Any honest conversation about maternity care needs to start with acknowledging the intellectual brilliance and medical advances that have shaped modern health care. Over the past two centuries, the work of clinicians and researchers has reduced preventable deaths, managed genuine emergencies, and transformed what is possible when pregnancy or birth becomes complex.

The difficulty is that this history of progress can create a reassuring conviction that we are, overall, moving toward better care for women and babies. This belief can foster a kind of false positivity, where rising rates of intervention, birth trauma, and maternal dissatisfaction are explained away as unfortunate but necessary side effects of progress.

Labour, as nature intended, triggers the release of hormones that support nurturing and bonding between a mother and her baby. Birth establishes the foundation for the mother–baby relationship, which plays a big role in the child's early development. This is why the way we intervene in birth matters.

In any sane system, medical intervention would be reserved for situations where it meaningfully reduces risk and improves outcomes. However, intervention has become the default approach. A clear example of this is the significant rise in caesarean sections. Caesarean birth is a lifesaving intervention when it is necessary. When it is not, it can introduce risks and consequences that are often minimised.

Decades of international research suggest that caesarean rates above around 10 to 15 per cent do not improve outcomes for women or babies at a population level. In Australia, the overall rate now sits at 41 per cent, with even higher rates among first-time mothers (AIHW, 2026).

Large-scale research published by The Lancet has raised concerns about this pattern, noting that much of the increase in caesarean use has occurred without corresponding improvements in maternal or newborn health (Boerma et al., 2018). These concerns are not coming from outside medicine. They are being voiced from within it.

By treating birth primarily as a medical event, modern maternity care can contradict the wisdom of the human body and, at times, its own commitment to evidence and to doing no harm. We also do not need to abandon medical achievement in order to honour knowledge rooted in long-standing human experience. We can have both.

Reducing women to passive recipients of medical care during one of the most significant passages in their lives is dehumanising. This not only affects women emotionally. It disrupts physiological, hormonal, and psychological processes that have evolved over millions of years to support bonding between mother and baby.

I do not advocate for a particular type of birth, nor do I promote one approach over another or judge any woman’s choices around this profoundly significant event. I am interested in the cultural context in which choices are made. For women to have genuine choice, we must recognise both the value of medical knowledge and the embodied wisdom women possess, and understand how modern maternity care diminishes women’s agency during one of the most significant passages of their lives.

References:

Australian Institute of Health and Welfare. (2026). Australia’s mothers and babies: Method of birth. https://www.aihw.gov.au/reports/mothers-babies/australias-mothers-babies/contents/labour-and-birth/method-of-birth

Boerma, T., Ronsmans, C., Melesse, D. Y., Barros, A. J. D., Barros, F. C., Juan, L., Moller, A.-B., Say, L., Hosseinpoor, A. R., Yi, M., de Lyra Rabello Neto, D., & Temmerman, M. (2018). Global epidemiology of use of and disparities in caesarean sections. The Lancet, 392(10155), 1341–1348. https://doi.org/10.1016/S0140-6736(18)31928-7

American College of Obstetricians and Gynecologists, & Society for Maternal-Fetal Medicine. (2014). Obstetric care consensus no. 1: Safe prevention of the primary cesarean delivery. Obstetrics & Gynecology, 123(3), 693–711. https://doi.org/10.1097/01.AOG.0000444441.04111.1d