Episode 126 - Consumer advocacy triumphs and turmoil
Mel:
[0:00] Welcome to the Great Birth Rebellion podcast. I'm your host, Dr. Melanie Jackson. I'm a clinical and research midwife with my PhD. And each episode, I cast a critical eye over current maternity care practice by grappling with research and historical knowledge to help you get the best out of your pregnancy, birth, and postpartum journey.
Mel:
[0:24] Welcome everybody to today's episode of the Great Birth Rebellion podcast. I'm here today with Amy Omar from Perth Birthlink, which is here in Australia. And Amy and I met at the Strength to Progress conference this year, which was in Perth. I was one of the presenters there and Amy, you also were a presenter. And after the conference, we had a really in-depth conversation about the work that you're doing in the consumer advocacy space for women and also the experiences that you've had as a consumer advocate as kind of a new kid on the block and this conversation is actually the reason why I wanted to interview you because I think that people who are new to a scene can see things that people who are in already really deep in the culture and deep in the world can't see. So today we'll be discussing consumer advocacy as an agent for change and celebrating the work that consumer advocates do but also what will be interweaved through this will be some tips and strategies and maybe some warnings for people who want to start doing this kind of work and just having a discussion around
Mel:
[1:39] Some of the toxicity as well that each of us have witnessed and that we kind of lamented about when we were chatting and just exploring this topic of consumer advocacy in maternity care from lots of different angles. As I said, it's such a powerful agent for change in maternity care and we'll discover the amazing things that consumer advocates have done for women here in Australia and in politics but also realizing it's not always peaches and what I also want to make people aware of is that often consumer groups offer two kinds of things a service to women you know usually support services and education services and resources for women during their pregnancy birth and postpartum then there's there's also this kind of political arm and it can be political behind the scenes. And I've definitely been approached by a lot of people asking me to do a podcast episode about consumer advocacy. And that's how our conversation started at Strength and Progress. You're like, hey, have you thought of doing an episode on consumer advocacy? And I said, I have, but I'm really, really cautious and nervous actually about this conversation, but I felt safe with you. I just thought that, you know, we had a shared experience.
Mel:
[3:06] So first, Amy from Perth Birthlink. Firstly, to introduce yourself to our audience.
Amy:
[3:13] Yeah, sure. Thank you so much for bringing me on, Mel. My name's Amy. I had a traumatic birth in 2020, like so many other Australian women. I thought that my love and my passion for birth would protect me through that process, and it didn't. I tried to have a home birth through a public system. I started to approach 42 weeks. I got to 9am at 42 weeks. The community midwife came out and checked me and she said, you're three centimetres, not four, that's not labour. Uh, we're leaving. Good luck. And I'd been in labor all night. It was COVID. We'd been in lockdown for two months. You know, it was my first pregnancy, first experience. And you know, the world had turned on its head and everything just went wrong. So I went to hospital and cascade of interventions began and it ended with a cesarean section that I still to this day believe I didn't need. And it was traumatic. I came home from the hospital in quite a fragile state. And I walked in the house and saw my birth pool still set up.
Amy:
[4:16] Burst into tears, absolute floods of tears. And I packed all of that away with my birth pool. I put it in the bag, we dropped it off from the people that we hired it from. And that is where that stayed. I've kind of got a previous history of PTSD and things like that. So I understood the frame of mind that I was kind of in, but I had this new little baby and everything that I wanted other than the birth.
Amy:
[4:40] So I packed it away and I left it there. And as I started talking to other mums, it became apparent that I wasn't alone. And one other mum that I spoke to is my best friend, Aisha. We went to school together and we turned up to our high school reunion, both pregnant, and we kind of reconnected through that. And through both having babies, she gave birth in the February, I gave birth in the May. We just came together like glue. Our husbands worked away and we'd both had a traumatic experience with our birth. So we really bonded over that and supported each other through all of the highs and lows of early motherhood. And then early motherhood with that added trauma on top, which we didn't really identify at the time, but I think we kind of knew what was going on. We then got pregnant again together in 2022 with our second babies. We hired private midwives and we planned home births. She got an epic physiological birth in her shower at home. Her midwife walked in the door. His baby was crowning. It was brilliant. I tried for three days and had a repeat C-section on Christmas Eve, but I walked away from that experience so empowered and I essentially had had the same situation happen twice.
