In her opening statement to the NSW parliamentary inquiry into birth trauma last week, mother of two Mary van Reyk spoke of her 10-year journey to becoming a mother. She described waiting in the same consultation room as pregnant women during one of her eight miscarriages and the specialist who told her “If you keep having miscarriages, one of those will stick”.
“I had to have a stranger tell me they couldn’t find a heartbeat while an ultrasound tool was still in my vagina,” Mary said in her written submission. “I will never recover from that moment.”
Throughout her pregnancies, Mary drew an enormous amount of support from a counsellor specialising in perinatal trauma through a program run by a local health non-profit, as well as pregnancy circles provided through a community care network.
Mary found the support she received in community care especially valuable “in the little day-to-day moments that can be very painful”.
“You know, you’re in the supermarket aisle and someone’s buying nappies, and that might hit your heart in a particular way,” Mary told Crikey. “But seeing someone else on that shopping trip who knows your story and sees you as a strong person going through this experience can really change that hurt into some kind of comfort.”
“One of the women who runs it is a woman of colour, and I am too, so I was able to get that cultural safety and cultural support in community care in a way I couldn’t through the public system, and that I think the public system is really missing.”
Mary said the mental health support she was able to access let her “move through the last eight years without my miscarriages and pregnancies having a serious ongoing impact on my life”.
“I was able to continue working; I was able to continue my relationship with my partner, my friends, my family. That’s not easy when you’re going through this process,” she said. “I fully credit the mental health support I received with that. But I was only able to participate in both of those because they were free.”
Neither program received support from the government. The nonprofit that provided Mary’s specialist counselling has now been discontinued due to lack of funding.
“The closure of that service was a massive loss for our community,” Mary said. “Even when it was there, there was a significant waiting time to get in. Other women I know had to wait for months, if they were able to get in at all.”
After Mary used up the 13 free sessions with her perinatal trauma counsellor, she was only able to continue seeing them in private practice.
“I was lucky enough to be able to afford continuing with my practitioner and paying the gap, but that’s not accessible to everyone. The gap was significant,” she said.
The lack of mental health support for people who have experienced birth trauma is only part of a wider crisis facing NSW’s mental health system. Last week, the NSW Mental Health Alliance called on the Minns government to urgently review funding levels for mental health services. Black Dog Institute executive director Professor Samuel Harvey told The Sydney Morning Herald that “the NSW mental health system is critically underfunded and on the brink of collapse … the mental health workforce is burnt out, and people who need help are falling through the cracks.”
More than 16% of adults in NSW experienced psychological distress in 2021-22, up from less than 10% in 2013-14. Despite the rise, NSW spent less on mental health services per person in 2021-22 than any other state or territory.
NSW Greens health spokesperson Dr Amanda Cohn is the chair of the state parliamentary inquiry into equity, accessibility and appropriate delivery of outpatient and community mental health care. She says the current funding model leaves mental health service providers “so under-resourced they are forced to prioritise crisis response and risk avoidance rather than providing care and healing”.
“Funding services on a fee-for-service basis or with session limits — the whole ‘10 or 20 sessions’ notion — has exacerbated fragmentation of care. Clinicians and people with lived experience have told us that what they need is to be able to form a long-term therapeutic relationship,” Cohn said. “Short-term contracts for narrowly targeted programs have left many organisations in a constant cycle of applying for grants, unable to provide their staff with job security or opportunities for growth, and unable to provide services with the flexibility to meet community need.”
Mary believes a health and mental health system that gives people the flexibility to access the support services that work for them is the key to ensuring fewer people have experiences like hers.
“Every person that goes through pregnancy is an individual, but we’re joining a system that has historically treated pregnancy as one experience. But that’s not how humans work,” she said.
“The person you get on any given day has the capacity to change your experience from an isolating one to an empowering one. We have to be able to talk to multiple people so we know that the person we choose to follow sees us as our whole experience, and not just what’s happening in that room at that time.”
NSW Minister for Mental Health Rose Jackson’s office could not be reached for comment.
The public health system can’t make everything right (or ’empowering’) for everyone. You can’t expect society at large to provide you with a mother. How can any system afford unlimited counselling; 13 free sessions seems good to me, and if it doesn’t help, perhaps it’s the wrong solution.
Sometimes you have to find your own way out of bad times; that’s life and it can be educational. I have experienced some of the events described here and I know what it feels like.
I see the Moderator(s) is/are really going at it today. On the G@za article, it has taken 45 minutes to approve three comments. Mine, posted 45 minutes ago, is apparently still under scrutiny. Unless of course it has not been approved, in which case I will never know because Crikey only tells you which comments have passed muster, but neglects to inform subscribers which of their comments it has spiked.
I sincerely believe that the majority of “Birth Trauma” comes from the simplistic attitude which emphasizes the “Natural” and fails to explain the complexities of human reproduction and the brutal nature of birth which is meant to ensure the survival of the fittest.
This is compounded by the pressure felt by the biological time, for most mothers, as they try to start for their family in their 30’s.
I remember one couple, who after 2 miscarriages in a row, were counseled that there was probably a genetic problem. The products of the third miscarriage gave the answer. The genetic aberration, at the time, was not one IVF could screen for.
These very strong people went through 19 miscarriages to get 3 perfect babies.
The mother told me that it was easier to cope because she knew that each miscarriage was not the baby she wanted.
the age of the women wanting children is rising after they have their ‘career’ started – but couples are surprised that biology is not a consumer item. Death in childbirth either of child or mother or both was common. Now when that happens there are coronial enquiries.
The point is that something that is unpredictable biologically has been made relatively predictable cannot be guaranteed.As for being in supermarket aisle where nappies are, give me a break. The same as being in the chocolate and lollies aisle when I am obese and on weight loss program.
The problem in society is that persons with fragile psyche encounter non idealised conditions – need to have counsellors for years [ at government expense] not to fix their problem but to cosset them from reality.
Try migrating to Gaza – as a reality check.
I actually believe that the prime driver of women delaying motherhood has much more to do with their HECS debt, than some esoteric “career” aspiration.
Having said that, in the run of things, one dud boyfriend can mess up a life.
As I am one of “Those 70’s feminists”, who is still best friends with her day care mother, I think that the pressure to “do it all” is almost suffocating for most women in this era.
I agree we can’t do it all and eventually we have to make choices – unfortunately for women doing it all is much wider spectrum so the stress comes from making choices and when it comes to the “rethink” stage time has flown. So has biology.
You would be surprised how often, a “stillbirth” is dismissed by the mealy mouthed, as a baby “who wasn’t meant to be”.
Late intrauterine and intra-partum still births are not part of any Coronial inquiry.
In the UK’s NHS midwife led model, inquiry after inquiry finds major faults, with a maternal death rate of 35 per 100,000 live births rather than Australia’s current rate of 7 per 100,000 live births.
Precisely – the safety in Australia gives an illusion that it has become a consumer item – when it isn’t. So some women want to give birth in peculiar circumstances – and when it goes pear shaped they blame everyone else.
Usually saying “Nobody told me”.