After an almost hour-long briefing, several things became apparent. Most important was that it is unlikely birthing services will return to Milton Hospital within the next two years, if at all.

How did it come to this? Three “adverse outcomes” led to the hospital’s maternity ward being delineated as level two, meaning it could only handle non-risky births. This saw the number of births drop which, in turn, led to the deskilling of obstetricians and midwives. And that has led to the current situation, where doctors say the deskilling makes it too dangerous to continue delivering babies at the local hospital.

Ms Mains was hesitant to say definitively the delineation to level 2 in 2013 led to the drop in births but did concede it may have contributed.

As with any service, the less patronage, the less viable it becomes.

Maternity services at Milton have reached the point from which there well may be no return. Ante and post-natal services will continue but birthing itself is destined to become a memory if the situation is not turned around quickly. And there seems very little chance of that.

Attempts to rotate doctors and midwives through the level 4 maternity ward at Nowra appear to have broken down. Doctors agreed to the rotations – designed to keep their skills up – if there was a guarantee Milton Hospital’s delineation would rise. Ms Mains said she was unable to give this guarantee.

She explained there were many dimensions to the delineation, not the least of which was the need for considerable capital expenditure for equipment and a nursery.

Add to that the reluctance of new doctors to relocate to the area and the future looks destined to have the vast majority of babies born in Nowra.  

One thing about which Ms Mains was adamant was that she was not attempting to impose a New Zealand maternity model in the local health district. 

The old maxim, “use it or lose it”, seems to have been proven here and it will take a mighty effort to turn things around.