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Report on Breathing New Life into Maternity Care conference
By Cas McCullough

I had the wonderful opportunity to represent CANA and Maternity Coalition as a presenter at the Australian College of Midwives national conference Breathing New Life into Maternity Care on December 1 to 2 in Sydney.

The conference covered a broad range of issues related to providing better care to women and improving services and featured talks by policy makers, politicians, consumers, obstetricians, midwives, and allied health professionals. Notably the conference was the first official engagement of new RANZCOG President Christine Tippett.

The networking opportunity was invaluable and I was able to make many new links on behalf of MC and CANA but in addition, Shelly Gower (from Birthrites in WA) and I were like broken records in each question time reminding everybody there that consumers should have a decision-making role in any process involving improving their care.

The aim of the conference was to highlight initiatives and talk about the benefits of collaborative care. As such there was a lot of talk about collaboration but little acknowledgement of the consumer’s central role in this collaboration. Many of the initiatives talked about were innovative and exciting but still, consumers were seen as an additional stakeholder rather than central to the process. Consumers were often left out of the process of developing guidelines and policies.

I firmly believe we (meaning us women) need to have more of a presence at these events to keep the pressure on in this regard.

It was great to see obstetricians there (albeit not many) and fabulous to meet the very famous Andrew Bissits from Newcastle. He truly gets birth and VBAC and all that surrounds it. It was refreshing after a weekend spent trying to convince obstetricians of the merits of midwifery care for VBAC and high needs women.

I had several conversations with Brian Peat, Head of Obstetrics at the Womens' and Childrens' Hospital in Adelaide and broached the BAC trial with him (well actually he broached it with me because I’d mentioned it in my talk. Needless to say we came at the issue from two entirely different perspectives but I appreciated the chance to talk this out. On a more positive note, it was great to hear that the Women’s and Children’s Hospital in Adelaide include women planning VBAC in their midwifery group practice (where women have primary care by a known midwife).

I feel a new sense of direction for the coming year after attending this conference. It is apparent that we still have our work cut out for us in terms of reaching obstetricians and policy makers and being taken seriously as key stakeholders in maternity care but I’m an optimist and feel we will get there one day.

CANA meets with the MSSC in Queensland about Risk Management
Report by Cas McCullough

Debby Gould and I represented CANA at our first meeting on Wednesday October 25th. We met with Anne Maddock (the Maternity Services Steering Committee (Qld) Risk Managment Consultant) and we felt it was a positive meeting. I was thankful that Debby was able to attend because she was able to articulate systems issues very clearly having been a midwife and having run her education and support group Birthtalk for the past 4 years. Anne asked us what we thought created risk and what we thought needed to happen to address this. We focused on communication issues between care providers and women, the lack of woman-centered care and fragmentation of services.

We also spoke about how safety was more than just physical but emotional, social, cultural etc. and the ripple effect these have in terms of outcomes for the short term and long term on the woman and her family. Debby expounded upon these and added that how a woman feels about birth is universal, crosses cultural groups and social groups, personalities etc and articulated how a bad experience of birth can impact on the woman and her family. She talked about the need for in-service training for health professionals to gain an understanding of why birth is important to women (and that it is important).

In terms of solutions I stated very clearly that it is essential that informed consumers be on steering committees and other decision-making bodies in order to effect change in the way care providers interact with women and the way in which policies are written. I also emphasised the need for them to change their whole language system around birth in the formation of policies and in documentation: ie. change the language and people will start to think differently… eg. “client” or “woman” instead of patient, “labour” instead of trial of scar.

Anne asked if we thought midwifery care benefited women in terms of reducing risk to which Debby expounded upon the virtues of one-to-one midwifery care and how it can increase physical and emotional safety for women. We also talked about this in terms of women who’ve had a prior caesarean and gave examples of what we thought were unsafe practices routinely imposed upon women in the hospital system.

CANA and Birthtalk present VBAC workshop at Optimum Birth Doula Conference

Cas and Debby (Birthtalk) co-presented a half-day workshop on supporting VBAC at the Optimum Birth Doula Conference on October 27^th and Cas was also invited to present a talk titled BAC to safe birth at the conference on October 28^th. Feedback from the workshop and talk was positive and they hope it is one of many opportunities to share their insights on how to support women giving birth after caesarean.

Cas spoke about her personal experiences of caesareans and VBAC to share insights on the psychological, physical and social impact of caesareans and how doulas were a part of those experiences. She also gave a breakdown of the realities and challenges that women planning VBAC face in the hospital system. These included the personal challenges for the woman who has been emotionally or physically scarred by their previous experience, system challenges in terms of dealing with hospital policy and culture, and interpersonal communication challenges in a situation where women and their care providers are under pressure. During the second half Debby gave practical advice on how to support women planning VBAC both prior to and during the birth and how to help women heal from a bad birth experience so that they can move forward to a next birth with confidence.

Health Quality and Complaints Commission (HQCC)
Cas had the opportunity to attend an information evening for the new Queensland HQCC on Thursday, 7 December. Commissioner Dr John Youngman outlined the purpose and structure of the HQCC and Cas had the opportunity to talk to staff and find out more about the HQCC’s services. To find out more about the HQCC, visit their website at: http://www.hrc.qld.gov.au/web/. Any woman wanting to raise concerns about their baby’s birth is welcome to contact us or Maternity Coalition for advice and support.

Ongoing Campaigns: BAC Trial
CANA is working in conjunction with Maternity Coalition to raise issues related to the ethics and validity of the Australian Collaborative Trial of Birth After Caesarean (ACTOBAC or BAC) with the National Health and Medical Research Council of Australia and participating hospitals. For further information go to the Maternity Coalition website via the links to the left or email bac@maternitycoalition.org.au.

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