Women need to be empowered with information about what could go wrong during childbirth so they're not meeting a doctor for the first time in a terrifying emergency situation, an inquiry has been told.
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The NSW parliamentary inquiry is investigating the prevalence of birth trauma, its long-term effects and whether there are sufficient protections in the health system to prevent it.
The inquiry was prompted by dozens of complaints around maternity care at Wagga Base Hospital being lodged with the Health Care Complains Commission by the Maternity Consumer Network.
Jared Watts, an obstetrician-gynaecologist who works in rural areas, said women should be given information about procedures such as emergency caesarean sections and instrumental deliveries long before they give birth.
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Patients would ideally meet multidisciplinary teams in the weeks before their due date, as birth trauma was often related to interactions with doctors during emergencies, he said.
"For the very first time they're meeting the obstetricians when, to be frank, their legs are in the air, they've never met these people before and they're doing things that they don't really understand," Dr Watts told the inquiry on Monday.
"This idea of obstetrician-led care, midwifery-led care, it needs to come back to patient-centred care (with) multidisciplinary teams.
"The last thing we want is traumatising women when we meet them for the first time, when we are performing a procedure in an emergency situation."
The first hearing of the inquiry got under way in Sydney on Monday, with further hearings scheduled for Wollongong on Thursday and back at Parliament House on October 9.
The inquiry was scheduled to visit Wagga on September 8, however it was delayed in the wake of unprecedented submissions and a new date is yet to be set.
Better early education about potential emergency scenarios could also assist with obtaining informed consent so women had time to consider their options, he said.
Researchers have suggested one in 10 women feel they may have suffered so-called "obstetric violence", a term the peak body for obstetricians and gynaecologists opposes on the grounds it wrongly implies intent to harm.
Instrumental or surgical intervention is now used in about half of the 300,000 births in Australia each year.
More on the birth inquiry
The inquiry has received 4000 submissions from across the country, from women, doctors and midwives.
A baby being handed to the wrong mother and a woman who was cut before the epidural took hold in an emergency caesarean at Wagga Base Hospital are among the haunting tales that have emerged from the publicly-released submissions around the Riverina's major hospital.
"The amount of coercion I have seen in my very short time in this career is horrifying," said one midwife with experience in two of the state's top-tier maternity hospitals.
Meanwhile, a midwife employed at Griffith Base Hospital in 2017 has already given a chilling account of her time on the maternity ward, saying she feared for patient safety, and her registration.
Australasian Birth Trauma Association chief executive Amy Dawes told the inquiry women regularly felt dismissed by healthcare providers when they reported ongoing pain after birth.
"That further exacerbated their mental health challenges because they're navigating looking after young babies ... or they're suffering from incontinence," Ms Dawes said.
"The psychological impacts and the physical impacts often go hand-in-hand."
On the first day of the inquiry, NSW Health Minister Ryan Park said the number of submissions showed birth trauma was an area of concern for many women.
The government was taking the issue very seriously, he told reporters.
"We need to make sure that every time a woman goes in to have a child in one of our hospitals and our health facilities, that we're able to give the very best possible experience and outcome for them."
The inquiry is expected to run for several months.
- with Australian Associated Press
