Health policy: outcomes for rural residents’ access to maternity care

Regular health care during pregnancy, birthing and the postnatal period is recommended for improving maternal and neonatal outcomes and accessing such care has become a common expectation for Australian families. Studies have highlighted the relative safety of birthing in rural hospitals even though these units are typically associated with low volumes of deliveries. Yet, in Queensland, the location and number of public maternity units shows a clear trend towards centralisation of services. During 19952005, 43% of Queensland public maternity units closed, with the remaining units predominantly located in coastal and more populated locations. The closure of rural maternity units is not restricted to Queensland: the National Rural Health Alliance estimated 130 rural maternity units had closed across Australia throughout the decade 1996-2006. Growing numbers of closed rural maternity units raises considerable questions regarding the care accessed by rural residents. This paper presents findings from research conducted in north Queensland which examined the impact of health policy on an issue that is of central importance to rural communities—access to birthing services.