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24 Jun 2025, by Amy Sarcevic
In 2024, a landmark parliamentary inquiry found ‘unacceptable’ rates of birth trauma in Australia, with one in three women directly affected.
One year on, how much progress has the sector made; and what more needs to be done, to further drive down these figures?
Ahead of the Obstetric Medico Legal Conference, we spoke with Professor Boon Lim of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANCOG) to find out.
Overcoming issues around informed consent
Complaints relating to informed consent were prevalent throughout the inquiry, with women reportedly feeling pressured into making choices they did not fully understand, or which, in hindsight, went against their preferences.
“A common theme was women feeling as though pain relief was not given appropriately, or they were not empowered to make decisions for themselves,” Prof Lim said.
“Oftentimes, there was no joint decision making, between the caregivers, consumers, and their birthing partners. When things didn’t go well, the partners weren’t necessarily engaged in the conversation at all.”
Prof Lim said the issue of informed consent is complex in obstetric settings, where decisions are often made in pressurised, fast-evolving situations.
“You need the right environment to provide the right care – and in obstetrics, workers are under pressure. Not only from the role itself, but against a backdrop of systemic workforce constraints.
“Then, compounding that, when poor outcomes occur, the pressure intensifies. Workers experience emotional fatigue, burnout and their resilience in the profession can suffer.”
While the government is taking measures to address workforce shortages, reprieve may be some time away. In the meantime, Prof Lim believes targeted antenatal education could drive progress.
“Antenatal training is often focussed on best-case scenarios, with an under-emphasis on what to plan for if things go wrong, what sort of interventions might be offered and what the medical implications of those are.
“We believe that if women are given more knowledge about common incidents in the birthing process, long before they give birth, they can make informed decisions without situational pressures,” he said.
Trauma informed approach
As well as exposing women to trauma, the birthing process can trigger memories or distress from past incidents – and it is crucial that clinicians handle this appropriately, Prof Lim said.
The inquiry revealed that some women felt helpless when emergencies unfolded during their birthing process, and this exacerbated their distress. For women with a history of sexual trauma, even routine examinations were challenging.
Prof Lim recommends that all clinicians practice trauma informed care – a model that has gained prominence throughout the healthcare sector, in recent years.
Backed by Federal funding, RANZCOG are working with the Australian Birth Trauma Association and the Australian College of Midwives to develop education in trauma informed care in Australia. There will be consumer input in the co-design of the training packages.
“The training, currently in pilot phase, will help staff manage and reduce incidents of birth trauma,” Prof Lim said.
“It will drive meaningful progress, even in the face of systemic challenges.”
Tailoring care for diverse communities
As well as trauma informed care, Prof Lim said more is needed to tailor obstetric practices for diverse communities.
In particular, people from First Nations or linguistically-diverse backgrounds, refugees, and the LGBTQIA community. The provision of care in rural, regional and remote communities is also a priority, he said.
Sharing more thoughts on how birth trauma could be reduced in these contexts, Prof Boon Lim will present at the upcoming Obstetric Medico Legal Conference, hosted by Informa.
This year’s event will be held 13-14 August 2025, at the Rendezvous Hotel Melbourne.
Learn more and register your tickets here.
About Prof Boon Lim
Professor Boon Lim, MBBS, FRCOG, FRANZCOG is a Senior Staff Specialist Obstetrician and Gynaecologist and Acting Clinical Director of the Women’s and Children Services, Tasmanian Health Service, North West.
Boon is currently Vice President of RANZCOG and Chair of the RANZCOG Governance, Finance and Risk Management Committee of the College.
He is actively involved in clinical research with several publications in peer reviewed journals, book chapters and is co-author of a textbook. He is a reviewer for several journals and an Editor of the British Journal of Obstetrics and Gynaecology.
He was a member of the ACT Medical Board of Australia, the Executive Committee of the Australian Preterm Birth Prevention Alliance and the National Steering Committee of the Stillbirth Clinical Research Excellence.
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