Amy:
[5:52] I transferred from a home birth, tried everything that I could and had a repeat C-section, but this time I had no trauma. And I attribute a lot of that to my care and continuity care, my brilliant midwife, who I remember actively falling in love with throughout my C-section. Like I was, it was like the scene in Twilight with the werewolves. I was like, I love you.
Amy:
[6:13] So it's that kind of experience. And we both walked away from it and we went, this can be better and it should be better and it can be done better. We were passionate and we wanted something to happen. And then we went to our local mother's groups from a child health nurse and we both just witness some outdated culture of don't lay down feeding your baby they'll get glue ear or pointing out someone in the crowd of having postnatal anxiety because they picked up their baby too quick and silly things and the other thing that we notice is that every single woman there was itching to tell someone their story of giving birth to a group of people that understood and that cared kind of all of these things happened and I remember specifically I was driving down the freeway after my mother's group. And I got on the phone to Eish and I said, I'm done. We're doing something about this. I'm dragging you along for the journey. I'm going to call it this and this is what we're going to do. And that's kind of where it was born. And it was originally to educate pregnant women and to try and help them find what we had, to make that connection while you're still pregnant with those people around you. Because nobody gets it like somebody else that's just given birth. You want someone who's right there in the trenches with you. So that was the original idea of birth link and it's just really grown from there and it's only grown in about 18 months so it's been a rapid transition.
Mel:
[7:31] And so that's where it started and I love that that was the inspiration because I do think this is how big ideas start so Perth birth link what is it now and this is probably really in line with the presentation that you did at the conference
Amy:
[7:45] Yeah, so now it's turned into a big advocacy piece. It actually started with a few other local advocates and midwives, people that have worked for a long time in the space in WA, calling for a birth trauma inquiry over here in the West after we saw what happened with New South Wales. And so we were approached by a few different people through other mutual connections in the community to ask if we'd be interested in doing more advocacy. It's something I'm naturally drawn to anyway, and I was like, yes, I just don't know how. I would love to. So all of this kind of came together and I made some connections with some other organizations over East. And all at the same time of this, a news story came out in the ABC of a woman here in WA named Neetu Thomas, who had an absolutely horrific experience in one of our hospitals. She nearly lost her life. She lost her uterus and she nearly lost her baby. And it was just horrific. And I just read the story and.
Amy:
[8:40] I just got mad. I got really pissed off and I just was like, that's enough. And I had had a little bit of a following on Instagram.
Amy:
[8:48] So I just got on my Instagram story and went, I've just had enough. I've had enough of this. Share your story with me because I'm going to do something with it. Because every week we were running these mothers groups and we're meeting more women. And week after week, we're seeing the same story and the same pain and the same trauma. And then we're also meeting pregnant women, watching them go towards the same thing. And we're seeing the same outcome. We were watching it happen and I was like, I couldn't fight for myself then, but I'm really like bloody ready to fight now. So I thought we'd maybe get 30 stories and take that to our health minister. We ended up getting 141 stories in a month and they were horrific. They were absolutely horrific. I sat every night reading these stories in floods of tears and I made it a point to make sure that I read all of these stories because I wanted to understand the complexities of of everything that was going on and make sure that I represented each of those women correctly. I did a bit of analysis. It's by no means a study, but I sat down and took a tally and we found that 75% of those women felt coerced by their care providers. 57% of them reported being verbally abused.
