Dangerous conditions for Queensland mothers and babies 

Published: 13 December 2022 
 
Single midwives are being left to care for up to 18 newborn babies and mothers in hospitals state-wide, a Queensland Nurses and Midwives’ Union (QNMU) audit has revealed.   

QNMU Assistant Secretary Kate Veach said the QNMU conducted a Count the Babies (CtB) audit across 40 public and private hospitals to highlight dangerous conditions in maternity wards state-wide. 
 
“The QNMU’s Count the Babies audit has revealed single midwives are being allocated up to 18 babies and mothers at a time,” Ms Veach said.  
 
“That’s more than four times the safe minimum standards outlined in the QNMU’s Safe Workloads in Midwifery standards. This is dangerous and cannot continue.  
 
“Australia’s outdated maternity funding system is putting mothers, babies and midwives at risk.” 
 
Acting QNMU Strategic Midwifery Policy and Research Officer Rebecca Rooney said under the existing federal government system, the majority of babies born in Queensland hospitals were not recorded or counted as additional patients alongside mothers.  
 
Ms Rooney, a practising midwife, said uncounted babies were classified as “unqualified” and not counted as an additional patient or included in midwives’ workloads. More than 60% of babies recorded in the audit were deemed unqualified or uncounted. 
 
She said Australia’s Commonwealth funding model for maternity care, which determines how patients are classified, counted and funded in all states and territories, was guided by federal legislation unchanged since 1973.  
 
“The QNMU is determined to make change on behalf of Queensland mothers, babies, families and those who care for them,” Ms Rooney said. 
 
“We know Queensland midwives are deeply concerned, distressed and experiencing exhaustion and burn out as a result of unsafe workloads and concern for those in their care. This cannot continue.” 
 
The QNMU and its members have long called for the introduction of midwifery ratios, like those outlined in Safe Workloads in Midwifery standards, to ensure mothers and babies are counted as separate patients and safe workload standards put in place. The QNMU’s Safe Workloads in Midwifery standards are one midwife to two babies and two mothers or 1:4 and a total of one midwife to three babies and three mothers or 1:6. The QNMU’s Count the Babies audit found:  

  • 7% of midwives reported up to 18 babies and mothers in total at end of shift
  • 27% of midwives reported handing over up to 16 babies and mothers at end of shift
  • 34% of midwives reported handing over more than 8 babies and mothers at the end of shift
  • 61% of babies born during the audit were unqualified or not counted as additional patients or included in midwives’ workloads 
  • 20% of respondents reported having unqualified or uncounted babies under 37 weeks' gestation in their care on the maternity ward
  • Almost 20% of respondents indicated they cared for between 1 and 3 unqualified or uncounted babies that required intravenous antibiotics and additional care
  • 27% of midwives reported at least one woman in their care required additional psychosocial support. A further 50% reported having 2 or more women in their care requiring additional psychosocial support
  • Overall, 29% of private and 25% of public hospital midwives reported acuity or need as high  
  • More than 50% of women receiving care had a caesarean section (major surgery) and less than 30% had a normal birth     
  • Over 84% of private hospital midwives and 64% of public hospital midwives reported the average acuity as medium or higher 
  • Midwives considered few women and/or babies under their care as low acuity (only 7.5% in private hospitals and 24% in public hospitals).

 
Ms Rooney said the audit findings were reported to the Queensland Health (QH) and state and federal governments. A second QNMU Count the Babies audit is planned for 2023.  
 

CtB audit recommendations include:  


  • Modernising the federal maternity services funding model to count and funding each baby as a separate entity to the mother (this is not currently occurring)
  • An urgent review of and change to the concept of ‘qualified neonates’ as defined under The Health Insurance Act 1973 regulation to ensure all babies are counted and funded
  • Genuine investment in, and growing of, the midwifery workforce and expansion of evidence-based continuity of midwifery care models
  • Removal of barriers that stop midwives working to their full scope of practice.

The QNMU applauds the state’s invaluable midwives.

The QNMU's Count the Babie audit report can be found at www.qnmu.org.au/CountTheBabies