What's birth like in Australia?

Hi all,

I'm a mum of 1 living in South East Asia at the moment and am becoming quite active in the gentle birth scene after an unnecesarean 3 years ago. I'm 4.5 months pregnant with my second. I'm interested and curious as to what birth is like in Australia in the public and private sectors. I witnessed my SIL's birth in 1999 in a private hospital and recall gym mats on the floor, a birth ball, intermittent fetal monitoring and usage of the shower for pain management. Are those tools/practices common in Australian hospitals? Is active birthing encouraged?

Thanks for your thoughts. I'm trying to flesh out my knowledge of what's available overseas in comparison to here - which is pretty dire to tell the truth!

It really depends on where you give birth. Many hospitals are very encouraging of active labour and have all sorts of equipment and birthing pools. Others...not so much. There are quite a number of birthing centres popping up around the place too (both private and public) which are independant or complementary to the hospital birthing facilities. These are very much geared toward active natural birthing.

my dds birth was as active as it could have been, used the bath, drug free, no monitoring until I had complications and interventions

How about access to food and water, also heat packs for the bath etc? Are TENS machine common usage?

:

---

How about access to food and water, also heat packs for the bath etc? Are TENS machine common usage?

---

I had all of those things, in a regional WA hospital. More resources than in my husbands Malaysian village, but much the same in terms of support.
I had access to intervention, which I wouldnt have had in the village, and I definitely would have died in childbirth

Trish do you mind sharing what you know of what was available to mothers in your hubby's Malaysian village? Was a bidan there to assist the mothers? Was the potential for maternal mortality due to lack of access to a hospital?

There were two Bidans in the district, and I attended 3 ladies over the time we were there. Transfer to hospital wasnt possible, it was over an hour, so if there was complications the outcomes werent good. The ladies I attended were both 'experienced' mums, except for 1, who was a first timer, but also had her aunty as support. I went out with one Bidan to one of the births, the other I knew, but didnt follow.

Gosh how long were you in Malaysia for and was this a kampung or in an iban community? Hehe am finding out more in this thread about what the birthing scene is like in my current backyard. It already sounds quite different to the public and private hospital birth scene in Malaysia.

i gave birth to DS in a public hospital. i was induced & had constant monitoring as well as being on a drip. despite this, i was able to request a wireless monitor so, while i was still attached to the drip, i could move around. i was encouraged to be in positions other than on my back, on the bed & was able to request (and have) a ball to sit on. this time (still public but diff hospital) i have been offered the opportunity to hire a TENS machine and also encouraged to take part in physio classes before the birth.

despite being induced & being hooked up to various machines, the midwives made clear that they would not be offering pain relief unless i asked about it - they left the decision to me to actually request rather than just offering (i think this is fairly standard?).

As OP have said it really depends on the hospital and the care givers.

I have been fortunate enough to have given birth in a fantastic rural hospital that offer ALL types of things to ensure the mothers birth of her baby goes smoothly. Pain relief options can include the gas, sterile water injections, pethadine, TENS machines, Epidurals etc. they have showers and large baths in all the labour rooms, fit balls, matts, beds, monitoring machines, you can bring in electric oil burners, music, they can dim the lights anything really.

The ONLY thing they won't allow is a water birth. Once you start pushing you must get out from the bath and I think my shower was turned off at that point but I wasn't paying attention to that :rofl:

I only had midwives and hubby in with me and a Dr came in to stitch me up post delivery,

Again not every place allows so much freedom, though so I count my blessings.

Nae x

:

---

Gosh how long were you in Malaysia for and was this a kampung or in an iban community? Hehe am finding out more in this thread about what the birthing scene is like in my current backyard. It already sounds quite different to the public and private hospital birth scene in Malaysia.

---

i lived there for 2 years but spent 5 months a year there over 10yrs (we didnt go last year with a newborn, but are going dec-march)
the ladies i supported were in the kampung. big difference to the hospital scene! dhs family is well off, and all went private, but all had loads of intervention.

Our first was at a private hospital with a "pro-natural" OB (by reputation). Well, we ended up being pushed into an induction (post-dates) and laboured under the ineffectual care of complete strangers (never met midwives before), having had to argue with the OB to try and control the way our induction proceeded. There was a lot of stuff that was just done as it was routine and we were unable to assert ourselves at the end (ignored, disrespected etc - as can more easily happen when you're cared for by strangers).