Amy:
[9:59] 46% of them were threatened and 32% reported being physically abused, including procedures against their will. One of them that I read, and I still think about it daily and I screamed no as he cut me and I'm like that this wasn't a police report I'm not reading something of a crime I'm reading someone's birth story and.
Amy:
[10:23] I just I just couldn't believe what it was so and then this is where it turned into the advocacy pieces that I and my colleague Emma Snogar she's a integrated birth therapist who I work with now and has joined my team and, compiled all of these stories together and we took them to the health minister and presented them to her office and had a lot of good conversations. And that's kind of where all of this began and started to grow from, from all those brave people that came forward.
Amy:
[10:49] And that has now become a large portion of the work that we do. It's led to other advocacy opportunities. We're now working with a local hospital to improve a lot of the processes there and try and bring things in line with the outcomes of the New South Wales trauma inquiry. So that's kind of the advocacy half of what we're doing and then simultaneously we're still trying to become a landing place for women as well we're starting up some peer-to-peer support programs in the new year so that I say while I'm fixing it there's somewhere for them to go as if I can fix the whole problem and to help people build their village because when you're in that fight or flight and that new mother feeling and it's so heavy and it's so hard. You need the people around you and it's not magic. They don't pop up. You don't give birth and 100 people appear to help you. You have to build that village and that's what we advocate and that's what we push for. So we try to have lots of community events where women can come and connect with each other and service providers that they can put into their village to help support them through all of those stages of motherhood.
Mel:
[11:56] I love how you're explaining this. this is making complete and total sense. One question that I have is, you know, that little step where you, you know, you got angry about Nithu. So your anger around the events of Nithu's birth triggered the desire to generate some change in your local area, you know, starting where you are. Can I just ask about the details? And I'm asking this for people who are listening to this thinking how can we do that where we are but you gathered the stories from other women and And then there had to be a step between, okay, I've got all these stories and I love that you analysed it because when you present these things to people who can generate some change, you know, in policy, in politics, they're not going to read 140 birth stories like you did. They're going to read your little summary and your percentages and they're going to be motivated by what you've learnt from all of those stories. So you did that, which kudos, that was a genius move. And then who did you call? Like what's the next step? After you've got all the stories, who do you ring to get an audience with somebody who can create some political change?
Amy:
[13:09] Yeah, so I started writing letters and I wrote to my local MP initially because that's where a lot of these things start is with your local MP. So you can go to them and highlight the issues that you're finding. That was the first meeting that I had and she wrote a letter to us to the health minister, you know, endorsing and supporting us and saying like, this is something I really want you to pay attention to. And then we wrote to the health minister as well about what we had compiled and what we had found and that we would like to deliver these stories. And then we were invited to meet off the basis of that. So we kind of wrote a bit of a detailed letter of taking them along the journey that we were on as well. And yeah, we were invited to go and meet with them. And then I think you also then have to, you know, play the part. I physically printed off every single one of those stories and handed them across and went, here's 141 West Australian women that are being abused in your hospitals.
Amy:
[14:01] And they've come to me and they've told me about it and I'm coming to you and I'm telling you about it. And here it physically is. There was a lot of power in that. And the other big half of it, which I haven't seen many other people in the West here doing is we share everything online for a number of reasons. It's accountability for people that we're working with and it's hope for the people that are sharing with us and taking them along the journey as well. I also would send regular updates to the women that shared their story with me to ensure that they knew what was going on. During this time as well, I was invited to meet with Fiona Stanley Hospital. And so I wrote to the women that had told me that they had birthed that Fiona Stanley and I asked for their permission to take their stories and most of them wanted it anonymously to the hospital. And then I could meet with them and say, here's my story at your hospital. Here's also several other women that have birthed here and the experiences that they've had. And I actually went through and I highlighted.
