By Megan Gorrey
Continuous care and improved maternal consent practices will form part of the NSW government’s response to a landmark birth trauma inquiry as Health Minister Ryan Park apologised for the state’s failure to provide a higher standard of care to thousands of women.
The government on Thursday supported 42 of the 43 recommendations from the inquiry, an Australian first, which were informed by more than 4000 submissions and six days of hearings in Sydney, Wollongong and Wagga Wagga between September 2023 and April this year.
Health Minister Ryan Park acknowledged the government had a lot of work to do to improve maternity care for women. Credit: Edwina Pickles
It heard harrowing testimonies from thousands of women across NSW who had experienced birth trauma – physical, mental and psychological injury or distress during pregnancy and childbirth.
The government said in its response it would speed up the delivery of five initiatives in the next 12 months to boost access to maternal continuity of care models; provide trauma-informed training for healthcare workers; improve the provision of information for women to enable them to be actively involved in decision-making and to give informed consent for labour and birth interventions; and to better support women who experienced pregnancy complications.
Park praised the courage of women who shared their “deeply personal and difficult experiences” and said the government was committed to improving mothers’ diverse health and wellbeing outcomes.
“We apologise to women who have not received the high standard of maternity care they should have,” Park said.
The inquiry’s final report had recommended as its top priority that all women should be provided access to continuity of care with a known provider throughout pregnancy and birth.
The report also urged that NSW offer comprehensive antenatal education, review laws around informed consent and require informed consent training for maternity health practitioners.
It suggested the state should better support women’s birth preferences, improve mental health support and postpartum services, and adopt trauma-informed practices in maternity care.
In its response, the government noted but did not support the 43rd recommendation as it was a request for the select committee chair, Animal Justice MLC Emma Hurst, to ask the Health Care Complaints Commission to consider publicly reporting maternity care and birth trauma complaints.
Hurst acknowledged the government’s support for most recommendations, but said the women who shared their stories in the hope of triggering “systemic change” needed to be assured that “major reform and appropriate funding will be dedicated to this space, not just tinkering around the edges”.
“I will be holding the government to account and ensuring the recommendations of this inquiry – which came directly from the birthing women in NSW – are fully implemented.”
Hurst had wanted expanded access to the Midwifery Group Practice – a scheme in which women are cared for during their pregnancy, birth and postnatal period by the same small team of midwives.
The government said it was committed to increasing access to midwifery continuity of care models.
Australasian Birth Trauma Association chief executive Amy Dawes said the inquiry highlighted the need for individualised care, whether that meant a home birth or a caesarean by an obstetrician. She said Park’s apology had “acknowledged and validated” women’s experiences.
“As an organisation, we feel incredibly hopeful, especially around the five initiatives to be accelerated,” Dawes said.
Sydney obstetrician and gynaecologist Dr Talat Uppal acknowledged maternity care was a “complex space” and she believed “we need to take women on that journey antenatally better”.
“Women come out on top when they have options,” she said.
The inquiry was triggered by complaints from 30 mothers about maternity services at Wagga Wagga Base Hospital, including allegations some were forcibly held down or given inadequate pain relief.
Australia’s largest study of women’s birth experiences found in 2022 that one in 10 women felt violated disrespected or abused during birth.
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