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Maternity care and services in rural Tasmania : the perspectives of rural women and health professionals

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Hoang, THH (2012) Maternity care and services in rural Tasmania : the perspectives of rural women and health professionals. PhD thesis, University of Tasmania.

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Abstract

Despite strong records of safety and quality maternity care, maternity care in
Australia is not meeting the needs of rural and remote women as evidenced by poor
access and outcomes. Rural communities have experienced substantial and ongoing
loss of maternity services for more than a decade. Consequently, rural women
have to leave their community and support networks to go to distant centres to
give birth. The loss of these critical health services has adversely affected rural
women, families and communities. Workforce shortages, safety and quality
considerations and cost considerations are the three interrelated reasons which
have led to the loss of small rural birthing services in Australia. To improve
maternity services in rural communities, it is important that women’s needs for the
services are identified and catered for as much as possible.
This study aims to:(i) identify the needs of women in maternity care in rural areas,
(ii) examine the current available maternity health services in rural Tasmania and
(iii) identify the gaps between the needs and services. A conceptual frame work
based on a literature review was constructed to guide the study. The study
employed a mixed methods design with a self-administered mailed survey and
semi-structured interviews as data collection methods. Six rural communities which
are representative of all rural Tasmania were chosen to conduct the study. Through
the health care and child health centres in these communities, 600 survey
questionnaires were sent out to women. The survey response rate was 35%. Semistructured
interviews were conducted with 22 women and 20 health professionals.
Descriptive statistics and Chi Square tests were used to analyse the survey data with
the use of SPSS 15. The interview data were analysed using grounded theory and
thematic analysis with the use of NVivo v8.0.
The findings indicate a set of unmet maternity needs of women in rural Tasmania
namely (i) access needs, (ii) safety needs, (iii) needs for small rural birthing services,
(iv) information and support needs, and (v) needs for quality services. The study suggests that the lack of maternity services in the Tasmanian rural areas transfer
risk from the health care system to rural families because of privileging of medical
model over a feminist theorising or primary care approach. The study provides
important recommendations for bridging the gaps between the women’s needs and
currently available maternity services. Firstly, antenatal, postnatal and support
services should be provided in the local communities through outreach or visiting
services. Secondly, rural hospitals without maternity services should be properly
equipped and prepared to deal with unexpected emergency childbirths to ensure
the safety for women and babies. Appropriately equipped and skilled ambulance
services should be in place for all rural hospitals. In addition, further withdrawal of
rural birthing services should be challenged and consideration given to reopening
closed rural services. Furthermore, women should be informed about all options
and services available through the collaboration of health professionals in local
areas and the regional hospital. Finally, child health services in rural communities
should provide quality services for women throughout their pregnancy and
postnatal period as part of continuity of care.
In summary, this study makes a contribution to the enhancement of maternity care
and services in rural Tasmania and consequently to improve access and outcomes
for rural women and their families.

Item Type: Thesis (PhD)
Keywords: rural women, maternity care, women's needs, rural maternity services, Tasmania
Copyright Holders: The Author
Copyright Information:

Copyright 2012 the Author

Additional Information:

Appendix 2 is a chapter from a published book:
Hoang, H., Le, Q., & McManamey, RM (2011). Social Impacts of Closure of Maternity
Services in Rural Areas. In Q.Le (ed), Health and wellbeing: A social and cultural
perspective, pp. 69-78. New York: NOVA Science Publishers Inc.

Date Deposited: 17 Aug 2012 04:33
Last Modified: 15 Jun 2016 02:33
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