The NSW Parliament Select Committee on Birth Trauma 1 published its findings on 29 May 2024, following six public hearings which had been held since 4 September 2023. The report contained 5 findings and made 43 recommendations to the NSW Government, which aim to address preventable birth trauma.
Recommendations
During the course of the six public hearings, the Committee heard about the "distressing and unacceptable" 2 experiences of individuals who have suffered preventable birth trauma in the NSW healthcare system. The Committee aimed to collectively address the prevention of these harrowing experiences by tabling 43 recommendations in its report. These recommendations included but were not limited to:
i. that the NSW Government conduct research to address issues relating to the adoption of the concepts of 'birth trauma' and 'obstetric violence' into State law, and the implementation of a formal recognition of obstetric violence to operate with the existing law of medical negligence 3
ii. that the NSW Government address the physical, psychological and financial impacts that individuals experience subsequent to a traumatic birth by reducing current cost barriers and increasing access to psychological support services 4;
iii. that the NSW Government address significant gaps regarding research into birth trauma in Australia through the provision of specific funding grants 5;
iv. that the NSW Government consider legislative reform which would allow women to seek justice in the instance that a medical practitioner fails to obtain informed consent from a patient 6;
v. that the NSW Government implement funding for medical practitioners to undertake training with respect to obtaining proper informed consent from a patient 7;
vi. that the NSW Government address instances of coercive or misled birthing interventions by reviewing NSW Health policies and guidelines, reviewing processes for seeking proper informed consent, and ensuring that any interventions are evidence-based 8;
vii. that the NSW Government appoint a standalone Chief Midwifery Officer to address the needs and challenges faced by midwives 9;
viii. that the NSW Government diminish unnecessary exacerbation of the trauma surrounding miscarriage and stillbirth by implementing dedicated spaces for these families as well as by providing medical professionals with training on bereavement support 10; and
ix. that the NSW Government review the current complaints process surrounding mistreatment in maternity matters and ensure that adequate information is provided to patients to raise concerns and make these complaints 11
Notwithstanding the 43 recommendations made, the Committee determined that its primary recommendation was that all women should have access to continuity of care models with a known provider 12.
Responses to the Report
A number of individuals have expressed concern and disappointment that the Committee has fallen short in establishing that birth trauma is a form of gendered violence 13. This disappointment is echoed when considering that the United Nations has identified obstetric violence as gendered violence 14.
There has also been significant disappointment expressed with regard to the Committee's failure to recommend universal access to the Midwifery Group Program which is a continuity of care model where a patient is provided with care by a team of midwives 15. One woman who experienced the benefits of the Program, Kate Finch, has stated "I want Health Minister Ryan Park to make sure that every woman in NSW can access this midwife continuity of care." 16.
Whilst the Committee recognised the need for legislative reform with respect to informed consent of patients, it failed to recommend that the NSW Government implement legislative reform to recognise and protect individuals from traumatic birthing experiences. Notably, Emma Hurst, Chair of the Committee, has stated that this "Failure to even consider legislative changes to protect birthing parents from obstetric violence is unacceptable" 17.
Conclusion
The Committee is notable as it is the first parliamentary inquiry in NSW which has examined and reported on preventable birth trauma 18. The NSW Government is due to publish its response to the report's findings and recommendations by 29 August 2024.
For further information regarding the Committee, its final hearing, and how to access a claim for compensation in instances of avoidable injury suffered as a result of negligent medical care, please refer to part 1 and part 2 of this series.
Footnotes
1
https://www.parliament.nsw.gov.au/committees/listofcommittees/Pages/committee-details.aspx?pk=318#tab-reportsandgovernmentresponses
2 Page 16 – https://www.parliament.nsw.gov.au/lcdocs/inquiries/2965/FINAL%20Birth%20Trauma%20Report%20-%2029%20April%202024.pdf
3 Page 58-59 – https://www.parliament.nsw.gov.au/lcdocs/inquiries/2965/FINAL%20Birth%20Trauma%20Report%20-%2029%20April%202024.pdf
4 Page 59 – https://www.parliament.nsw.gov.au/lcdocs/inquiries/2965/FINAL%20Birth%20Trauma%20Report%20-%2029%20April%202024.pdf
5 Page 60 – https://www.parliament.nsw.gov.au/lcdocs/inquiries/2965/FINAL%20Birth%20Trauma%20Report%20-%2029%20April%202024.pdf
6 Page 108 – https://www.parliament.nsw.gov.au/lcdocs/inquiries/2965/FINAL%20Birth%20Trauma%20Report%20-%2029%20April%202024.pdf
7 Page 108-109 – https://www.parliament.nsw.gov.au/lcdocs/inquiries/2965/FINAL%20Birth%20Trauma%20Report%20-%2029%20April%202024.pdf
8 Page 109 – https://www.parliament.nsw.gov.au/lcdocs/inquiries/2965/FINAL%20Birth%20Trauma%20Report%20-%2029%20April%202024.pdf
9 Page 113 – https://www.parliament.nsw.gov.au/lcdocs/inquiries/2965/FINAL%20Birth%20Trauma%20Report%20-%2029%20April%202024.pdf
10 Page 137 – https://www.parliament.nsw.gov.au/lcdocs/inquiries/2965/FINAL%20Birth%20Trauma%20Report%20-%2029%20April%202024.pdf
11 Page 148 – https://www.parliament.nsw.gov.au/lcdocs/inquiries/2965/FINAL%20Birth%20Trauma%20Report%20-%2029%20April%202024.pdf
12 Page 10 – https://www.parliament.nsw.gov.au/lcdocs/inquiries/2965/FINAL%20Birth%20Trauma%20Report%20-%2029%20April%202024.pdf
13 https://www.abc.net.au/news/2024-05-29/dissent-amongst-mps-in-inquiry-report-about-birth-trauma/103906280
14 https://www.ohchr.org/en/calls-for-input/report-human-rights-based-approach-mistreatment-and-obstetric-violence-during
15 https://www.seslhd.health.nsw.gov.au/royal-hospital-for-women/midwifery-group-practice
16 https://www.abc.net.au/news/2024-05-29/dissent-amongst-mps-in-inquiry-report-about-birth-trauma/103906280
17 https://www.abc.net.au/news/2024-05-29/dissent-amongst-mps-in-inquiry-report-about-birth-trauma/103906280
18 Page 10 – https://www.parliament.nsw.gov.au/lcdocs/inquiries/2965/FINAL%20Birth%20Trauma%20Report%20-%2029%20April%202024.pdf
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