Amy:
[14:54] All of the sections of interest. I was like, well, here's the example of where you've coerced them. This is where she's told you that you're abusing her. So trying to be really visual, make it easier for the person taking in the information so they can't gloss around it. And it's very in your face. That was kind of the steps that we took to get those meetings and to advocate those meetings. And then if we were ignored, we would start calling them and going, hello, have you got my letter. And then if there's still no response, I think the next thing after that would be like bigger public displays, like protests and things like that. But we didn't have any need. The state here was very receptive and very interested to speak with us and to work with us from the get-go. So that was really positive.
Mel:
[15:36] You know, with activities like protests and noisy things, like getting into the media, those are steps that, purely in order to get an audience with politicians. You know, we don't just have a big protest and make a big sound and then do nothing else. It's the marketing ploy of trying to get somebody's attention. So you didn't have to employ those strategies. If you had gone to this initial meeting and your local MP hadn't advocated for this issue and written that letter to the health minister, did you have a strategy for what next?
Amy:
[16:11] Yeah, I was just going to keep trying other MPs. My local politics knowledge is lacking, so I'm kind of learning as I go. But it was just reaching out to anyone that I had. Prior to this, I was a business analyst. So that was a big part of, I think, why I've had success, because a lot of the skills that I developed there have allowed me to know which boundaries to push here. And I found throughout my career that my solution to my problem can't just solve my problem. It needs to solve other problems as well. So then you have a collective solution and the more people that need the same solution drive for the same outcome. If I wouldn't find any resolution in a silo, I then start trying to branch out to others and see if the solution that I'm looking for is also a solution that they want as well. And it's whether we are working with women that live in other areas going, hey, can we go and meet with your MP?
Amy:
[17:07] You have to ask, right? So asking all those questions, and then I'm a big believer in like the carrot and stick. So you really have to leave the stick as the absolute last option. And you've really got to try and coax people along the path with you because that's when they want to work with you is that you have this open and amazing conversation. I met with a local hospital yesterday, for example, and I sent them quite a difficult letter to receive of lots of things that I'd heard about in the local area, lots of complications that they were having. And, you know, if I was the executive director of a hospital and I received this letter, I would have gone like, okay, yuck, we have a lot of problems here. And the meeting ended with us having a hug. So...
Amy:
[17:50] I think a lot of it is that a lot of the things in this space, people either want to burn the system down or they want to fight or they want to yell or they want to scream and they want aggression. And you want aggression because you have previous trauma and because you're angry because you're sad, but people don't want to work with that. They want to work together and they want you to understand where they're coming from as much as you want them to understand where you're coming from. So if we're going to have success in this space, we have to make sure that we're meeting each other where we're at and we're doing what we can together rather than being, like butting heads because if you go into these meetings and you meet with these people you send these letters and they're abusive or they're angry or they're extremely pointed some of the language that I see I'm like oh okay they don't want to work with you they'll go okay and they'll send you a letter and fog you off but if you're like hi I've noticed these issues this is I believe this is indicative of your culture. I would really like to work with you to improve this. I have some ideas. Will you meet with me? They're like, yeah, because they don't want to have to come up with a solution themselves. They have a nothings to do. They're running a whole hospital. So if you're like, hi, I've noticed a problem and I've got some ideas of solutions. Would you like to meet with me?
Mel:
[19:05] With all people, nobody wants to be the object of someone's anger and abuse. In these communications, there's, where you're trying to advocate for change, bringing trauma and your anger and your frustration, although they are completely understandable and justified, there has to be a process by which you can park them for a minute in order to offer some effective communication and respectful communication and realize that the person that you're talking to probably wasn't the perpetrator of these things. They're just in a position that they can enact some change and help you enact some change. So actually you're allies. And so I think you're exactly right. Part of the issues that I see in consumer work is that often the women who are working in this space, just like you are coming from a real from a place of real trauma and they unleash that anger upon I don't want to say they unleash their anger
Amy:
[20:13] I find things like this I explain this with a story about myself when I first had my my son I walked away from my birth and I was going to be a doula, and I was going to be a doula because I wanted to save women and I now look back at that and realize how misplaced that is. And this is not an attack on doulas. I think doulas are brilliant, but I meet so many doulas that have come into the work because they have so much of their own trauma that they haven't dealt with. And then they're kind of bringing it into other people's births. And that was exactly my trajectory is that's where I was going to go and save women, but I can't save anyone. And I can't take responsibility for that. And I think that goes for all of us is that, We need to make sure that we are okay within ourselves and that we are comfortable and that we've kind of got control over how we feel and a good understanding of how we feel so that we can check it and use the fire in our bellies to push ourselves forward without abuse, without anger, without rage and remain professional and approachable, I think is the biggest point. And you have to do a lot of work to get there. it's really hard if you don't do the work and go through that journey yourself you're not you're not ready to help anyone else because you haven't helped yourself yet.
