MCA calls for urgent systemic reform

Women report feeling rushed, dismissed, and “just another number” — we know why and we know how to prevent it – it is time for urgent systemic reform

Birth trauma has long-term impacts on mental health, family wellbeing, and future engagement with maternity services. Some women avoid or terminate future pregnancies or disengage from the system entirely due to disrespectful care. 

In addition to universal access to continuity of midwifery carer, The Birth Map is a woman-led, structured approach to birth preparation that supports sensemaking, communication, and confident decision making. It has been identified as a tool suitable for universal use across maternity care models.

A national evaluation of The Birth Map has revealed widespread systemic barriers in Australian maternity care that contribute directly to birth trauma and identifies simple, immediately implementable solutions to prevent it. The findings align with national and international evidence showing that relationship-based care improves outcomes for women, babies, and care providers and reduces burnout and legal risk.

The study, conducted across multiple models of care, found that women frequently experience short, provider-controlled appointments, fragmented care, inconsistent messaging, and dismissive responses to questions. These factors undermine informed consent, increase anxiety, and heighten the risk of trauma during pregnancy, labour, and birth.

Lead researcher Catherine Bell says the findings show that birth trauma is an avoidable outcome, which can be prevented through effective communication and system design.

“Birth trauma is not an inevitable part of maternity care — it is preventable with the removal of systemic barriers.”

The evaluation found that The Birth Map, a structured, consumer-designed, woman-led decision support tool, facilitated communication, strengthened decision making confidence, and enhanced birth experiences. However, Bell emphasises that tools alone cannot compensate for structural issues.

“The Birth Map helps women make sense of their options, but it cannot fix rushed appointments, fragmented care, or coercive clinical cultures. Australia urgently needs a shift from consent-seeking to decision-supporting, relationship-based care.”

The research identifies two urgent reforms:

1. Provide structured decision-support from early in pregnancy

Women need clear, neutral information and question prompts at the first antenatal appointment — not late-term pamphlets, decision aids, templates or rushed conversations.

2. Resource care providers for relationship-based care

Continuity of midwifery carer in collaboration with obstetrics where wanted, respectful maternity care training, effective communication and Supported Maternal Decision Making (SMDM) are essential to reducing trauma and improving outcomes.

Media Contact

Catherine Bell Email: md@maternitychoices.org.au