Insights: NSW Birth Trauma Report

The NSW Legislative Council Select Committee on Birth Trauma marks a significant step forward in recognizing and addressing the impact of birth trauma on parents and families across New South Wales with the release of their report this week. The unprecedented scale of evidence received and the depth of community engagement reflect a growing recognition of the importance of addressing this form of gendered violence.

What were the key findings:

• There are a number of individuals who have suffered preventable birth trauma in New South Wales and the experiences of the people who gave evidence to this inquiry are distressing and unacceptable.
• That urgent efforts must be made to address avoidable and preventable factors that contribute to birth trauma.
• That in some cases of birth trauma, women have recounted that they experienced this as a form of violence.
• That prospective parents need to be provided with clear and comprehensive education about all aspects of pregnancy and childbirth so that consent given to any obstetric intervention is fully informed.
• That a 'one size fits all' approach is inadequate for the New South Wales maternity care system and that tailoring care to meet the needs of individuals is essential for improving outcomes.

The catalyst for this inquiry was the increasing awareness of birth trauma and concerns about its effects on individuals and families. The Australian Birth Experience Study (BESt)from Western Sydney University highlighted that 28 percent of women experienced birth trauma, with more than one-in-ten experiencing some form of obstetric violence. Additionally, a complaint lodged with the Health Care Complaints Commission on behalf of 30 women who alleged traumatic birth experiences at Wagga Wagga Base Hospital underscored the urgent need for action.

Through over 4000 submissions and six public hearings held in various locations, the committee heard from a wide range of stakeholders, including healthcare practitioners, researchers, government agencies, and most importantly, individuals who bravely shared their stories of pregnancy, childbirth, and early parenthood. The committee recognized the unacceptable number of preventable birth trauma cases in New South Wales and the urgent need to address the contributing factors.

Several key factors contributing to avoidable birth trauma were identified, including:

• the lack of continuity of care
• trauma-informed practices
• antenatal education
• informed consent practices
• respect for women's birthing choices; and
• culturally-appropriate services within maternity care.

The committee made 43 recommendations to the NSW Government to address these issues, with a primary focus on ensuring all women have access to continuity of care models with a known provider, such as midwifery continuity of care.

The report also emphasized the importance of comprehensive antenatal education, reviewing laws around informed consent, supporting women's birth preferences, improving mental health support and postpartum services, and adopting trauma-informed care practices in maternity care.