Mel:
[21:31] That anger and trauma and turmoil is okay to exist with and acknowledge that you have but you can't bring it into every interaction when you're trying to advocate because it's as you highlighted will be unproductive will make you less desirable to work with and therefore less effective in the space.
Amy:
[21:54] Hard.
Mel:
[21:56] It's really hard. And this is it. So many people move into advocacy because they want a solution to the problem that they face and they want women, they want to change things for other women. And it's so noble and it's so needed and it's so effective. But you reduce your effectiveness when you bring your anger and trauma to the interactions and the communication with people who can make change. So you did this process of collecting the stories, going to MPs, communicating the needs of the women in your area. And it did mimic a lot of the actions that other consumer organizations were doing in New South Wales and over Australia in order to be heard for the birth trauma inquiry. Yep. Did you at any time tap into any of those existing consumer networks to get advice or help or strategy, anything that they could do to help you in your purpose on the other side of Australia?
Amy:
[22:57] Yeah, most definitely. I was really lucky that I connected with Alicia Staines from the MCN. She has been a brilliant support, helping me navigate a lot of the complications from running my organization to where I go to start this process. And she's coached me amazingly. I often send her a text and she'll reply to questions and complications that I have. So that has been brilliant. And I also speak a fair bit with Better Births Illawarra, and they've been doing some training lately of how to lobby and things like that. So they've invited us along, which has been amazing to tap into that. So there's a lot of collaboration going on in there. But then I've also come up against some other complications.
Amy:
[23:39] We originally were collecting the stories with the Maternity Consumer Network to begin with. And Alicia's not their current president, they've got someone else. And it just kind of came to the point that we were going in different directions. We want the same outcome, but our method was a little bit different. And I think the method that they were looking at, they wanted protest and they wanted loud and they wanted angry. And I think that that has worked for them in the past and that's great, but we're the ones on the ground here in WA. And I think WA, we're our own little weird, funky group of people. It's very kind of reserved here. And I don't think that we were in the right space to be doing anything loud like that. I think we would have just got shut down and put away really quickly. So when we kind of found that our values didn't align, we decided to continue on our own with the stories and still with the coaching from Alicia. But I think that that was what worked out better for us. And I learned early on that, you know, with this organization that I'm running, I've got a clear idea of what I want to happen and when and how and how I want to manage things and how I want that to look going forward. So we've put a lot of effort into making sure we have a good code of conduct and that we've got good processes behind us so that when we engage new people, because it's all based on volunteers and people, you know, with a fire in their bellies and they're ready to come and fight and do the hard work and the hours –.
Amy:
[25:00] We need to make sure that we're following a really good strict code of conduct to make sure that we always remain the approachable and open organization that we're aiming to be and that's right for the place that we're advocating in, I think is the key there. Yeah, that was kind of the complications that we've seen with working with other areas. And then we have a lot of collaboration and we have a lot of discussion with a lot of the other groups. I think some of us are going to write some letters together, but I am pretty passionate about making sure that within WA we're the people on the ground here and we have to navigate that political climate ourselves in the west because I think it really does differ to the east coast and I didn't know that until I you know was a lot further into this than I am now.
