When Did We Start Outsourcing Birth?

Birth in Australia has changed significantly. In 2010, 56% of women went into labour spontaneously. By 2023, that had fallen to 40%. Today, 41% of Australian babies are born by Caesarean.

Those numbers don't tell us whether any individual intervention was necessary.

But surely they should make us curious.

How did we get here?

Have we become so accustomed to managing birth medically that we've forgotten it is also a physiological process?

Your body is doing something extraordinary. Your baby is moving through your pelvis. Hormones are changing. Your pelvis can move. Position matters. Gravity matters. Time matters.

And sometimes medicine absolutely matters.

Those things don't have to oppose each other.

But we can't put all the responsibility on the medical system

This is the uncomfortable part.

We've outsourced some of our responsibility too.

We'll spend hours researching prams, car seats, cots and baby monitors, then walk into one of the biggest physical events of our lives knowing surprisingly little about how birth actually works.

How does your pelvis move? How does your baby move through it? Why does gravity matter? How can movement help? What happens during pushing? What are common interventions actually doing?

You don't need to become a birth expert. You don't need to second-guess every recommendation your medical team makes.

But you should understand the body you're about to give birth with.

Take pushing.

When your baby moves through the lower part of the pelvis, the sacrum and coccyx need freedom to move backwards, helping create more space.

Now think about the position we most commonly associate with birth: lying on a bed, on your back, legs up.

Your weight is directly on your sacrum and coccyx, limiting how freely they can move.

Once you actually see and understand the mechanics of the pelvis, it raises an obvious question:

Why would lying on our backs automatically be the default?

That doesn't mean you can never give birth on your back. Birth changes. Circumstances change. Medical care can change what's possible.

But shouldn't women understand these basic mechanics before they're in labour?

Taking responsibility doesn't mean controlling birth

You can prepare brilliantly and still choose an epidural. You can understand physiological birth and need an induction. You can plan a vaginal birth and have a Caesarean.

There is no gold medal for an intervention-free birth.

Birth is unpredictable.

Preparation doesn't give you control over the outcome. It gives you knowledge and agency when the plan changes.

It means that when something is recommended, you understand enough to ask:

Why are you recommending this? What are the benefits and risks? What are my alternatives? Is this urgent? What happens if we wait?

Then you can make a decision with the people caring for you rather than feeling like birth is simply happening around you.

That's the kind of birth preparation I believe in.

Not "vaginal/spontaneous/natural birth at all costs". Not rejecting medical care.

Women who understand their bodies, understand their options and know they have a role to play in their own birth.

Your medical team is responsible for providing appropriate medical care.

But preparing for birth?

That responsibility belongs to you too.

Learn how your body works. Understand your options. Ask questions. Practise. Prepare.

You won't be able to control your birth.

But please don't outsource it.

"Know your body. Know your options. Ask WHY. Own your birth."

Source: Australian Institute of Health and Welfare, Australia's mothers and babies.