Content warning: This article contains descriptions of childbirth, obstetric violence and references to birth trauma.
Having recently given birth to my third child, I know all about the anxieties that accompany pregnancy and labour. Like any prospective parent, my strongest wish as my due date neared was for the safe delivery of my baby. In Australia, a country with one of the lowest infant mortality rates in the world, it was a wish that, fortunately, would more than likely be fulfilled.
But that wasn't my only priority for childbirth — I was concerned about my own health and how my body would recover from a third pregnancy and birth. Unfortunately, maternal outcomes are not as rosy in Australia, which has a high rate of intervention during childbirth. In 2017, caesareans and instrument-assisted deliveries accounted for 35 per cent and 11 per cent of births respectively. More worryingly, one in three women reports experiencing birth trauma.
In our foetal-centric antenatal model, the health and wellbeing of the person giving birth are secondary considerations, stemming in part from a belief that suffering is a defining characteristic of childbirth. But what if a 'safe delivery' meant not just a healthy baby, but a healthy mother too?
At a recent COAG meeting, Federal Health Minister Greg Hunt introduced a national strategy to improve maternity services across Australia. The plan includes a shift to a midwife-led continuity of care model where the same health professionals provide care through pregnancy, labour, birth and the postnatal period. It's a model that a Deakin University study found reduced both the overall C-section rate and the number of episiotomies performed during childbirth.
The drive to reduce the caesarean rate, however, often means the risks of vaginal birth are downplayed. Stefan Hansson, Professor in Obstetrics and Gynaecology at Lund University, wrote at the Conversation that he 'worried' that C-sections were 'marketed' as a safe way to avoid pelvic floor problems:
'Women are well aware of the discomfort and embarrassment associated with urinary incontinence and have an understandable fear of sexual dysfunction. But despite the reported findings that suggest decreased risk with a caesarean delivery, these problems are manageable, treatable and, importantly, not life-threatening.'
But the injuries that some suffer after vaginal deliveries — particularly instrument-assisted deliveries — are so severe they can hardly be described as manageable or treatable. Amy, a woman who shared her story at the Australasian Birth Trauma Association website, recounts how a traumatic