Mel:
[25:45] Well that's good for people to know when they're doing this kind of thing in all other areas of Australia is that the culture is vastly different and the political climate is vastly different and to be wise that you can't use a cookie cutter method of advocacy all over Australia. So that's an amazing discovery that you made through this journey. And good on you for just identifying the intricacies of that rather than just trying to repeat what other people have done to create change, but actually really properly assess the climate and political climate and the culture of your area. So you've set it up. I mean, because you're a business analyst, your brain would work differently to a lot of other people, which I love. I love that you've used this skill set to apply it to this because it sounds like you have set up a business structure of sorts. And that's in acknowledgement that when people have to work together, there has to be some kind of framework. Rules of engagement, I suppose. So this code of conduct, did you write that from scratch? Or is there some kind of, you know, template that people could use? You know, like when they're listening going, how do you write a code of conduct? What would that look like?
Amy:
[26:57] Yeah. So there's actually some really great resources. There's the community directors, I think that the association, I've got to look up their name properly, but the community directors, It's a free registration with them. So I should probably start by talking a little bit about our structure. We're an incorporated association and that's a not-for-profit organization and we have a board that runs our company. So I'm the chair of the board. My best friend, Ish, we started with as a co-chair. My husband's a treasurer at the moment, although I'm probably going to start looking for a better treasurer. He's talking it entirely at the minute. So I'm like, okay, once we start raising some money. My sister is the secretary.
Mel:
[27:40] So your sister's, sorry, we're going back. So what you're saying is there is actually an entire structure behind this. So you've set it up as an incorporated non-for-profit.
Amy:
[27:52] Yep, an incorporated association, which is a not-for-profit company. Yep.
Mel:
[27:57] Yes, and he wants to register. That's like a registration process.
Amy:
[28:01] Yes, we had to write a charter and some objectives and then go through the process of registering. We had to get lots of IDs and like community director IDs. We had to register an ABN after we did that so that we had our company name. Then following on from that, we've got a few other things that we need to do, like become a registered charity so that we can get something that's called DGR status.
Amy:
[28:28] And DGR status is goods tax receipt status. So that means that when people donate money to us, they get money off of their tax. And that's a big thing for finding corporate sponsors, large donations or anything like that. And then we also need to finish getting a charity license, which allows us to receive the charitable funds. At the moment, we've got someone acting for us, allowing us to do that, but we've got to go through and do our own. We've then got to do the financial side of the business.
Amy:
[28:55] It's a really a big multi-layered slug. And every time I think I've got it done or sorted, there's another layer of compliance that I need to do. So the ACNC website, which is Australian Charities and Not-Profit Commission website is a great place for all of those resources that you need, for all of the documents that you want to write and all of the information about the board positions that you appoint people to when you create a board and they can it can it sounds very intimidating and big but it's around my dining room table so it's very doable and achievable you can engage a third party like an accountant or someone like that to do it but it obviously will cost a significant amount of money you can do it without becoming incorporated as well you can just stand up and be an advocate there's a few independent advocates that work here in WA and they sit on maternity advisory groups at the hospitals and advocate in the community and work with the unis and things like that. But we decided to become a not-for-profit from the get-go because of the other services that we offer and we wanted to make sure that there was never misconstrued that this was for any personal gain.
Amy:
[30:02] I think a lot of things with women and business can get really complicated and it can look like you're trying to profit off of other people's suffering, particularly in this space. And that's something I wanted to be really clear about from the start is that I'm here only to support. To be frank, it costs me money and I work endlessly, but it's because I love it and it's because I want this. So if you're looking for money, it's not here. And that was a big driver and us becoming a not-for-profit organization and yeah those are the areas that we've found a lot of information and then just some coaching as well a friend's a colleague's wife actually coached me through the process of starting my organization of setting everything up and writing those things so there's a lot more to come and a lot more to do for us to be compliant but that's where we're at now.
