To prevent a reoccurrence of pregnant patients lying on the floor in Frere Hospital’s labour and delivery ward, the Eastern Cape health department will appoint 18 new midwives to the ward by the end of August.
The department said its appointments were at an advanced stage and were vital, as Frere maternity’s already constrained staff will lose six nurses to retirement at the end of the month.
These appointments are part of a strategy the department has implemented to prevent the crises that culminated in May that, through investigative reporting from GO!&Express, revealed pregnant patients lying on the floor in the ward’s admissions passage.
Patients were seen lying on the benches, couches and on floor cushions, waiting for an available bed for hours and even days with some of them as overdue as 42 weeks.
The department said this was caused by an influx of patients being referred to Frere from their local clinics and four surrounding district hospitals, resulting in the hospital effectively providing services to 3-million people with constrained staffing and resources.
Department spokesperson Siyanda Manana confirmed that in addition to the new midwives the department will also be strengthening the referral system between Frere and Cecelia Makiwane and empowering the latter with staff and resources to handle more births.
Presently the influx of pregnant patients at Frere who are both antenatal and postnatal are being accommodated in Frere maternity’s M4 ward as a short-term crises intervention.
M4 was used originally for gynaecology and obstetrics patients however gynaecology patients have been moved to ward C9 in the main hospital to focus on the overflow of obstetrics patients.
On most days, the ward is completely full, with all 32 beds in the ward taken up, with an average of three nurses and no cardiotocography (CTG) machines, which are used to monitor foetal heart rate.
On July 25, GO!&Express called the ward and confirmed that at the time of calling , it was being manned by only one community service sister.
In response to questions, the department said: “We are not in an ideal situation, but we are guided by the severity of the patient’s condition and reroute patients to the area of care that is equipped for the person.
“In obstetrics there is quick patient turnover, so patients are being admitted and discharged all the time. But, in the long-term, we will be strengthening primary healthcare services, improving outreach to referring institutions to capacitate staff to deal and manage certain patients that can be managed at lower levels, as well as equipping doctors working in peripheries.
“We continue to serve our community and mothers with what we have and not turn away any pregnant woman seeking medical attention.”
On July 29, GO!&Express visited the hospital and saw four expecting mothers, once again, lying on the couches and benches in admissions in labour and delivery. However, the mothers said they were not part of the overflow patients but were emergency cases that had been told to wait in admissions to be monitored more closely.
After her delivery, one of the four mothers said: “I arrived 6am and the doctor examined me immediately, as I came here for c-section.
“They kept checking us and the doctors and nurses are doing their best to accommodate all the patients.
“We have our bundles (of joy) in our hands, and they are healthy and strong. Thanks to GO! because their service improved after your article.”
Dr Margreet Bernardt from Sensitive Midwifery network, for independent midwives, welcomed the imminent appointment of the 18 midwives.
She said: “If all the clinics and district hospitals that filter into Frere Hospital had passionate, dedicated, quality midwives and an enabling environment, mothers would choose those settings.
“It would be amazing if we have dedicated midwife-led units who are run by quality, passionate midwives, close to the mothers’ homes. These places should be the options of choice for women to go there, not the tertiary referral hospital, which is intended for high-risk pregnancies and births.
“There is a shortage of ‘skilled’ midwives, meaning those nurses who have dedicated themselves to working in maternal and neonatal care.
“In SA, midwifery education is part of nursing education but many young graduates are scared to work as a midwife and work in other departments.
“There is a massive need for midwives that are trained to international standards.
“We also need to ensure that students receive education tailored specifically to midwifery, rather than needing a nursing background first,” Bernardt said.
