Just days from her due date, Alysha Fameli is devastated after Wollongong Hospital management denied her request to bring in an inflatable birth pool so she could experience a water birth.
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After a traumatic birthing experience with her first-born, the Wollongong woman said she'd done her research and even engaged a private midwife to ensure the birth of her second child was far more positive.
However despite ongoing talks between her midwife and hospital management in the past two months, on Saturday they were told that the hospital would not allow them to bring in the birth pool Mrs Fameli had purchased.
"The end of my labour and the birth of my son at the hospital in 2016 was a very stressful and traumatic experience, and it left me fearful of birthing," she said.
"When I fell pregnant again, and discovered I was excluded from the hospital's midwifery group practice program, I decided to obtain the services of a private midwife to ensure the continuity of care I felt I needed to be confident in birthing again.
"As part of that process, I had hoped to use a birth pool to manage my stress and pain levels through birth, and to facilitate a gentle water birth."
Mrs Fameli said initially discussions were positive, yet on the weekend her midwife Rachele Meredith was told the request had been denied.
"We were told it was due to issues such as filling, emptying and maintaining the temperature of the pool," she said. "However Rachele is highly experienced in in-home births. She regularly overcomes these issues in people's lounge rooms, so I don't understand how they can be a problem in a much better equipped environment - such as a hospital birthing suite."
On the Illawarra Shoalhaven Local Health District's website, it states that "there are options for birthing including water births"; but Mrs Fameli does not believe the facilities in the birthing suites are conducive to this.
"There's one suite with a small, restrictive bath and another small bath located in a supply closet - I actually used that during my first labour and there were nurses coming in and out to get towels and other supplies," she said. "When you're heavily pregnant you need a birth pool, not a bath, as the whole idea is to have freedom of movement."
A child and family psychologist, Mrs Fameli knows the value of a positive birthing experience. Yet with her due date on Thursday, she's resigned herself to the fact her birthing choices may be limited.
"I know the profound effect an adverse experience during birth and the early days can have on a parent's capacity to cope with the early stresses of parenting - and the effect it can have on an infant - so I wanted to create a positive experience the second time around," she said.
"Unfortunately I will miss my opportunity to birth in the water, but I'm sharing my experience in the hope that other women may have greater choice. That Wollongong Hospital will work harder to provide women with options in birth that are not just intervention based."
'It's disgraceful,' says Better Births Illawarra president
After years of advocating for better births at Wollongong Hospital, Giselle Coromandel is disappointed to discover women are still being denied choice.
The president of advocacy group, Better Births Illawarra, said while an inflatable birth pool was an option at several other public hospitals - the experience of Alysha Fameli at Wollongong Hospital was not isolated.
"We're disappointed and frustrated that someone who has already gone through a traumatic experience, and has worked so hard to heal from that experience, has been denied this opportunity," she said.
"It may seem like something simple, but it's really important to her and it's an option she should be entitled to and have access to.
"We've heard of similar requests from women being denied by Wollongong Hospital. However we've had meetings with executives at the hospital who've talked about the concept of women-centred care; about the need for women to speak up for themselves to get the birth they want.
"Alysha has done just that - and it's appalling her request has been rejected."
Ms Coromandel said it was also confusing as the hospital had provided her with an inflatable birth pool for her own home water birth: "So what's going on that it can't be set up in the hospital when it's able to be done safely in a home environment?"
She said an inflatable pool would also be a good option when the hospital's birthing suites were temporarily relocated during the upgrade of the current suites early next year.
It's a work health and safety risk: hospital management
Wollongong Hospital Acting Maternity and Women's Health Service Lead, Karen Atkin, said the safety of mothers and babies was always the top priority for the health district.
She said the NSW Health policy, Maternity - Towards Normal Birth in NSW - supported access to water immersion for labour and birth.
"Water immersion is offered during labour and birth, where clinically appropriate, through use of baths within the Wollongong Hospital Birthing Unit," she said.
"The use of water is one of a number of options provided to pregnant women during labour and birth, which also include the use of showers and birth props such as beanbags, balls, stools and mats.
"The birthing unit does not allow women to bring their own inflatable birth pools into the hospital, as they present a number of work health and safety risks."
She said the $2.2 million redevelopment of Wollongong Hospital's Birthing Unit would include remodelled bathrooms to "better support modern birthing standards".