Second time went through a public homebirth program. We had our own midwife, who we got to know well and built a good relationship with. And even though I only met our backup midwife once before the birth, we spent an hour chatting and I felt realyl comfortable with her. They were great and we felt very well supported and safe. Even when we transferred to hospital they were there for us and I felt safe, knowing that I was cared fro by someone that knew me and really 'cared' for me.

Neither labour & birth was straight forward, but second was much more satisfying for me - primarily because I knew that we gave my DD the best birth we could, whereas I cannot say the same for my son.

It seems a lot of carers in the maternity system don't really respect mother's right to determine what happens. There's some sort of presumption of incompetence once you have a baby inutero or something :dunno: Some are fabulous of course, but the lack of continuity of care or care with a known midwife (in may places) really hampers their ability to help mothers also. (In Perth, for eg, you can only get care with a known midwife if you plan a homebirth!)

It's eye-opening so far... to know how much choice there is in Australia! :( Can I ask how much communication is given by the staff to the parents regarding procedures and drugs before they are performed or administered?

Here where I am, informed consent is basically non-existent unless you educate yourself hugely + find an obgyn who really will accept your wishes (which doesn't always happen during the birth) + fight fight fight fight fight.

Examples - waters broken without any discussion at 3cm dilation; cytotec being prepared for VBAC mother who is at 9cm dilation; pethadine injection without any discussion prior.

:

---

It's eye-opening so far... to know how much choice there is in Australia! :( Can I ask how much communication is given by the staff to the parents regarding procedures and drugs before they are performed or administered?

---

Depends where you are birthing, and who the staff are on the day. On paper, they follow informed consent principles, the reality is often different.

Again it depends on your hospital and circumstances too.

My last birth was a VBAC, I had excellent MWs who were supportive of my choices and knew well before hand that unless under emergency situations was I to be offered anything other than gas. I knew going in that it would be in both mine and my babies best interest to be monitored throughout and I was prepared to kiss my vbac goodbye should the need arise.

I actually asked at one point to be examined to see how far dilated I was but the next thing I was pushing so it was a bit late for that.

BUT - they cannot just "go ahead" and do anything without consent unless the mother was unconcious. Well thats how it is at my hospital. They cannot administer drugs without consent as the patient could very well be allergic. If they did they would be up for a law suit! Though in saying that there are circumstances where the risk to mother and baby can out weigh the consent thing.

With my first baby,born by emergency ceasar, I was told what the Drs thought SHOULD be done and given the option to do things my way. I chose the Drs way. I had to sign a consent form before they administered the Epi. I was told what I was drinking when I had to neutralise the contents in my stomach and the next day when I had drips and cathedars, I demanded they take them out or I was going to do it myself.

I guess to comparing two different countries systems and methods is not very fair either. We have relatively good health care here in Australia compared to other nations and the very fact that we CAN choose is nothing to be sniffed at. The other thing too is some women choose NOT to educate themselves and leave every decision to the care givers. They believe the staff will always do the right thing...which is not always the case.

Can I ask you something ........Are you planning on birthing here in Australia?

I am curious to know why you are curious about our systems etc and how they differ to yours :rofl: I mean obviously there are restrictions etc in place for women over there but how is knowing what our options here in Aust goingto benefit yourself or other mothers over there (if that makes sense at all).

I am a curious kitten :D

:

---

BUT - they cannot just "go ahead" and do anything without consent unless the mother was unconcious. Well thats how it is at my hospital. They cannot administer drugs without consent as the patient could very well be allergic. If they did they would be up for a law suit! Though in saying that there are circumstances where the risk to mother and baby can out weigh the consent thing.

---

Unfortunately, these things have happened to BB women- procedures done without consent, drugs given without consent. And actually proceeding with a law suit is so incredibly difficult that it rarely happens.

A woman should always have the right to refuse medical treatment.

:

---

Unfortunately, these things have happened to BB women- procedures done without consent, drugs given without consent. And actually proceeding with a law suit is so incredibly difficult that it rarely happens.

A woman should always have the right to refuse medical treatment.

---

BB women or not they STILL have the right to know what is being done and STILL have the option to say no.

It does happen that medics play god and don't consider the womans right of choice ... as I said in my quoted part of the post, I was referring to my particular hospital. They do not do things without consent unless a woman is unconcious or unable to make that call herself.

