit found:   

• 11% of midwives reported having up to 20 or more mothers and babies in their care at shift’s end     
• 27% of midwives reported having over 8 and up to 18 mothers and babies in their care at shift’s end    
• 47% of midwives reported the mother's acuity (level of care required) as high     
• Only 31% of women had an unassisted vaginal birth. Caesareans are major surgery and require higher levels of care and attention post birth 
• 78% of babies counted were unqualified or uncounted meaning Commonwealth funding through the activity of care for the baby is not provided (2022: 61%).    

For the full CTB findings and asks, which include addressing midwives’ psychosocial safety, scope of practice, contemporary midwifery practice and career pathways to support First Nations midwives, visit www.qnmu.org.au/CountTheBabies 

Contact: 0422 550 278