Wagga GP obstetrician Trudi Beck and physiotherapist Jenna Mooney explain birth trauma and how can it be avoided

Studies into the birthing experience in Australia have shown more than 30 per cent of women go through birth trauma.

Pelvic health physiotherapist Jenna Mooney is part of the multidisciplinary team at Wagga's Nova Heath that seeks to deliver "gold standard" care for new and future parents.

She said while injuries during birth are relatively common, these are not always traumatic. Birth trauma is something unique to each person that experiences it.

"There can be physical birth trauma like tears, prolapse, urinary leakage, or psychological trauma - that is not understanding what's happening, having a lack of choice, being through experiences like blood loss or medical intervention," she said.

"Some women may come through birth without a physical injury ... but will come out with birth trauma because of other factors that have played into it.

"It's not straightforward. It's unique to every individual, and not just about the birth itself. It's about what's happening in their lives at the time of birth, what their beliefs are, and what their coping strategies are."

Difficult births can become traumatic when people feel they have lost control over the process.

Nova Health GP obstetrician Trudi Beck said doctors can can take steps to stop a difficult birth from becoming traumatic.

Informed consent from patients is essential, but often challenging for practitioners to obtain during the labour process - fear, pain and drugs may impair someone's ability to take on new information and make decisions in the moment.

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Dr Beck said antenatal education is vital to reducing the burden on everyone during what can be a fraught time for new families.

"In most cases, it's [birth trauma] related to a loss of feeling of control, or lack of psychological preparedness for what was to come," she said.

"At the other end of the spectrum, there are women we see professionally and think 'that sounds like a very challenging birth', but if they have been prepared psychologically, if they felt well supported, if they've been well communicated with, they may not perceive that as trauma.

"The language and communication that are used can be the difference between a birth injury and birth trauma.

"We know challenging things happen around the process of pregnancy and childbirth. We need to ask what things we can put in place so that trauma is not the consequence of a birth injury."

Ms Mooney and Dr Beck said the best way to avoid birth trauma is to ensure people feel supported through "continuity of care" - that is seeing the same professionals through the antenatal, birthing and postnatal process.

The trust and understanding that develops through long-term engagement can prepare families to have difficult conversations before, during and after the birth.

Multi-disciplinary care from obstetricians, psychologists, physiotherapists and other allied health workers offers the best preparation for the many challenges that can arise giving birth.

Understanding possible complications and decisions that may have to be made in the moment ahead of time is key to making families feel they have agency over the process and normalisation of their experiences.

"The one thing we really try to hammer home in our patient cohort is the right to them having informed consent over the process of childbirth and labour, because that's something that probably isn't mainstream enough," Dr Beck said.

"Although things might be done under time pressure - and I know what that time pressure feels like from a clinical point of view - there is always time to respectfully discuss with a woman that this is what we think we should do, this is the alternative, what do you think?

"It's about antenatal education. We can talk about how to best physically and emotionally prepare their body with the information that's available in a perfect world, women would be seen on a continuity basis with multi-disciplinary support. That's the gold standard worldwide."

Unfortunately for many women, this level of care remains out of reach. The resources necessary to offer gold standard care are rarely available through the public system.

This can leave families thousands of dollars out of pocket for what Ms Mooney views as necessary consultations to prevent birth trauma.

"It's really challenging to access public health care for specialists in allied health - especially pelvic floor physio," she said.

"In NSW, we're really limited in what we have available, and I don't agree with that. It's something all women should have access to both in pregnancy and post-birth.

"But also psychology and other aspects of care. That's an area I really hope to see improve in the future, because It's something a lot of women can't access because of cost - especially rurally and regionally."

Law firm Slater and Gordon will visit Wagga in September to consult with women who believe they have experienced birth trauma.

Wagga's scheduled hearing for the birthing trauma inquiry has been delayed, due to an "unprecedented" number of submissions.

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