Monique Ryan (Kooyong, Independent) Share this | Hansard source

I thank my friend and colleague the member for Werriwa for raising this very important issue in the house and for discussing it with such generosity. Australia is one of the safest countries in the world in which to become pregnant and give birth, but there are still risks and losses associated with that process. One in four women—I'm one of them—loses a pregnancy to miscarriage. That is more than 100,000 Australian women every year. Every day, six Australian babies are stillborn. As many as a thousand babies die every year in the first 28 days of life. The loss of a baby, any baby, is a devastating outcome with far-reaching impacts on individuals, families and communities. In the past, as we've heard, these losses were often discounted or diminished, shrouded in silence. Families were told to move on, to try again. But every loss, whether through miscarriage, stillbirth or neonatal death, is a personal tragedy. So this month, and especially on 15 October, we remember those babies who are no longer with us. Every baby matters, and every baby deserves to be remembered.

As a paediatric neurologist, I know that compassionate care, timely support and open conversations are so important to help parents and children recover from this loss. So I commend organisations like Red Nose, SANDS and the Stillbirth Centre of Research Excellence that act to lead the way in advocacy support and education. Their work is vital, and it deserves our full backing.

It's absolutely vital that we ensure appropriate access to bereavement counselling, that we improve hospital protocols for miscarriage and stillbirth and that we recognise the emotional toll of these experiences on mothers and fathers. We have to ensure that we always provide best practice bereavement and mental health care for all parents, including those who have subsequent pregnancies, which can be really difficult after such losses. It's also important that we acknowledge that our Aboriginal and culturally diverse communities face disproportionately higher rates of stillbirth and that they often lack culturally safe care. Australia's National Stillbirth Action and Implementation Plan was launched in 2020 after a 2018 Senate inquiry which established a lack of improvement in our rate of stillbirths. It's really important that we continue to support research into this area as part of our efforts towards public health monitoring and continuous improvement.

While every woman has the right to choose her preferred model of maternity care and place of birth, there are risks associated with some forms of birth, such as freebirth, which can result in poor outcomes for mothers and for babies. All deliveries should be attended by trained professionals able to provide medical support when needed to always ensure the best possible outcomes for mums and for babies. The recent evidence of better outcomes in private obstetrics in Australia suggests that we really need greater continuity of care in our public system. Many women experience fragmented care models with mixed medical and midwifery care or GP shared care when they would prefer a continuity-of-care model. This might include continuity of midwifery care in the public system, private obstetric care or care from a privately practising midwife in the private system.

Continuity of care is particularly important for high-risk populations such as Aboriginal and Torres Strait Islanders, migrants and refugees, and remote and rural women. However, it is not available to or accessible for many. At least 14 private maternity units around the country have closed in the last five years alone. It's absolutely vital that we maintain local services to provide patients with the choice, to reduce the travel burden, to manage obstetric emergencies and to ensure equitable care. It's very important that women have a choice in how they give birth and for that choice to be informed and supported. It's absolutely vital that we provide the very best possible support for those parents who do experience miscarriages, stillbirths or neonatal death. So, again, I thank my friend and colleague the member for Werriwa for raising such an important issue in the House this evening.

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