By Dr Kathryn Austin, AMA (NSW) President
FEATURE BIRTH TRAUMA INQUIRY IMPORTANT OUTCOMES
AS WE COMMUNICATED to members at the time, the inquiry was driven by considerable social media input, often from those with a direct financial benefit from pushing the agenda.
The outcome of this inquiry could have been disastrous, with a significant and real risk of new legislation around obstetric procedures, an outcome which would have made practicing obstetrics impossible.
As an obstetrician I saw firsthand the impact of this attack on my colleagues in obstetrics. I also saw the risks the Inquiry presented not just to obstetricians but doctors in all specialities as well as for our midwifery and nursing colleagues. Obstetrics is often the canary in the coalmine and this
On Wednesday 29 May, the Upper House Inquiry into Birth Trauma handed down its report into Birth Trauma. The Inquiry had been called following the formation of a minority government in the wake of the March 2023 NSW election.
inquiry was a perfect example.
AMA (NSW) responded to the challenges this inquiry posed. We knew that this was a matter of defending our profession and our standards without diminishing the experiences of those who had experienced trauma or difficulties with their pregnancy or birth.
AMA (NSW) prepared a detailed submission1 which was submitted on August 15th 2023.
I, along with AMA (NSW) CEO Fiona Davies and AMA (NSW) Media, Communications & Policy Manager Rahni Sadler set up a series of meetings at State Parliament with MPs on the Committee. These briefings proved critical in conveying to committee members the dedication of doctors, midwives, nurses and health
workers in maternity, obstetrics and paediatrics. We also explained the necessary role of interventions and the complex legal issues impacting on doctors.
On October 9th I appeared before the inquiry, along with Fiona Davies. I provided an opening statement2 explaining that doctors want what expectant parents want, a birth that
AMA (NSW) Councillor Eveline Staub giving evidence to the Committee.
“We knew that this was a matter of defending our profession and our standards without diminishing the experiences of those who had experienced trauma or difficulties with their pregnancy or birth.”
DR KATHRYN AUSTIN
is medically and psychologically safe for both mother and child. I described the best outcomes as being achieved by a collaborative, multidisciplinary team-based model of care, with each profession supporting and respecting the opinion and approach of others. I called for realistic pathways to adequate antenatal education but just as importantly post-natal education as to why interventions may have been necessary. I called for better training and resourcing for such education and those who provide it. I warned that the result of this inquiry could be highly detrimental to the specialty of obstetrics stating, “If the inquiry
results in recommendations that are not safe for those working within the system, this could lead to a catastrophic failure to attract and retain the workforce we so desperately need across the state.” I then answered questions on my statement and was asked to provide answers to questions on notice3 which we did following the hearing. We then arranged for AMA (NSW) Councillor neonatologist Dr Eveline Staub to appear. In preparation for her appearance we were asked to provide a submission4 on her behalf. Dr Staub appeared before the committee on the 8th of April 2024. She gave an opening statement5 and in questioning provided powerful evidence on the dedication involved in achieving exceptional outcomes in maternal care and the tragic impact for the children and families who have poor outcomes in labour. Dr Staub noted that most parents who experience admission to the NICU (Neonatal intensive care unit) express distress about the lack of warning they were given during the ante-natal
period that their child could end up with significant complications from birth. AMA (NSW) was again asked to provide answers to questions6 on notice, which were submitted shortly after the hearing. The final report7 was released with references to the AMA’s input on most pages. While the Chair tried to continue her attacks, the body of the report contained limited or reasonable recommendations and critically, stopped the worst of the harms. Without the input of AMA (NSW) we believe the outcomes could have been far more detrimental to doctors, not just in obstetrics, but across the profession. These outcomes were achieved through significant work over many months, work only made possible with the support of you, our members. dr.
I will continue to work with the ministry and government for the next steps following the Birth Trauma Inquiry Report and in formulating an AMA (NSW) Response. Members are invited to email president@amansw.com.au to express opinions or comments.
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Dr Austin and AMA (NSW) CEO Fiona Davies giving evidence at the Upper House Committee on Birth Trauma
Birth trauma inquiry chair Emma Hurst spoke of her disappointment after the report was handed down.