Actor, producer and activist Zoe Naylor shares the insight she garnered while co-creating Birth Time: the documentary which explores the ins and out of the Australian maternity system – and why she believes the system, itself, is “broken”.
Our maternity system is broken. We have a postnatal depression epidemic, with suicide being the leading cause of maternal death in the developed world. Birth trauma is rampant. We have incredibly high intervention rates in birth, yet research shows that this is not leading to better outcomes for mothers and babies.
For the past four years, I have been co-writing, researching, producing and directing a feature documentary, Birth Time: the documentary alongside midwife Jo Hunter, and doula/birth photographer Jerusha Sutton, that shines a light at what is really happening in our maternity care system.
From my own experience as a birthing woman in this country and from the interviews and research we conducted, it has become evident that we are facing an enormous human rights issue that is happening right under our noses.
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Get educated about childbirth – the right way
I would consider myself a highly educated and resourced woman, having won a scholarship to University, completed two degrees and been school captain of a private girl’s high school in Sydney.
When it came to enter into the journey of motherhood, however, I couldn’t have been more uneducated or under-prepared. This was of course, my responsibility.
I blindly trusted that the gold standard was the obstetrician in the private hospital setting. I had little to no regard for the monumental rite of passage that is the process of childbirth; and I didn’t question my social fabric that guided my friends and I to pee on the stick, visit the GP and get a referral to the obstetrician – who was to be the care provider for the birth of my baby.
There is no doubt that interventions can save lives. But with a current 35 per cent caesarean rate in Australia when the world health organisation deems 10 to 15 per cent to be a healthy rate, we must begin to ask ourselves why?
High rates of intervention in childbirth
Professor Hannah Dahlen highlights, “in this country our intervention rates are very high, yet these interventions are not leading to better outcomes for mothers and babies”. The Australian Institute of Health and Welfare (AIHW) reports that:
- 34.2 per cent of (or one in three) women are medically induced.
- 22.5 per cent of (or one in five) women do not labour at all and have a planned caesarean section.
- 78.2 per cent of women use analgesia in labour for pain relief
- 16.6 per cent of women are given an episiotomy
We are losing connection and trust in one of the most transformative, powerful, primal and pivotal rites of passage we will ever undertake in our lives.
“I felt like I had failed myself”
I only know about the transformative power of this rite of passage because I’ve been able to traverse the threshold twice now – both consciously and unconsciously with the births of my children.
During my first labour, I felt like I was holding onto the back of a freight train and barely hanging on. I was out of my body and totally overwhelmed by labour’s ferocity and power. The midwife I had got to know during my pregnancy wasn’t on call when I went into labour and I felt incredibly alone. I had no idea what was happening to me.
By the time I arrived at the birth unit I had checked out. I felt like I had failed myself. Although I ended up having a normal physiological birth with my first, I tore badly and emerged emotionally traumatised.
“The hand that rocks the cradle rules the world”
Speaking of birth trauma, Dr. Eugene Declercq notes that “mothers who met the criteria for trauma also experienced levels of depression and difficulties with attachment that become more serious as time goes on if they’re not treated”.
“We live in a time where it has become normal to disregard the importance of a woman’s experience of birth. It is not widely known that our birth and birthing experiences deeply impact the way we navigate the world and our capacity to engage in and enjoy motherhood. The hand that rocks the cradle rules the world,” Professor Hannah Dahlen adds.
These research findings were particularly palpable for me having experienced postnatal depression after the birth of my first baby.
Improving the experience of childbirth
Dr Rachel Reed believes, “improving women’s experience of birth helps them set up a stronger bond with their babies, decreases their risk of postnatal depression and encourages them to trust their maternal instincts when it comes to mothering their children. Care, connection, respect and trust begin with the mother baby bond.”
The question that we asked in the documentary as we traversed the country is, “What would it take for women to emerge from their births physically well AND emotionally safe?”
For my second pregnancy I chose a very different experience to my first. I was wiser, more informed and becoming educated. This time I wanted the fullest experience of Continuity of Midwifery Care to protect the sanctity of the entire birthing experience.
“I was seen, I was met, I was held”
My midwife, Midwife Jo visited me every month at home from 12 weeks pregnant and weekly in the weeks leading up to my due date. She got to know me better than my own mother. Every thought, fear, the things that made me tick, what I needed. And as Professor Sally Tracey informed us, “that kind of attuned and sensitive care just cannot be upheld in a system wired around money and the clock.”
My second labour was totally different. Physically, ironically, it was actually much more difficult. Beau was posterior and 10 pounds. To commit to that labour required all of me.
Yet, after that birthing experience I truly was transformed in a way I had never known. It was like decades of healing in one process. I was seen, I was met, I was held through every contraction and expertly supported through every transition to the point that I honestly felt I could have done it again a few days later. There is no way that thinking was even possible first time around.
“It was still difficult – but I was supported”
In this second birthing experience I was also able to sit in and be with the pain in a way that felt far more embodied and present. It was still difficult – but I was supported. I navigated my fears far more robustly.
And when I reached my outer limits and faced myself again, this time I could look into my midwife Jo’s eyes and feel the lineage of the women who had traversed the threshold before me and I trusted her when she said, “I could do it”, even when I thought I could not.
Olympians have expert teams that help them win gold medals. Women equally deserve to have a dynamic birthing team who help them truly achieve their goals when it comes to giving birth. To that end, I would suggest a doula and an experienced midwife. Jo continued to come to my home after giving birth every day for a week, then weekly until six weeks postpartum.
One woman, one midwife
We made this documentary as a catalyst to motivate action and instigate change. We aim to educate women and pregnant people about different maternity services that are available to them. For them to understand they have a choice, and to share information about new and evolving midwifery models of care.
If all women could choose to work in partnership with one midwife who provided them with continuity of care throughout their entire pregnancy, birth and postnatal period, more women would emerge from their births physically well and emotionally safe.
Interestingly, currently only eight per cent of women in this country can actually access Continuity of Midwifery Care within the Midwife Group Practice Model, which is incredibly low considering the research into the better outcomes for women and babies. Moreover, only 0.4 per cent of women give birth at home.
All women deserve to have a named midwife for their pregnancy, labour and postpartum. It’s time we changed the system and helped women reclaim what is rightfully theirs. When we improve women’s experiences around birth, we change the world!
The Birth Time team will travel around Australia from 11th February to 7th March, 2021 to attend 14 premiere Q&A screenings.
In an emergency please call 000.
If you or someone you know needs help, phone Lifeline on 13 11 14 or the 24- hour Suicide Call Back Service 1300 659 467.
Mental health professionals are available 24/7 at the beyondblue Support Service – 1300 22 46 36 or via beyondblue.org.au/get-support for online chat (3pm-12am AEST) or email response.
If you’ve experienced pregnancy loss or stillbirth and need support, call SANDS on 1300 072 637, Lifeline on 13 11 14 . If you’ve experienced the loss of a child call Bears of Hope on 1300 11 HOPE.
Zoe Naylor is an actor, journalist, producer, activist and public speaker. She mentors women on wellness globally and has co-written, directed and produced Birth Time: the Documentary alongside Jo Hunter and Jerusha Sutton.