What happens to birth choice in Australia when the midwife insurance exemption ends on 31 December 2026? In Episode 16 of The Birth Series, Keshia Tognazzini talks with doula, birth educator and Hygieia Health advocate Fiona O’Shaughnessy about where things stand in the birth world right now. Fiona explains the insurance issue facing second midwives. If second midwives can’t afford to attend births, primary midwives can’t attend home births either. That could leave women with only two options: a highly medicalised hospital birth, or a free birth they may not have chosen. They also talk about how the media covers free birth and the people who support it. They look at the gap between the headlines and what really happens in the community. They talk about birth trauma and the NSW inquiry: more than 4,000 people made submissions, it made 43 recommendations, and Fiona says only one has been implemented. And they ask why systemic problems keep being blamed on women, doulas and birthkeepers. Fiona also shares the story of Hygieia Health. The charity is dedicated to preventing and healing birth trauma. In August 2026 it opened Hygieia House in the Northern Rivers, a community hub for education, birth, postpartum and support for birth workers. Its long-term vision is an independent birthing hospital, “in our lifetime.” In this episode: Why the midwife insurance exemption matters, and why the issue is about choice, not home birth How a lack of options can push women into free birth for the wrong reasons The midwife shortage and the toll of being on call How the media portrays free birth, stillbirth and birth workers The extremes in birth culture, and the large middle ground most families are in Hygieia House: what it offers, who it’s for, and where it’s heading Why separating mothers and babies makes no sense, and what the evidence says “It’s not a people problem, it’s a system problem” How you can get involved: rallies, screenings and events 🗓️ Upcoming events Allowed to Birth documentary screening + live Q&A panel, Byron Bay, 17 November. All proceeds go to Hygieia House. Keshia and Fiona will both be there! https://www.eventbrite.com.au/e/allowed-to-birth-byron-bay-nsw-documentary-screening-plus-live-qa-panel-tickets-1994521157473 Grandmother of All Rallies, Mullumbimby, 21 November. Arrive 12:30pm for a 1pm start. Bring banners, kids, partners and anyone who cares about birth choice. Please register so organisers know numbers. https://events.humanitix.com/grandmother-of-all-rallies-mullumbimby-nsw Other local rallies (21 November) and the main rally in Canberra (24 November): https://www.homebirthaustralia.org/ An Evening with Jane Hardwick Collins and Rhea Dempsey, 25 November, in person and online hygieiahealth.org/events Birth Worker Circle at Hygieia House, 26 November. Open to midwives, doulas, birthkeepers, students, postpartum doulas, massage therapists and anyone working in or around birth. To attend, email hello@hygieiahealth.org 🌱 Support Hygieia Health Website: https://hygieiahealth.org Make a one-off donation: https://hygieiahealth.org/donate-once Become a Founding Member: from $50 a year, with exclusive events, updates and discounts. Founding memberships close in December! https://hygieiahealth.org/donate Hygieia Health Podcast: https://podcasts.apple.com/ph/podcast/hygieia-health-podcast/id6830207167 🤍 Our sponsors 🌿 INBLUEM Skincare Pure, plant-based skincare made in Byron Bay. No toxins, no fillers, no fuss. INBLUEM is offering Return to Wisdom listeners a discount. 👉 Use code RETURNTOWISDOMPODCAST at inbluem.com/returntowisdompodcast 💞 Kim Anami Holistic sex and relationship coaching for reconnecting with your body and your partner. Register for courses here (using this link also supports the podcast): https://kimanami.ontraport.com/t?orid=511555&opid=2 🍄 Superfeast This episode is brought to you by Superfeast. Enjoy 10% off your order with the code RETURNTOWISDOM https://www.superfeast.com.au/ The Birth Series from Return to Wisdom examines free birth and birth culture with nuance and a critical eye. It does not promise definitive conclusions. Please weigh the evidence for yourself. If this episode sparked something for you, please like, share and leave a review.