Our birthing revolution that’s leading the nation
QUEENSLAND Health has taken the unprecedented step of trialling new guidelines for maternity clinicians to work closer and listen more to women who say "no" to their birthing recommendations.
Rising numbers of women are taking control of their own labours and refusing to be bullied into procedures and interventions they do not want, while experts admit doctors may not always know best.
Queensland is leading the nation by moving towards change and accommodating respectful conversation when a woman disagrees with doctors, rather than shutting down her wishes.
The trial is running at the Royal Brisbane and Women's, Rockhampton, Bundaberg, Hervey Bay, Emerald, Thursday Island and Mount Isa hospitals until September, and if successful will be rolled out across the state.
No other state has made the move to partner with women in this way to try to work towards shared decision-making.
Consumer lead in the trial Dr Bec Jenkinson told The Courier-Mail that the idea that "doctor always knows best" is outdated and not always best for the woman.
"My research shows that there is a fairly predictable pattern of trying to get women to comply with sometimes inflexible hospital policies. Some report feeling pressured and tell of abusive encounters when they speak of wanting a certain kind of birth. But Queensland Health is leading the way for change," Dr Jenkinson said.
The birthing expert says that when a woman feels that she is being listened when the stakes are low she is more likely to trust the care giver if things don't go according to plan and turn high risk.
"No woman wants to put their baby's life at risk, they just want to have their say on the way they would like to have their baby," Dr Jenkinson said.
The trial puts in place processes that will allow clinicians to document the patient's care and feedback.
The latest available research from the Queensland Centre for Mothers and Babies: Having a baby in 2010 shows that of 3500 Queensland women, only 48 per cent of those who had a C-section had consented, 70 per cent were informed and consented to epidurals, the rest did not and 26 per cent had not been informed of their episiotomies.
Australia has one of the highest rates of C-sections, still births and serious birthing tears in all the OECD countries.
Families in the maternity care system can experience high levels of peri-natal anxiety and even PTSD as a result of birth trauma.
"For consent to be valid it must be freely given, without coercion or inducement and can't be trumped by hospital policy," Dr Jenkinson said.