Position Statement on Birthing Practices Legislation

November 2025

Executive Summary

Fill Your Cup acknowledges and supports the intent behind RANZCOG and the Australian College of Midwives' call for consistent national legislation restricting birthing practices to registered health professionals. We recognise that such legislation, aligned with South Australia's existing framework, aims to enhance maternal and infant safety.

As birth doulas, our professional practice already requires the presence of a registered medical professional—whether a private midwife, hospital-based midwife, or obstetrician—at all births we attend. This commitment reflects our understanding that doulas are non-medical professionals who provide emotional, practical, and informational support, while clinical expertise remains the domain of registered practitioners.

However, we believe the conversation must extend beyond legislative restrictions to address a more fundamental question: Why are women choosing to birth without medical professionals? The answer lies in critical gaps within our current maternity care system—gaps that legislation alone cannot address.

The Current State of Australian Maternity Care

Australian women face a maternity care system in crisis:

•      1 in 3 women describe their birth as traumatic—a rate that should concern all stakeholders in maternal health

•      Only 14% of women can access midwifery continuity of care models—the recognised gold standard in maternity services

•      86% of Australian mothers navigate pregnancy, birth, and postpartum without true continuity of care

Research consistently demonstrates that midwifery continuity of care delivers superior outcomes: a 24% reduction in preterm birth, a 16% reduction in fetal loss and neonatal death, and significantly higher maternal satisfaction with lower intervention rates. Yet the vast majority of Australian women cannot access this evidence-based model of care.

Understanding Why Women Choose Free Birth

When women choose to birth without medical professionals present, they are often making what they perceive as the safer choice based on previous traumatic experiences within the hospital system. This speaks to a critical failure in how we are supporting women through birth.

For many women, the fear of repeating past trauma or experiencing trauma for the first time in a clinical setting outweighs their concerns about birthing without medical assistance. This reality demands our attention and reflection as a health care community.

The real question is not whether to ban non-medical professionals from attending free births—it is understanding why women feel safer birthing alone than within our current maternity care system. This should concern all of us.

Fill Your Cup's Professional Practice Standards

Fill Your Cup maintains rigorous professional standards that align with the spirit of the proposed legislation:

•      We are non-medical professionals and do not provide medical advice or clinical care

•      We operate within our defined scope: practical support, emotional support, evidence-based information, and advocacy

•      All our resources are sourced from government and hospital-based websites, peer-reviewed research, and evidence-based guidelines

•      We require medical professionals to be present at all births we attend

•      We work collaboratively with clinical care providers rather than as substitutes

We bridge the gap between medical care and emotional support. We do not replace midwives or doctors—we complement them by providing the continuous presence and advocacy that our fragmented system cannot consistently deliver.

The activities restricted under South Australian legislation—including management of labour stages, placental delivery, and clinical assessment—fall well outside the scope of doula practice. Our role is fundamentally different: we provide the continuous emotional and practical support that research shows significantly improves birth outcomes when delivered alongside appropriate medical care.

Our Recommendations: Investing in Proven Solutions

Rather than focusing solely on legislative restrictions, Fill Your Cup calls on governments and health policymakers to invest in evidence-based solutions that address the root causes driving women away from the current system:

1. Expand Access to Midwifery Continuity of Care

Increase funding for midwifery group practices to expand access beyond the current 15% of women who can access this evidence-based model. When we can provide every woman with the gold standard of care, we address the fundamental drivers of birth trauma and dissatisfaction with the maternity system.

2. Integrate Doulas as Complementary Support

Recognize and integrate doula support alongside midwifery continuity models as complementary, not competing, services. Research demonstrates that continuous doula support reduces c-section rates by 39%, shortens labour by 41 minutes, decreases requests for pain medication by 10%, and reduces negative birth experiences by 34%.

3. Foster Collaborative Care Teams

Establish collaborative care frameworks where midwives provide clinical expertise and doulas provide continuous emotional and practical support—working together rather than being positioned in opposition to one another. This integrated approach offers the best outcomes for Australian families.

Conclusion

Fill Your Cup supports measures that enhance maternal and infant safety. We recognise the validity of concerns that motivate the proposed legislation and affirm our commitment to operating within appropriate professional boundaries.

However, we believe lasting change requires more than restrictions—it demands investment in the evidence-based care models that address why women currently feel unsafe within our maternity system. When we bridge the gap that leaves 86% of Australian mothers without continuity of care, we create a system where families choose medical support not out of obligation, but because they trust they will receive respectful, evidence-based, woman-centred care.

Fill Your Cup welcomes the opportunity to collaborate with RANZCOG, the Australian College of Midwives, and government policymakers in developing comprehensive strategies that enhance maternal care across Australia. Together, we can create a maternity system that truly serves all Australian families.

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Dr. Renee White

CEO, Fill Your Cup

BSc (Hons), PhD (Biochemistry)