Birth trauma inquiry hears women's needs ignored during birth

A NSW parliamentary inquiry into birth trauma has heard the health of a baby is often prioritised over the wellbeing and autonomy of the mother, which has lasting impacts.

The inquiry, which received 4000 submissions from mothers, doctors and midwives around Australia, is examining the prevalence and effects of birth trauma and whether there are sufficient protections for patients.

The probe was prompted by dozens of complaints lodged by the Maternity Consumer Network about birthing trauma experienced at Wagga Base Hospital.

During an inquiry hearing in Sydney on Monday, several women shared details of birth experiences that left them suffering physical and mental injuries, including a refugee mother who said she was racially discriminated against by hospital staff.

Six weeks after being granted a protection visa and settled in Australia, Elahe Yazdani discovered she was pregnant with her first baby.

As a single mum in a new country, Ms Yazdani said she had little support during and after her pregnancy and was often given information in English, even though it was not her first language.

At 41 weeks, she was forced to have an induction and later an emergency caesarean against her wishes.

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She was also asked to sign medical consent papers without adequate translation and interpretation services.

Ms Yazdani said three years on from her son's birth, she still felt she was a "nobody" in the hospital.

"Because my hair is black, because English is not my first language, because I'm a refugee, because my skin is brown, why don't you care about me? I'm here like any other patient," she said.

Dulce Munoz, who gave birth to her daughter in 2010, said sexism, racism and ageism in the state's hospitals was systemic.

After enduring a 72-hour labour, during which her pain was regularly dismissed as "normal", she also had to undergo an emergency caesarean.

Ms Munoz said health-care professionals needed to educate women about informed consent and their rights during childbirth.

"The fact that we expect women to go through pain, unnecessary pain, is the root of all this," she said.

"I felt I was dying inside ... but no one believed me because I was expected to be in pain because I was giving birth."

Maternity Consumer Network president Emilia Bhat said many women, regardless of their race, felt their concerns were dismissed during birth in favour of the baby's wellbeing.

"Women are told all that matters is their baby and that makes them feel like their wishes and needs don't matter," she said.

"When they do try to question it, they're treated like they're selfish."

Australian Medical Association of NSW vice president Kathryn Austin said there is a desperate need for funding of birth education and health literacy to properly prepare soon-to-be parents.

Dr Austin said no birth comes without risks and birth impacts occur in almost every delivery, with or without intervention.

"Birth is often low risk until it's not anymore," she told the inquiry.

"Doctors are forced to make split second decisions to save mother, baby, or both.

"Often parents do not understand why decisions are taken because they have not been fully educated about the potential need for intervention before birth."

Of all the women in Australia who gave birth vaginally in 2019, 85 per cent suffered some degree of perineal trauma and one in five women will require some form of instrumental intervention in their delivery in their first pregnancy, according to the Australian Institute of Health and Welfare.

"A lack of understanding of the scope and frequency of these birth impacts has contributed to the levels of trauma," Dr Austin said.

Dr Austin said many parents have unrealistic expectations of the control they will have and the possibility of requiring medical intervention should be seen as a part of the normal birthing progress process, not an unexpected or traumatic outcome.

The inquiry heard hospitals servicing culturally and linguistically diverse areas should require appropriate staff training on patient's cultural birthing practices.

Representatives from Zamzam Mums and Bubs, a volunteer group based in southwest Sydney, said pathways to help more women from multicultural backgrounds to become midwives as well as targeted recruitment would improve care.

"To ensure that a woman and her preferences are at the centre of interactions means establishing clear preferences right from the very first interaction and to respect these choices," volunteer Yusra Metwally said.

"This is what woman-centric care is all about."

The inquiry will hold a hearing in Wagga on December 12 - at a venue yet to be determined.

The committee leading the probe had been due to hold a Wagga hearing on September 8, but that was delayed almost as soon as the date was set due to the overwhelming number of submissions.

Australian Associated Press

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