'The Me Too of birth' as women speak up about trauma

Dan Himbrechts/AAP PHOTOS

A new Me Too movement is unfolding as Australian women speak up about birth trauma and the right to consent in a medical setting, a leading maternity academic has told an inquiry.

The NSW parliamentary inquiry into the prevalence and effects of birth trauma has attracted 4000 submissions from women, doctors and midwives around the country.

Hannah Dahlen, a midwifery researcher from Western Sydney University, said it was a landmark moment for women at a time when surgical birth intervention rates were rising.

"No means no, except apparently in childbirth and it's time to change that," Professor Dahlen told the inquiry's first public hearing on Monday.

"This is the Me Too movement of birth now finally coming to fruition."

Several studies by the university showed a third of Australian women have experienced birth trauma, which can include fearing for their lives, loss of control and pelvic floor damage.

The research found one in 10 women reported "obstetric violence", defined as a dehumanising or abusive birth experience.

One woman involved in the university's research spoke of having her placenta "aggressively" pulled out while an obstetrician told her to be quiet, and another was forced to have a caesarean when there was no emergency.

The interventions most associated with trauma were caesareans during labour, inductions and instrumental births involving the use of forceps or a vacuum, the research showed.

Prof Dahlen said women fared best when they had a relationship-centred model of care with a consistent midwife or obstetrician during pregnancy and birth.

"There's no doubt continuity of care has got to be one of the biggest things in protecting women, regardless of what happens during their birth," she said.

Deborah Willcox, the NSW Health deputy secretary for strategy and planning, said the department acknowledged the distress and bravery of women who shared their stories.

"We are sorry this has been their experience and NSW Health commits to listening and learning from what they're telling us," Ms Willcox said.

Jared Watts, an obstetrician-gynaecologist who works in rural areas, said women should be given information about emergency procedures long before childbirth.

Patients would ideally meet multidisciplinary teams in the weeks before their due date, as trauma was often related to interactions with doctors during emergencies, he said.

"For the very first time they're meeting the obstetricians when, to be frank,  their legs are in the air, they've never met these people before and they're doing things that they don't really understand," Dr Watts said.

"This idea of obstetrician-led care, midwifery-led care, it needs to come back to patient-centred care (with) multidisciplinary teams.

"The last thing we want is traumatising women when we meet them for the first time, when we are performing a procedure in an emergency situation."

Better early education about potential emergency scenarios could also assist in obtaining informed consent, he said.

The inquiry, which will run for several months, is due to hold another hearing in Wollongong on Thursday.