By Megan Gorrey
NSW should appoint a “chief midwifery officer” and boost the number of midwives in the state to reduce the likelihood of women experiencing trauma when giving birth, an inquiry has urged.
An upper house committee on Wednesday handed down 43 recommendations from the state’s landmark birth trauma inquiry, which was informed by more than 4000 submissions and six days of hearings in Sydney, Wollongong and Wagga Wagga between September 2023 and April this year.
Animal Justice Party MLC Emma Hurst says the “unprecedented” amount of evidence the inquiry received reflected the growing recognition of the importance of tackling this “form of gendered violence”. Credit: Kate Geraghty
Animal Justice MLC Emma Hurst, who chaired the inquiry, said in the final report the stories many women shared about their experiences of giving birth in NSW were “distressing and unacceptable”.
“It was clear to the committee that there are a significant number of individuals who have suffered preventable birth trauma in NSW,” she said.
“We also found that urgent efforts must be made to address avoidable and preventable factors that contribute to birth trauma.”
The committee said the inquiry identified critical gaps in support for women, including: “A lack of continuity of care, lack of trauma-informed practices, inadequate antenatal education, inadequate informed consent practices, a lack of respect for women’s birthing choices and experiences, and a lack of inclusivity and culturally appropriate services within maternity care.
“We also heard that some of these issues are exacerbated by maternity workforce shortages and resource constraints,” the report said.
The committee recommended as its top priority that all women should be provided access to continuity of care models with a known provider throughout their pregnancy and childbirth.
“Midwifery continuity of care was identified as the ‘gold standard’, which is why the report also recommends the NSW government invest in and expand midwifery continuity of care models, address midwifery shortages and appoint a standalone chief midwifery officer,” the report said.
The job of a chief midwifery officer – a role that exists in Queensland and the UK – would be to advise the state government and help tackle a shortage of maternity health services.
Jessica Santos, with son Kaya, and Katherine, with son Cooper, experienced traumatic births with their first children. They are urging the NSW government to enable women to access continuity of care during their pregnancies and childbirth. Credit: Kate Geraghty
Ashfield mother Jessica Santos, 39, agreed enabling women to have the same midwife throughout their pregnancy and birth should be a priority for the government. Santos said she suffered from a “fragmented model of care” when she gave birth to her daughter at a Sydney hospital in 2022.
“I ended up giving birth with an unknown midwife, who I didn’t feel was invested in my labour.
“I really do believe that if I had stayed with [my original midwife], I would have had a vastly different and positive experience with her.”
The report recommended NSW offer comprehensive antenatal education, review laws around informed consent, and require informed consent training for maternity health practitioners. It also suggested the state should support women’s birth preferences, improve mental health support and postpartum services, and adopt trauma-informed care practices in maternity care.
Labor MPs opposed the appointment of a chief midwifery officer “without seeking to undertake a review of the evidence available to support this investment”.
“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 Suvaal said in the report.
In a dissenting statement, Hurst expressed disappointment that some critical recommendations had been “watered or voted down by the majority of committee members”.
She wanted a finding that some cases of birth trauma could be considered a form of gendered violence and for the government to investigate legislative changes to recognise obstetric violence.
Hurst also 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.
Hurst said on Wednesday the report was “just the beginning”.
“There’s still a long way to go. I think as this becomes a real global conversation, a lot of those recommendations will come up for further conversation,” Hurst said.
Health Minister Ryan Park said the government would consider the report and respond in time.
The inquiry, the first of its kind in Australia, was triggered by complaints from 30 mothers about maternity services at Wagga Wagga Base Hospital.
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