Nurses and midwives at a Sydney hospital will turn away pregnant women from Monday under strict new geographical boundaries that have been imposed to counter critical staff shortages.
According to a resolution unanimously endorsed at a NSW Nurses and Midwives Association meeting a fortnight ago, staff at Penrith's Nepean Hospital maternity ward "have no choice but to limit the number of new maternity patients who enroll" until such time that management can ensure their ward is "appropriately staffed".
While staff have assured the community that no "high risk" or emergency obstetric patients will be denied care, the move will leave expectant mothers in the Blue Mountains with no maternity service.
"We are forced to this position with the greatest regret for our community," said the staff resolution, adding: "We urge management to progress and recruit midwives against the vacancies as an absolute priority."
In stark contrast to the resolution passed by her staff, Nepean Blue Mountains Local Health District chief executive Kay Hyman claimed there was "no change" in the admission criteria for maternity services. She also insisted the hospital would still welcome Blue Mountains residents.
But on Friday, a Nepean midwife told Fairfax Media: "We will turn them away. We're stretched to the brink. The time has come where we either look after a few people well or a lot of people badly."
With a chronic shortage of midwives across the state, there are growing fears amongst health hierarchy that the Nepean revolt could trigger a domino effect by maternity staff at Sydney's flagship hospitals including Liverpool and Westmead.
One senior area health service source said: "It's official: Midwives have been stretched as far as they will go. They are committed to providing the highest standard of care but under present workloads, that's now impossible. Westmead is in a worse state than Nepean."
In March, a Fairfax Media investigation obtained an internal hospital document showing Nepean Hospital's maternity department was 21 full-time staff short, leaving midwives concerned the department was "no longer able to function safely".
The story also revealed that in order to meet "financial obligations" Nepean was being further stretched by a budgetary directive that it slash its use of agency midwives, nurses and overtime.
While local area health management denied services were being compromised, the cracks had already started to show.
On February 5, a heavily pregnant Paula Bailey arrived at Nepean Hospital with her husband, Scott, only to be sent home three hours later without any medical assessment.
When Mrs Bailey arrived home, her water immediately broke, triggering a frantic dash back to Nepean where she gave birth in the car park.
Two days later, an overdue Michelle Trotter presented at Nepean, only to be sent packing with Panadeine Forte and sleeping pills. Within two hours, she was rushed back, having given birth on her own kitchen floor.
Three months on, Nepean midwives claim bosses have still not provided a "credible plan" for recruiting or backfilling the 21 vacant positions in the Woman and Children's Service.
But Ms Hyman said the area health service "actively recruits to fill any staffing vacancies" and continues to meet with maternity staff about "any issues or concerns."
"We have advertised nationally and internationally and have already successfully recruited to 12 positions. Four midwives have already commenced, with the remaining to begin working at Nepean Hospital throughout June and July."
While the NSW Government insists it is searching for genuine solutions to its midwife recruitment problem, Fairfax Media has found there is still no midwife re-entry course available in NSW to professionals wishing to rejoin the workforce.