There is such a wide variety of experiences and options here. I went through the public system with DD 9 and a bit years ago and felt much more "pushed" into things during her birth - I was advised to have a pre-emptive epidural as I was being induced and was just told how the induction would progress rather than being encouraged to let each step take effect before moving on to the next etc.

I recently had my son in the private system and cannot fault my experience at all - my OB was fantastic and fully supportive the entire way of my desire to do things as naturally as possible, even when this didn't entirely go according to plan and I needed to be induced again and wound up with an assisted delivery - he explained *why* intervention was necessary and because we had built that relationship over the course of my pregnancy I felt I could trust him completely. I hadn't met my midwives prior to labour but they were all fantastic (I had about 8 over the course of 2 days) and treated me with the utmost respect and care. DH and I had the final say over everything that happened and needed to give consent to any procedures/drugs etc

In principle, women have the right to autonomy over their bodies and informed consent. In practice however, some 'carers' do not respect this. The law is on their side - they can always play the 'it was medically necessary' line and in truth, few parents question this treatment in any case. Not just doing things without informed consent, but telling mothers they 'have' to be induced/have VEs/cannulas/etc, etc - it's pretty common really.

You have to do lots of research in your options & care providers. The surest way to be sure, is to actually build a relationship with them - so continuity with a known carer. Even if you go private and get to know your OB, you probably won't have the option to get to know your midwife (even *if* you can do 'shared care', you may not be caseloaded to a particular midwife and will have to labour with whoever happens to be there at the time).

I think there's variation b/w hospitals, however, if you educate yourself (on which hospitals will support your wishes), and have a great support team (i.e, partner, a doula or a private midwife) in hospital - you probably stand the best chance of having the type of birth you want (of course, not counting any real emergency).

I went public with my first son, went overdue, was induced and ended up having a c/s. I tried for a VBAC (public again in Melb). I had to fight some of the Dr's who thought an 18 month gap wasn't long enough b/w kids to try VBAC. We had a doula with us second time around which was fantastic. She could advocate for my wishes when I couldn't talk and was a great support to both myself and my husband. I think the staff can sometimes pressure the partners into making decisions that you may not want.
They couldn't induce me and I went overdue. They broke my waters to see if I could get into labour and gave a strict timeframe (looking back, doomed to fail with the stress I was feeling). Another c/s.

Third time around, it's hard to find many public hospitals or private obs who support VBA2C. There are some, but I've had to do my research and I'm switching providers at 16 weeks to private. A great Dr who I'd met public also works private and I really trust her. Birthing centres which are more pro-active/calmbirth/no intervention, but won't take you on if you've had a caesar or are 'high risk' for other reasons. Some hospitals have birthing pools, however their policies differ on whether these are to be used for labour and/or birth and not sure if they're keen on VBAC'ers using them. I'm asking for cordless monitoring this time around to at least use the shower. Will have a birth plan with my wishes and will again ask that we be given time to consider any intervention suggested. They were pretty good about this with my previous two experiences.

This is all great stuff. NaeNae, in many ways I'd be keen to birth back home in Australia if we had a family home there - as it is my family all live in studios or tiny two-bedders with flatmates - so we'd have to rent! And by god accommodation prices in Australia is the stuff of heart attacks.

If I had to birth in Australia it would likely have to be in the public system as we no longer have private health insurance.

Having said that, it sounds pretty darn good in the Aussie public system - a darn sight better than here where in the public system you get:
*Automatic AROM - literally close to 100% rate
*No mobility once in the birthing ward
*Automatic episiotomy - literally close to 100% rate
*Most likely forceps delivery
*In a birthing ward where you are separated from other birthing mums by curtains around your beds.
*The cost of a vaginal birth is about $70 total for the top tier of treatment and about $10 for the lowest tier. The cost of a c-section in the highest tier is about $300!

It isn't much better in the private system. Honestly. Every birthing mother has to have an obgyn and there are no true midwives. Active birthing is still something of the future. Mothers are told to lie on their backs and not move in case the EFM doesn't work. Some obgyns have 70% c-sect rates, some obgyns have 95% episiotomy and AROM rates. The rates and stories are horrific. So many women too have no idea that their birth wasn't best practice and believe that they're never able to birth vaginally. In the group I volunteer with, we are coming across many examples of birth trauma. Two weeks ago, I know of about 6 women who had unhappy/traumatic births and not necessarily because there were complications. One mum was told to hurry up or they'd need to induce as the obgyn had a dinner appointment that night!

