Birth trauma preventable yet affects too many women

Australian women who give birth are experiencing "obscene" rates of trauma as advocates call for universal continuity of care, midwifery leadership, antenatal education and respectful healthcare practices.

But experts say trauma can be prevented and is not a given when it comes to birth.

Giving birth is one of the most profound and life-changing events in a woman's life and should be predominantly positive.

Yet one in three women will experience birth trauma, either physically or emotionally, affecting their lives for years to come.

Birth Trauma Awareness Week is held each year to highlight the issue and provide support to women and their families who have experienced it.

It is also an opportunity to examine maternity care and ensure better outcomes for women and their babies.

Jess Pigram suffered from a life-threatening postpartum haemorrhage after giving birth to her daughter Shiloh in 2019.

She had to undergo two surgeries shortly after her birth and ended up losing 3.6 litres of blood - more than 60 per cent of her body's total amount - which resulted in her needing multiple transfusions.

"I'd just had my baby and all of a sudden there's all these people and I'm being rushed into the operation room ... there was a point where I thought I was going to die," she tells AAP.

While the physical recovery has been complicated by permanent pelvic floor damage, the mental trauma from the experience has also stuck with Ms Pigram for years.

It is often most acute around the time of her daughter's birthday which can be difficult to navigate.

"When you go through trauma, you never forget it," she says.

"I'll never be the same person I was, but that's okay because I have my daughter."

Ms Pigram said her wife Katie, who was also mistreated by hospital staff during Shiloh's birth, has been instrumental in her recovery.

Connecting with Birth Trauma Australia, the peak national charity dedicated to supporting women, people, fathers, partners and families after birth-related trauma, was also hugely important.

But looking back, Ms Pigram wishes she'd known how many women experience trauma during birth.

"It was so isolating at the time and I felt like no one understood," she says.

"I wasn't aware that one in three women experience birth trauma and it took a long time to realise how many other women are affected."

Rates of trauma indicate maternity services are doing something seriously wrong, former president of the Australian College of Midwives Jenny Gamble says.

"It's obscene that 30 per cent of women report that they had a traumatic childbirth," she says.

"The system is scaring and traumatising women about having a baby."

Studies have found women who have a traumatic birth experience will subsequently choose to either birth completely outside the system, invest in a private midwife or seek a planned caesarean.

Some may even decide not to have another baby after a previous traumatic experience.

A landmark inquiry into birth trauma by the NSW parliament attracted international attention as well as thousands of submissions from patients, doctors, midwives and experts around Australia.

The final report released in 2024 found the rates of birth trauma were unacceptable and made 43 recommendations, including an overhaul of the health system.

Chief among the recommendations was the need for accessible continuity of midwifery care, which experts have been calling for for years.

Hospitals that provide continuity of care, where a woman has access to the same midwife throughout her pregnancy, during the birth and postnatally, often have better outcomes for the mother, baby and care provider.

It's also more cost effective.

"We have this fantastic evidence that shows what needs to change but we have all these road blocks," midwife and Monash University lecturer Joy Kloester said.

"Birth trauma can be prevented, it's not a given, and the best way to prevent it is continuity of care."

Queensland recently appointed a chief midwifery officer, which Professor Gamble said was something all states and territories needed.

"We need to stop treating having a baby like an acute medical event," she said.

"It's a physiological event that requires a social and primary model of healthcare."

Research shows women who consider their birth experience positive do so not because of what happened medically but because they were heard and respected throughout the process.

For those who do experience trauma it's often because they felt like a body on a table.

"It's not about avoiding intervention but about ensuring the woman feels like the central person in that care ... being informed and respected is so essential," Ms Kloester says.

Birth trauma occurs on a spectrum, with obstetric violence at the extreme end.

One in 10 women experience obstetric violence in birth, recognised by the United Nations as a form of gendered violence.

Bernadette Lack is a midwife of almost 20 years and also works in pelvic health supporting women through her business Core and Floor Restore.

Her practice includes birth debriefs and she says many women apologise to her for becoming emotional when they share their stories.

"You carry your birth experiences with you until the day you die," Ms Lack says.

"Birth isn't just about a baby being born, it's about a mother being born too.

"Trauma isn't a memory, it's a reliving ... when people have experienced previous trauma, it can easily be triggered again by the smallest thing: a smell, a sound, a touch, a tone."

Recovering can also be financially inaccessible to many women who may have to see multiple care providers to address mental and physical trauma.

"Healing from birth can require huge investment," Ms Lack says.

But she wants women to know that it's never too late to begin the process of healing.

"There's often a lot of grief and people can feel scared to lean into their feelings (but) I believe the body is so capable of healing when you meet with the mind and body together," she says.

"I would love for more older women to come (for a birth debrief) because it would enable them to support the current birthing generation better and also so they don't have to continue living their life holding onto their trauma."

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