Feminism has reached the birth space (and it’s about time).   It’s no surprise that women want to own their pregnancy care, birth space, and postpartum journey. 

I am Canadian born and trained in Obstetrics and Gynaecology here in Australia, with my two girls born here during my training. I have experienced pregnancy and birth as both a practitioner and a patient in Australia and even though Australia offers first world maternity care, I see that our public system has deficits.

More than 70% of women birth in the public system. Us health workers are a cohort of very well meaning and caring people overall, yet we know patients can feel lost in the system. Too many people at one time in this very precious pregnancy and birth space can result in confusion, unnecessary anxiety, and lack of trust in care providers.  

I believe a breakdown of communication and trust is one factor as to why women experience birth trauma.  Unfortunately, not all health systems are currently set up well to provide continuity of care appropriate to individual patient risk.  It’s a sad reality and something that governing bodies need greater understanding to rectify.

What is another option? Many women choose to take their care into their own hands, and seek out a private care provider, which can be found in a Private Obstetrician or a Private Midwife.  Who a woman seeks to care for them is a very individual choice.  The important thing to know is that your carer has appropriate training and is registered with the Australian Health Practitioner Registration Authority (AHPRA) without any restrictions on their practice.  You can easily look up your care provider on AHPRA. 

https://www.ahpra.gov.au/Registration/Registers-of-Practitioners.aspx

In my experience, many women view the birth itself as a defining moment in their lives, and their self-identity.  For this reason, I think an informed choice on a birth preference is a women’s right.  Some women might elect to have a caesarean section, others will trial labour, and others will trial labour after a previous caesarean section (TOLAC or VBAC).   It is important to understand your options, and the risks and benefits to each option, while at the same time be armed with the knowledge that pregnancy and birth can be totally unpredictable, just like the rest of life.

We use the word trial of labour, as there are many reasons why a trial of labour may not result in the desired spontaneous vaginal birth, with no perineal trauma.  As a care provider, it is my duty to try and facilitate your birth preference and overall care goals, while at the same time ensuring both you and your baby are safe.  This takes patience, and experience, and is the most rewarding and intimate part of my job.  

We put a lot of pressure on ourselves as birthing people to achieve set birth preferences. If we don’t achieve our birth preferences, some women will feel great disappointment and internalize this as a failure on their part.  This is when you need to seek help about how you are feeling, as I can say with confidence, you are definitely not a failure. 

It is important to remember that a “birth intervention” can be life-saving for you or baby, but it is equally important to be informed as to the risks and benefits of that particular intervention as it pertains to your individual circumstances.   This is where your trusted and experienced care provider is integral in communicating what is happening in your space, so that you can make an informed decision.  This is where I take great care to make sure you feel heard.

At the Ballarat Women’s Clinic, we are invested in helping you make the birth choice that is right for you and your baby. It is an honour to be asked to be part of this intimate period of your life and a responsibility that we hold with the highest regard. 

You can find some more information on pregnancy care options in Victoria here:

https://www.betterhealth.vic.gov.au/health/servicesandsupport/pregnancy-and-birth-care-options

Written by Obstetrician and Gynaecologist Dr Kate Stewart