I could go on and on and on and on...............

So mainly, I'm asking these questions as I really want to know how can things be better here. I feel that if we can train midwives here in TRUE midwifery that would be a start. If they would allow women to be active and mobile in labour, that would make a HUGE difference. Hopefully the group I volunteer with will get a forum with the obstetrics society here to put forward some suggestions for improvement. Diplomacy and 'saving face' will be necessary though!

:

---

BB women or not they STILL have the right to know what is being done and STILL have the option to say no.

It does happen that medics play god and don't consider the womans right of choice ... as I said in my quoted part of the post, I was referring to my particular hospital. They do not do things without consent unless a woman is unconcious or unable to make that call herself.

---

And women everyday say no in hospitals in Australia and are then threatened, held down, assaulted, raped and maimed.

I am glad that you have not experienced things done to you without your consent. I would have had trouble believing that these things happen today in Australia if i had not experienced it myself. Other women have had favourable experiences at the hospital that i birthed my DD, mine was not.

I have gone through a midwifery group practice in a public hospital and have had a fantastic experience with both DD's and Im seeing the same midwife this time around too

I had premature rupture of membranes at around 36 weeks with both DD's and was technically change over to obstetric care, however both times I saw a Dr for about 5 minutes in total and had my midwife with me through out. Even though I had PROM with DD1 without labour I was able to go home on OAB ang given a chance to establish labour naturally which it did. With DD2 labour started when my waters broke. As I was preterm the hospital policy was to use fetal monitoring but I was able to use it wirelessly. I delined antibiotics with DD2 and my decision was respected. With DD I did have a registrar ask me to stop walking so much as the monitor wasn't working well when I was doing laps of the ward but my midwife stepped in and suggested we monitor a couple of contractions while I was standing still, everything was fine so I continued my walking.

I could have had a water birth if I was at term. I could not deliver in the birth centre due to being only 36 weeks however there was a shower, fit ball, mat, bean bag, heat packs and my midwife got some clary sage oil to help progress labour when it slowed down. As the model of care I had chosen is based upon a more natural view off childbirth analgesia wasn't offered but I knew if I requested it it would be available.

I also liked the pre and post natal care I had. The midwife visited me at home or I went to her in a local community centre prior to the birth which was great when I was pregnant with DD2 as no long drives to the hospital or huge waiting lines. The post natal care was fantastic. I think I had visits the 4 times the first week with DD2 (we went home the day after she was born) then weekly for a few weeks which is much more frequently than the regular maternity care follow up

I honestly think in Australia it depends on your carer as to whether they listen to your needs and seek permission for interventions, they all 'should' legally and ethically but that doesn't always happen. I think wherever you are getting a chance to learn about your caregiver and their practices and building a trusting relationship is the most important thing. I cant imagine going through birth woth a complete stranger caring for me

I hope you get the birth you want

Wow Sweeties. As much as I can complain about the lack of choice here, we certainly seem to have a lot better than over there!
All the best with your advocacy work. You probably need a two-pronged approach: working to change attitudes & approaches on the medical side, but also supporting parents to demand better care.
Good luck!

Sweetie, sadly those stats dont surprise me at all, thats why many women choose to birth at home, rather than hospital.
I had one cousin (no kids) ask why I wasnt booked for a csection, since it was 'easier'. He nearly fainted when told I birthed a 10 pounder with no pain relief, and am VBing next time too (if all goes to plan)
My relatives are lucky to have had private healthcare, and great support to stay at home until the last minute. Many women I met homebirthed as a way of life, hospital was for risky pregnancies.

It's such an uphill climb here... and every time we seem to go up... something happens to bring things down again. Sometimes it just gets so hard suggesting, encouraging, persuading, sometimes fighting. We're doing lots to try and educate families (demand) and as for hospitals (supply), if we could just ask them to fork out a bit of money to equip hospitals with gym mats, birth balls, even just to allow the use of a shower - some very few items in our massive wishlist - and allow mums to use them, I reckon there'd be a calculable improvement in vaginal birth rates. Getting a whole systematic overhaul - apart from a shift in perspective - seems impossible at the moment! :wall: :pray: