More than 40 per cent of babies born in Canberra arrive via C-section. Photo: Claire Fenwicke.
It’s a brave man who wades into a discussion about what women should do with their bodies! Fortunately, Canberra’s women and midwives have been leading this conversation for more than 40 years and have at last gained government commitment for a new standalone birth centre in Canberra – giving them more choice for their pregnancy journey.
Place of birth matters. Research continues to show the further someone is from a hospital, the better their birth outcomes. It also shows midwife-led continuity of care, which supports a woman or birthing person throughout pregnancy, birth and the postnatal period with a known midwife, helps them and bub achieve better outcomes – no matter their risk profile.
Allowing women and birthing people to choose their place of birth and supporting them with midwife-led continuity of care are the most powerful ways we can offer support and lower the number of unnecessary C-sections.
Birthing in hospital often leads to what’s known as the “cascade of intervention”. Hospital policies and hospital timelines start one intervention, which leads to another, then another, until a birth involves an induction, instruments and interventions. It ends in a C-section with an exhausted mother now needing to care for a newborn while recovering from unnecessary major abdominal surgery.
Some who’ve experienced that cascade don’t even realise there is a choice.
Canberra’s high C-section rate is not a feminist achievement of choice in birth. It’s a symptom of a deeply patriarchal system that has denied women and birthing people the choice and control they want over their own bodies.
While C-sections are lifesaving interventions, Canberra’s rates are very high – more than 40 per cent of all births. Compare this to the World Health Organisation saying 10-15 per cent of C-sections are important life-saving interventions.
This difference might be because as a regional centre Canberra gets more complex referrals. It might be because some people may be making a genuine choice that they want surgery.
But most of that gap is likely because we’ve failed to provide women and birthing people with better options. In Canberra we have the options of giving birth in a hospital, in a hospital-based birth centre or at home – and home birth sounds great but some of these choices can be difficult to access.
Our hospital-based birth centres have long waitlists and the public home birth program requires having a partner, friend or family member back your decision. If your support person is unsure, your choice over your own body doesn’t matter.
It’s not true bodily autonomy if you need someone else’s permission.
This is why midwives and the Canberra community have been calling for a freestanding birth centre for decades – to give people more choice over their body and birthing journey.
In February 2023 I tabled two petitions with more than 3000 signatures and brought forward a motion asking the government to conduct a feasibility study into a freestanding birth centre for Canberra.
I’m thrilled that after doing this study, the ACT Government has announced the northside hospital will have a new standalone birth centre. It will have a fully separate entrance (close enough to allow a transfer to hospital if necessary) and the space will be designed in consultation with midwives and the community.
This is great news for Canberra’s women and birthing people. And this gold standard maternity care – allowing people to choose a standalone birth centre and supporting them with midwife-led continuity of care – means fewer people will need that hospital.
Better birth is possible but only by providing women and birthing people with genuine choice. I’m reminded of something one of the brilliant speakers said at a midwife event I attended.
“The political discord is failing women … let’s not debate the safety around birth but look instead at how we can make it as safe as possible for each individual woman.
“Birth centre midwives rise above institutional culture that finds itself ‘disallowing’ women.”
