This report examines the prevalence and experience of birth trauma in New South Wales, finding that a significant number of individuals experience preventable birth trauma due to avoidable factors within the maternity care system. The report focuses on the identification and mitigation of preventable factors, proposing 43 recommendations  including improving education, strengthening informed consent practices, expanding access to continuity of care models, and implementing trauma-informed care principles.

Contributing factors of birth trauma include:

• a lack of continuity of care,
• lack of trauma-informed practices,
• inadequate antenatal education, 
• inadequate informed consent practices, 
• a lack of respect for women’s birthing choices and experiences, and 
• a lack of inclusivity and culturally-appropriate services within in maternity care. 

The report acknowledges that birth trauma often stems from systemic issues within the maternity care system and that some of these issues are exacerbated by maternity workforce shortages and resource constraints. 

Findings

1. There are a number of individuals who have suffered preventable birth trauma in New South Wales and the experiences of the people who gave evidence to this inquiry are distressing and unacceptable.
2. That urgent efforts must be made to address avoidable and preventable factors that contribute to birth trauma.
3. That in some cases of birth trauma, women have recounted that they experienced this as a form of violence.
4. That prospective parents need to be provided with clear and comprehensive education about all aspects of pregnancy and childbirth so that consent given to any obstetric intervention is fully informed.
5. That a 'one size fits all' approach is inadequate for the New South Wales maternity care system and
   that tailoring care to meet the needs of individuals is essential for improving outcomes.

Key Recommendations

• Invest in and expand midwifery continuity of care models, including Midwifery Group Practice, particularly in regional, rural, and remote areas. 
• Implement mandatory trauma-informed care training for all maternity healthcare practitioners and improved mental health support for women and families affected by birth trauma.
• Review and potentially revise laws regarding informed consent, drawing on practices from other jurisdictions, and ensuring that all maternity healthcare practitioners receive comprehensive informed consent training. 
• Review of existing hospital policies and guidelines on interventions to ensure they are evidence-based and prioritize informed consent. 
• Establish formal debriefing clinics at all public hospitals with maternity services.