The Rural Doctors Association of Victoria
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Obstetrics
The availability of maternity units is highly significant for the rural population of Victoria.
The Victorian rural population is isolated and requires maternity units within reach of expecting mothers. Traveling in labour is dangerous and the more that do it the greater the number of adverse outcomes. ½ hr traveling time is optimum but no longer achievable because of unit closure. 1 hour travel distance should be feasible for the State to keep babies 'born before arrival' to a minimum.
Repeated studies have shown rural obstetrics in accredited units to be safe no matter how small the unit. GP Obstetricians work in all sizes of rural towns including the larger where they supplement to work of specialists. There are strong indications that rural specialist obstetricians are diminishing in numbers.
8 Training positions are funded by the State through the Regional training programs. They are open to any selected doctor available for the one year period, but also by negotiation can be spread over a longer period of time in conjunction with registrar training. Doctors with adequate overseas experience can have their capabilities checked and work without formal Australian qualification.
The Diploma of Obstetrics is a qualification aimed at antenatal care only. The FACRRM (obstetrics) will be a formal credential for rural obstetrics. The Joint consultative Committee (ACRRM, RACGP and RANZCOG) operates a system of certification. RDAV is happy to provide further advice concerning these qualifications.
Rural GP obstetricians throughout Australia are credentialed to perform instrumental delivery and Cesarean section. They work in collaborative teams with Midwives. The aim is safe working hours which allow the GP to additionally conduct community practice.
Whilst the GP may conduct deliveries according to maternal choice, normal deliveries are conducted by midwives. GP obstetricians must maintain skills in normal delivery. In larger units with good on-call back up and good midwife skills, GPs do not always attend every delivery unless by choice.
Closures of units continue to occur. The RDAV is highly concerned to protect the remaining network of rural units. Any doctor wishing to obtain assistance with studying or practicing rural obstetrics may contact the RDAV to help facilitate training or placement.
Where decisions counterproductive to proper operation of maternity units are being made, it may also assist to contact RDAV early.
