Select Committee on Birth Trauma chair disappointed by lack of support for consideration of 'gendered violence'
Birth trauma inquiry chair Emma Hurst described the report as "just the beginning" of work to protect parents from harm and distress. (ABC News: Keana Naughton)
The head of a New South Wales parliamentary inquiry has expressed her disappointment at the lack of support for birth trauma to be considered a form of "gendered violence".
The Select Committee on Birth Trauma has released its report with five findings and 43 recommendations to try to ensure more people do not suffer trauma during their pregnancies and childbirth.
The findings state that a number of individuals have suffered preventable birth trauma in NSW, that their experiences are "distressing and unacceptable", and that urgent efforts must be made to address this.
"Our hope is that the evidence documented in this report will not only inform the NSW government's consideration of these matters, but more importantly, prompt action across Australia and the world with the hope that every birth is met with dignity, respect and compassion," committee chair and MP Emma Hurst said in the report.
The inquiry's priority in its 43 recommendations is for the NSW government to ensure that all women have access to continuity of carer models with a known provider.
However, it stopped short of recommending universal access to the Midwifery Group Practice, something advocates had been calling for.
Ms Hurst said she was disappointed by this outcome.
"This report doesn't go far enough. I think that we needed to be much stronger in our recommendations around Midwifery Group Practice," she said.
Naomi Bowden was one of dozens of women who gave evidence, sharing her experience of her daughter's stillbirth. (ABC Illawarra: Sarah Moss)
The inquiry also recommended the need for comprehensive antenatal education, a review of laws around informed consent, and a requirement for maternity health practitioners to undergo formal training in this area.
It also asked for greater investment in mental health support and postpartum services, and the adoption of trauma-informed care practices in maternity care.
After testimony from several mothers who experienced stillbirth and miscarriages, the report also recommended specific spaces for women experiencing maternity loss in public hospitals.
This included waiting rooms separated from pregnant women and babies, as well as additional state-funded psychological support for parents who experience loss.
One of the recommendations was also directed at health practitioners who provide individualised maternity care to ensure their patients' birthing decisions and preferences are "supported and respected".
The inquiry has asked the NSW government to undertake consultation to consider whether legislative change was needed to protect these staff.
Missing midwives
Mother Kate Finch said her experience of birth improved dramatically after she gained access to the Midwifery Group Program, which pairs a woman with a known midwife before, during and after birth, for her second baby Cooper.
"I don't want anyone to have to go through the trauma and loneliness of that hospital delivery I had in my first birth," she said.
"I want Health Minister Ryan Park to make sure that every woman in NSW can access this midwife continuity of care."
Kate Finch gave evidence at the NSW Birth Trauma Inquiry of her positive experience with the Midwifery Group Program. (ABC News: Keana Naughton)
Doctor Amanda Cohn was a committee member who opposed restricting the continuity of care recommendation to midwives only.
She said allowing an open-ended recommendation allowed for regional and rural women to access GP and obstetrician-led continuity care, which sometimes could be the only option available.
Consumer group Better Birth Illawarra agreed elements such as the lack of universal Midwifery Group Practice was disappointing, but said the report was a good first step.
"This is a once-in-a-generation opportunity for the NSW Health Minister Ryan Park and the NSW government to embed a woman's right to access an empowered birth in maternity health systems," founder Sharon Settecasse said.
Call for 'gendered violence' inclusion
Chair Emma Hurst included a dissenting statement in the report, outlining recommendations which were either "watered or voted down" by other committee members.
Women in Wollongong protested outside one of the inquiry's six hearings. (ABC Illawarra: Sarah Moss)
She had wanted a finding that some cases of birth trauma should be considered a form of gendered violence, and for a recommendation that the NSW government investigate the possibility of legislative changes to recognise obstetric violence.
"This fails to recognise the power imbalance between birthing parents and health practitioners, and the systemic issues that were clearly presented to the committee regarding the presence of obstetric violence in maternity care systems globally," the chair stated in the report.
"Failure to even consider legislative changes to protect birthing parents from obstetric violence is unacceptable."
NSW government MPs also disagreed with a recommendation that was included in the report.
Recommendation 31 asked the NSW government to appoint a Chief Midwifery Officer.
"We do not believe the inquiry sufficiently established a case to support appointing an additional high-paid executive in NSW as the best use of resources," Labor MP Emily Suvval stated in the report.
"And equally, we believe a fiscally responsible approach would include a review of the progress already achieved to strengthen senior midwifery representation in the NSW government."
8,000 mothers surveyed
The inquiry was set up following a mass complaint launched by mothers against the Wagga Wagga Base Maternity Ward and on the heels of research by the University of Western Sydney.
A survey of 8,000 mothers found one in three experienced birth trauma in Australia, and one in eight experienced obstetric violence — defined as preventable harm in maternity care.
The inquiry received a record 4,000 submissions and held six hearings across the state.
It heard from women who reported inadequate and disrespectful care, mothers who were denied pain relief, bullied, coerced, and given medical procedures without consent in NSW hospitals.
It also heard of experiences of racism and discrimination during pregnancy and birth.
Medical professionals gave evidence of extreme understaffing, a lack of trauma-informed training, and defended life-saving decisions made under emergency scenarios.
Mr Park welcomed the report, and praised the efforts of birthing advocates and the mothers who gave testimony.
"I'm very pleased that the report was handed down," he said.
"We as a system now will carefully and methodically work through this and respond."
He said work had begun to improve the system, with a state birthing and maternity blueprint underway, and an expert advisory group and a consumer group in place.
The NSW government has three months to respond to the inquiry's report.