Every woman deserves access to continuity care. Every woman needs a midwife. Some women need a doctor. Every woman deserves both professionals working together.
Birth Trauma Awareness Week is an opportunity to acknowledge the experiences of women and families affected by birth trauma and recognise the clinicians committed to providing safe, respectful maternity care. The Australian College of Midwives (ACM) welcomes the growing national focus on this issue and supports the work of Birth Trauma Australia, the women who have shared their stories, and the recent RANZCOG Birth Trauma Roundtable.
Awareness is an essential first step, but it must lead to action. Supporting women who experience birth trauma is vital, but so is preventing avoidable trauma before it occurs.
"Birth trauma isn't just about what happens in the birth room, it's about whether a woman felt heard, respected and in control of decisions about her own body," said ACM Chief Midwife Kelley Lennon. "We know how to prevent much of this trauma. Continuity of midwifery care enables women to have access to a trusted relationship throughout their pregnancy, birth and beyond, and that relationship is what makes respectful, informed care possible. The Birth Trauma Awareness week is important, but what women need now is action: policy that makes this model of care available to every woman in Australia."
The highest level of international evidence demonstrates that midwifery continuity of care improves outcomes for women and babies. The 2024 Cochrane Review, involving more than 18,500 women across 17 randomised controlled trials, found that women receiving continuity of midwifery care were more likely to experience a spontaneous vaginal birth and less likely to have a caesarean section or instrumental birth. Women who have continuity of midwifery also experience fewer interventions and better overall birth outcomes compared to standard fragmented care.
"Australia has the evidence," said Dr Alison Teate, ACM President. "What is needed now is the policy commitment to ensure every woman can access continuity of midwifery care, regardless of where she lives or how she chooses to give birth."
Professor Hannah Dahlen AM said "We must prioritise relationship based care for all childbearing women. While we have come a long way in reducing adverse physical outcomes for women and babies we are seeing increasing birth trauma, especially psychological trauma due to disrespectful care. This is having significant effects on the wellbeing of mothers, babies and families. Relationship based, respectful maternity care is the way best way to reduce this."
"After birth trauma in my first birth from a fragmented system, I know what a midwife with me through pregnancy, birth and postpartum means. Yet most women still lack access to a known midwife. Every day that passes, 1 in 3 women experience preventable birth-related trauma. Continuity of midwifery care prevents birth trauma. It's time our leaders stopped sitting on a solution that works." Sharon Settecasse, President, Better Births Illawarra.
Not every woman will have a straightforward pregnancy or birth. Some women will require obstetric, medical or multidisciplinary care, in addition to midwifery care, and that care should be available whenever it is needed. That is why ACM continues to advocate for maternity reform built on collaborative models of care.
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