Birth: the forgotten feminist issue Alecia Staines

Dr Heather Mattner, psychologist and midwife, joins me to discuss birth trauma. Studies suggest one third of women experience birth trauma. In the current maternity system, she believes 100% of birthing women are experiencing birth trauma. We discuss symptoms, prevention, the overall maternity system, previous trauma's impact on birth trauma and what women and the system can do to reduce birth trauma. Heather says: Birth trauma is preventable harm. And, birth trauma does not favour/disfavour any women regardless of age, culture, spirituality, religion, parity, gestation, intellectualism, status etc etc. That in itself is probably evidence enough to say it is a systemic issue against women - all gestational women.

Dr Heather Matter's qualifications: 

Perinatal Health Psychologist 

PANDA Clinical Champion

Honorary Clinical Senior Lecturer (Psychology)

The University of Adelaide

heather.mattner@adelaide.edu.au




---

Support this podcast: https://podcasters.spotify.com/pod/show/alecia-staines/support

In this episode, Dr Rachel Reed and I, discuss the all too common "diagnosis" of Gestational Diabetes, and how this affects a woman's treatment pathway, often leading to induction, women being treated as a source of risk for their baby, and the cascade of intervention. Rachel explains how so many women have come to be diagnosed with Gestational Diabetes, why else we're seeing so many women having an induction of labour, medical risk, and birth trauma. We discuss the ceremonial practice of birth, the "identity crisis" midwives are currently going through, and why birth is the forgotten feminist issue. 

You can read more from Rachel at her blog midwifethinking: MidwifeThinking

Her recent books are: Why Induction Matters and Reclaiming Childbirth as a Rite of Passage

She also co-hosts the podcast The Midwives' Cauldron 

You can see Dr Rachel Reed formerly from USC’s School of Nursing and Midwifery was interviewed for Birth Time: The Documentary. She states:

“In Australia we have a heavily medicalised maternity system that leads to a lot of interventions for women, many of whom do not particularly want or need them,” said the Senior Lecturer in Midwifery.

“There have been reports of coercion and manipulation. Often, it’s not done intentionally – rather more as an attempt to mitigate medical risk. But what is not counted is the emotional risks facing women if they experience disrespectful care.

“Birth trauma is not about how a woman births. It’s about how she was treated during birth. There’s more to trauma than a physically traumatic experience.”


---

Support this podcast: https://podcasters.spotify.com/pod/show/alecia-staines/support

Midwife and researcher, Nigel Lee, joins me to talk about the Perineal Tear Bundle (bungle?!) that was rolled out in Australian hospitals a few years ago, in a feeble attempt to reduce the incidence of 3rd and 4th degree perineal tears. It consisted of 5 different practices applied to women during birth, in an attempt to reduce 3rd of 4th degree tears. These tears extend to include the muscles around the anus (3rd degree) or into the anal passage (4th degree). We discuss what the evidence says, the issues with most of the elements of the bundle, consent, the rise of episiotomy, what his own research found when interviewing midwives about the Perineal Tear Bundle, what other parts of the world are doing to reduce 3rd and 4th degree tears, and what Australia needs to do in order to improve outcomes. 

Link to Nigel's research: 2021 Allen, J., Small, K., Lee, N. How a perineal care bundle impacts midwifery practice in Australian maternity hospitals: A critical, reflexive thematic analysis. Women and Birth. In press https://doi.org/10.1016/j.wombi.2021.01.012

2018 Lee, N, Gao, Y, Lotz, L and Kildea, S . Maternal and neonatal outcomes from a comparison of spontaneous and directed pushing in second stage. Women and Birth. 32(4), e433-e440.https://doi.org/10.1016/j.wombi.2018.10.005 https://doi.org/10.1016/j.wombi.2018.10.005

2018 Lee, N., Firmin, M., Gao, Y., & Kildea, S. . Perineal injury associated with hands on/hands poised and directed/undirected pushing: A retrospective cross-sectional study of non-operative vaginal births, 2011–2016. International journal of nursing studies, 83, 11-17. DOI: 10.1016/j.ijnurstu.2018.04.002 

More on the Perineal Tear Bundle and midwifery practice here: Bundles for perineal care: the impact on midwifery practice - Transforming Maternity Care Collaborative


---

Support this podcast: https://podcasters.spotify.com/pod/show/alecia-staines/support

Jolene specialises in trauma as an Accredited Mental Health Social Worker. She shares how trauma effects our body, and how previous trauma can impact birth. Various studies over the years have shown how women who've experienced trauma are more likely to experience birth trauma, but it's never been described in detail; how trauma impacts the body and our births. I invited Jolene on to explain why this link occurs, how a part of the brain called the Amygdala overrides the prefrontal cortex (logical part of our brain) to ensure we survive. Jolene describes how trauma isn't stored in our mind in a narrative memory sense, but felt-senses and patterns of behaviour in certain situations, which can included fight, flight or freeze response. We discuss how women can understand how their trauma can impact their births, how birth companions and care providers can identify and help women during birth who've experienced birth trauma.   
In this episode, I share my childhood trauma with having my own mum suffer from Bipolar, Borderline Personality Disorder and multiple suicide attempts. As a child, I learnt that in order to survive, I needed my mum to survive, and a strong sense of self-reliance in order to not "be let down". I describe how this impacted my birth through my need to "control" the situations in order to feel safe and secure. 
You can find Jolene here: Child and Family Therapist | Jolene Hutchings | Bli Bli
A recommended reading resource we spoke of is: The Body keeps the Score by Bessel van der Kolk

---

Support this podcast: https://podcasters.spotify.com/pod/show/alecia-staines/support

Although Rachael and I have never spoken on the phone or via Zoom before, we worked closely together during the 2018-2020 Bush Baby Media Campaign. It was the largest maternity campaign the country has ever seen- at least 8 Front Page stories, National morning TV, nightly news, The Project and international interest. It was an national award-nominated media campaign. As a result of this campaign, Queensland created a Rural Maternity Taskforce and subsequent report to ensure some sustainability of our rural maternity services. In this episode, we discuss what the evidence says for rural births, what were the results of the Bush Baby Campaign, the service capabilities of hospital maternity units and some tips on running a good media campaign to lobby for maternity services. 


---

Support this podcast: https://podcasters.spotify.com/pod/show/alecia-staines/support

Jodie shares her journey to receiving care in a Birth Centre in Brisbane, her journey into advocacy and some of the amazing campaigns she helped create to improve access to the Birth Centre. We also discuss the obstetric lobbying, including the label "the killing fields" the Birth Center was known as by the obstetricians opposed to it. You can find Jodie's book here: What Does It Feel Like Being Born? by Jodie Miller. 


---

Support this podcast: https://podcasters.spotify.com/pod/show/alecia-staines/support