英国の妊婦「たらい回し」事情医師の一分/ウェブリブログ

英国の妊婦「たらい回し」事情

<< 作成日時： 2008/03/22 00:25 >>

　満床のため妊婦の「たらい回し」がイングランド中でおきている。
　保守党による調査で、調査に応じた103のトラストの40%以上が入院を断ったり他へ転送した。大きな出産施設ほど断らざるをえない危険な状態にある。1/10の施設は10回以上断ったという。イングランドで最も大きな出産施設であるLeicester大学病院でも28回閉鎖した。年間3,000分娩以上を扱う施設の74%が妊婦受入を断った。
　労働党のマニフェストでは2009年までに全ての女性が選択権を持てるようにすると言っている。また全ての女性が同じ助産婦が妊娠の間中をサポートするようにするとも約束している。
　既に施設が限界を超えているのに、政府は出産施設を閉鎖する計画である。労働党政府は、小規模な地方の施設を切り、大きな施設に集中させる計画である。
　妊婦は出産のために旅行したくはない。出産が迫ってきて、施設が閉まっていることに気づくのは大変なことだ。他の病院に転院させるのは例外であるべきである。そうできるのはその間に可能な限り母子の世話ができると保証できる時のみである。
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Last Updated: Thursday, 20 March 2008, 08:21 GMT
Maternity units closed to mothers
http://news.bbc.co.uk/2/hi/health/7304811.stm

Pregnant woman
Some maternity units frequently have to turn women away

Many hospitals across England had to turn away women in labour last year because they were full, figures show.

More than 40% of 103 trusts that responded to a survey by the Tories said they had shut their doors or diverted women to other sites.
Larger maternity units seemed to be more at risk of having to close, the inquiries by the Tories suggested.
The government said maternity units sometimes were forced to take action because it was hard to predict demand.
Labour's manifesto statement says that by 2009 all women will have choice over where and how they have their baby.

It is a major cause of anxiety to telephone, or even arrive at a maternity unit, when in labour to find the doors are shut
Spokesperson, National Childbirth Trust

It also promised that every woman would be supported by the same midwife throughout her pregnancy.
Out of 103 trusts - 70% of the total - providing maternity services that responded to the freedom of information request, 42% had to close their units or divert women to another site at least once in 2007 because of capacity problems.
One in 10 said they had shut their doors more than 10 times.
University Hospitals of Leicester NHS Trust, one of the biggest maternity providers in England, reported closing 28 times.
Of those trusts that had to turn women away, 74% had more than 3,000 births last year, the Conservatives said.
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Shadow health secretary Andrew Lansley said: "The government's plans to close maternity units when services are already overstretched fly in the face of common sense.
"Labour are fixated with cutting smaller, local maternity services and concentrating them in big units.

When this does happen it is often only for a few hours and to ensure mother and baby can receive the best care possible
Department of Health

"But women don't want to have to travel miles to give birth.
"And they certainly don't want to have to travel even further because they're turned away by the hospital of their choice."
A spokesperson for the National Childbirth Trust said: "Parents lose all sense of control when they are told that the unit at which they have planned to give birth has been closed temporarily, at short notice.
"It is a major cause of anxiety to telephone, or even arrive at a maternity unit, when in labour to find the doors are shut.
"Unscheduled closures should only occur in very exceptional circumstances when to keep a unit open would be unsafe."
A Department of Health spokesperson said diverting women to other hospitals should be the exception rather than the rule.
"It is difficult to precisely predict when a mother will go into labour and sometimes, at times of peak demand, maternity units do temporarily divert women to nearby facilities.
"When this does happen it is often only for a few hours and to ensure mother and baby can receive the best care possible."
Sally Russell, director of Netmums said: "This puts women in a state of anxiety around childbirth at a time when they want everything working in the right way.
"There's a tendency for PCTs to think of birth as a one-off occasion but it affects mothers and children for a long time to come so it's important to get this right."
Louise Silverton, deputy general secretary of the Royal College of Midwives, said women should have a choice of how and where they give birth.
"If a unit closed because of staff shortages, then their choice is eroded and their experience of birth suffers."

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　英国では妊婦の50%が病院から追い払われる。
　ＮＨＳの母性ユニットは満床のため半数近く施設で妊婦を追い払う必要があった。さらに、設備とスタッフ不足のために1/10の施設が10回以上閉鎖していた。大きな出産ユニットのほうが小さいものより閉鎖せざるを得なかった。
　妊婦は遠方の病院へ行きたくないし、選んだ病院に断られたために別の病院へ行きたくはない。
　40代女性の妊娠増加と肥満妊婦の増加の圧力にさらされている。出産を扱う147のＮＨＳトラストのうち103がデータを提供した。このうち42%は閉鎖か、受入困難で別の施設に移ってもらった。
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Women in Labor Turned Away from Wards
Nearly 50% of Expectant Mothers in the UK Were Turned Away from Hospitals
http://abcnews.go.com/Health/story?id=4487660&page=1
LONDON, March 20, 2008

Nearly half of NHS maternity units had to turn away women in labour last year because they were full, figures showed on Thursday.

Furthermore, a shortage of facilities or staff led to almost one in 10 of these trusts closing more than 10 times.

The figures, collected by the Conservative Party under the Freedom of Information Act, showed large maternity units were more likely to be forced to shut their doors than smaller ones.

Shadow Health Secretary Andrew Lansley argued the government's policy of closing small maternity units in favour of larger ones "flew in the face of common sense", and he called for the retention of smaller wards.

"Women don't want to have to travel miles to give birth," he said.

"And they certainly don't want to have to travel even further because they're turned away by the hospital of their choice."

The Royal College of Obstetricians and Gynaecologists (RCOG) said 400 extra consultants are needed in England and Wales.

Maternity units are being put under additional pressure because of the growing birth rate, increased numbers of obese women giving birth -- who require extra care -- and the rise in the number of women in their 40s becoming pregnant.

Richard Warren, RCOG honorary secretary, said: "It is imperative to ensure that maternity units are appropriately staffed and resourced to meet the demands that the service requires."

Of the 147 NHS Trusts that provide maternity services, 103 provided figures.

Of these, 42 percent reported having closed or having been forced to divert women to another site at least once last year because of capacity problems.

(Reporting by Avril Ormsby; Editing by Steve Addison)