Australia’s maternity system, led by midwives, faces a birth trauma crisis

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I wrote only two weeks ago about the abuse of obstetric patients in the midwife led systems of four countries, Ghana, Guinea, Myanmar, and Nigeria. A study in The Lancet raised the alarm.

The abuse was tied to patient age and social standing suggesting that it was a reflection of power relationships. These are all midwife led systems with very few doctors. The authors postulate that gender discrimination within these countries means that women who finally have some power over others may take advantage of that power.

Why do midwives cause so much birth trauma and what are they going to do about it?

Now comes word that women in Australia, another country with midwife led maternity care is facing a birth trauma crisis.

According to Australia’s maternity care at ‘crisis point’ with birth trauma rates increasing in today’s news.

Up to one in three Australian women have experienced birth trauma and one in 10 women emerge from childbirth with post-traumatic stress disorder (PTSD) and according to researchers, the problem is getting worse.

Toowoomba mother Jessica Linwood clutched her husband Daniel’s hand as she described the birth of their first child — when she experienced a postpartum haemorrhage — as “terrifying”…

“[A] midwife was pushing on my stomach to contract my uterus back down.

“I had said it hurt and [that] she was hurting me and she told me that I [would] die if she didn’t do it.

The midwives and doulas of Australia, though their lobbying group, blame the problem on medicalization.

The Maternity Consumer Network (MCN) has blamed the problem on overmedicalisation during childbirth, and said the national caesarean rate of 34 per cent was three times the rate recommended by the World Health Organisation.

But C-section rates have been rising for at least two generations and have held steady for the past decade; birth trauma, in contrast, has only become a problem relatively recently, as midwives have gained more power within maternity systems. The dirty secret about birth trauma is that midwives are responsible for a lot of it.

Why? Because they promote their OWN interests over the interests and needs of patients. Indeed, the Australian midwifery group behind the MCN has as its motto: “Midwifery Continuity of Care for Every Woman.”

Not, ‘Safe Care,” not ‘Respectful Care,” but ‘Midwifery Care.’

At the heart of midwifery abuse of patients is the fact that midwives, while claiming to be with women, promote “normal birth,” a midwife-centered, one size fits all model of care. It’s hard to imagine anything more disrespectful  and traumatizing than telling women how they ought to give birth and ignoring what they might want (pain relief, interventions, maternal request C-section), yet this is precisely what campaigns for normal birth do.

The article itself is a form of astroturfing.

According to Merriam Webster, astro-turfing is:

organized activity that is intended to create a false impression of a widespread, spontaneously arising, grassroots movement in support of or in opposition to something (such as a political policy) but that is in reality initiated and controlled by a concealed group or organization (such as a corporation).

This article and others like it are intended to hijack the serious problem of birth trauma for the benefit of midwives, the very people causing the problem.

Don’t believe me? Look who is quoted in the article, a midwifery leader, an executive at a midwifery group, a pro-midwifery lawyer.

The Australian midwifery leader Hannah Dahlen wants more midwives:

Professor Dahlen said women who had continuity of midwifery care — the same midwife through pregnancy, labour, birth and six weeks post-partum — had less medical interventions and were more satisfied with their births.

The midwifery executive wants more money:

“If we actually started to move some money into that bucket we would see benefits in spades.”

And the pro-midwifery lawyer, Bashi Hazard, refuses to acknowledge that midwives are responsible for a great deal of birth trauma. Several weeks ago I asked her publicly on Twitter to explain the difference between a doctor who performs a painful exam over a woman’s protests and a midwife who denies an epidural over a woman’s protests. She mounted an extended tantrum in an effort to deflect attention from the fact that she couldn’t supply an answer.

What would it look like if midwives actually cared about birth trauma instead of merely weaponizing it to increase midwifery funding and employment?

The first thing they would do is admit their own complicity and set up training programs FOR MIDWIVES to address THEIR ROLE in causing birth trauma. They would stop promoting normal birth, which reflects THEIR preferences and start respecting patient preferences.

But that’s not going to happen since this isn’t about preventing birth trauma; it’s about promoting midwives.