Samantha Cambray
Birth Healing


The Honourable Nicola Roxon
Minister for Health and Ageing
Parliament House

10th March 2009

Dear Ms Roxon,

RE: Report into the Maternity Services Review

I refer to the above report handed down on February 21st this year. Reading through the report, I find many recommendations commendable, including the attention given to the need for continuity of care; more access to pertinent and accurate information for birthing women; enhancing midwife practice; raising breastfeeding rates; and a less fragmented system when it comes to the range of health professionals that may be involved within a woman’s antenatal, birthing and post natal care.

My orientation is that of prevention of and recovery from the psychosocial implications of traumatic birthing experiences. I am a consumer who has sustained trauma from birthing, and now run a small not-for-profit group online for people who have been through traumatic birthing experiences.

Whilst perinatal depression is given just attention in the report and in society in general, a much more underestimated problem is that of Post Traumatic Stress Disorder in the perinatal period. In a study by Alcorn in 2006, over 45% of women were found to have had traumatic birth experiences as defined by the DSM-IV (a diagnostic tool for psychological conditions) and 4.5% had full PTSD at three months post partum.

The report states “Evidence strongly indicates that mothers who have good mental health in the perinatal period have positive impacts upon the cognitive, emotional and behavioural consequences of their children.” I fully agree with this statement, and PTSD can be one such condition that can affect the mother-baby dyad in a challenging way.

As such, I specifically request the government to take into account the following suggestions originally recommended in my submission into the Maternity Services Review, to help prevent birth trauma and assist women and their families in recovering from birth trauma:


1. That the Federal Government play a directive role in ensuring a major paradigm shift occurs in the maternity system to see birth as a natural event, not a medical event that needs to be ‘managed’, and therein medical intervention only occurs when medically indicated and not for convenience or to shorten the duration of the birthing process as this leads to birth trauma and the cascade of interventions;

2. That the Federal Government runs a community education campaign aimed at pregnant women and their partners, and those of child bearing age, of what birth trauma is and how it can be prevented;

3. That the Federal Government runs an education campaign aimed at health care providers in the maternity system (including obstetricians, midwives, doulas, general practitioners and other professionals) about issues surrounding birth trauma;

4. That the Federal Government fund a network of organisations that address the needs of women with birth trauma, and those who prevent birth trauma, nationally, and that these services are made accessible to women with very young children;

5. That maternity services are urgently expanded to offer more midwife run birth centre style options, where an appropriate, comfortable and private space is made for women to birth in, supported by midwives and/or doulas, in a way conducive to natural birthing, and that medical and other interventions are available in a timely way- when medically indicated (which will not be necessary in most births and should only happen in line with World Health Organisation recommendations);

6. That the Federal Government takes action to see that more doulas are trained and made affordable and accessible to women, in an effort to provide support to women in traumatic situations, and to help guard a psychologically and physically safe birth space.
I also see that it is vital that homebirth is an option available to all birthing women. I find it very concerning that, as stated in the report, many submissions advocated for more and better access to homebirth and independent midwives, the report suggests that homebirth will effectively become illegal in all but rare state-run services due to the review’s recommendation that midwives have indemnity cover, and that no insurer will currently indemnify independent midwifery. The report cites the current low numbers of women who homebirth as justification, however this is a simplistic view that fails to take in the inequities in the maternity system that make homebirth inaccessible to the vast majority of women.
Homebirth not only affords a range of potential benefits to the mother-baby dyad, but also takes the pressure off the ailing health system, and allows for a women-centred paradigm to reach dominance in society. I also believe, from much research and anecdotal evidence, it can help prevent birth trauma in many cases.
I congratulate the Government in taking the steps necessary to reform our maternity system so it meets the needs of our women and babies in a physically, and just as importantly, psychologically safe way.

Kind Regards,
Samantha Cambray
Founder and Director
Birth Healing: http://birthhealing.forummotion.com/