Mel:
[30:55] What I also would love to advocate for is the a bit of a challenging of that culture of like we can't make money off this for ourselves yes in a sense that if we want you guys to keep working at this and advocating for us and the same goes for all the advocacy groups if we want you guys to be able to continue doing that we can't rely on you to be self-funding all these activities because that's a pot that's limited that's like unless you've come into a lot of money and you've got all this time, there's going to be a point where you could no longer afford the time, energy and finances to keep this kind of thing going. So while I do think it's not a place to get wealthy off people's misfortune and off this political issue, there has to still be a line where you guys are not left, I guess, you aren't sacrificing your finances in order to do this. And so,
Mel:
[31:58] I guess what I want to say to people is, can we just lower the expectation that you guys are going to be the sacrificial lambs here and just try and offer some financial investment into these kinds of activities without the judgment of, oh, how dare you make money off this? Actually, we all need to make a little bit of money to feed our children and maintain our lifestyles. And again, I'm not saying this is fancy cars or anything, but I guess what I'm saying is that we need to honour this work by making sure that you guys are still financially not worse off having done this. So how do you fund this at the moment and what's the aim?
Amy:
[32:47] At the moment my husband flies in from two weeks away and I go hello darling I need you to have the kids and I need two grand because I've had an idea so that's currently how it's funded, Um, that's not sustainable. We've applied for a few grants. There doesn't seem to be many grants specifically that we can apply for that really meet our needs. So that's another kind of wing of advocacy that I'm going to have to do. And I'm going to start writing some more letters to ask the federal government to put the focus on this as well, and to potentially look at where we can fit and how we could be funded in some capacity. So that's another task that we need to do.
Amy:
[33:27] We're running a raffle lately. We've been donated a lot of amazing things by a lot of local businesses. So we're doing a bit of a raffle to try and raise some money for next year. But a lot of that comes even with the funds that we raise with a lot of caveats on what we can and we can't spend it on. For example, the Lotteries Commission, when we got our permit for our license, they said, what are you going to spend the winnings on of the raffle? And we said we wanted to run it for our peer-to-peer support program. So that would be room hire, catering and crèche. and under their definition, crèche was not covered because it's too individual of a service. So we now may get some money for the room hire and I think maybe for a little bit of catering, but I still don't have any money to pay for the crèche services that we need to run and they're fundamental to the success of this. So it's about picking up all the layers and going back. I'm going to start asking more MPs again for some money. I'm going to write to the federal government and ask for what grants could be potentially available for organizations such as mine. And there may be things I just don't know about. There's only so many things I can Google until 2 o'clock in the morning. We need to then get our charity status so that we can start accepting donations. And hopefully some of my previous colleagues are listening from my oil and gas and mining days. I'm going to come meet with you soon and ask for money for my project. So...
Mel:
[34:47] Yes. And I've seen other consumer organizations in terms of fundraising do things like run conferences, sell merch, some sell products and publications. Like there's a raft of things you can do, but essentially you need people to spend money on your stuff, raffle tickets, whatever it is, in order to fund your activities. And what I'm hearing is that your time isn't funded. It's going to things like the room hire and feeding people who come and potentially things like transport to a meeting.
Amy:
[35:24] At the moment, it's purely self-funded. I don't take anything at all from it, but it's early days. And I think if we slug it out now and we do the hard work now of setting it up right, we will be able to find those sponsors and find those partnerships and those grants and make it happen. And I'm really lucky that the team that I've got behind me are just all women, just like me, giving any time that they possibly have to this cause. My best friend who I run this with just have her third baby. He is not a happy one. She's really in the depths of it. So she's taken a step back for a while. And that's exactly how it runs for all of us with this is we give what we can when we can. And life happens and it stops and it's slow. And maybe the progress is, you know, really granular at times, but we just keep chipping away and it doesn't have to be everything all at once. It's just what we can, when we can, and we'll eventually get to the point where we can hopefully find some funding and find some money and we can just keep growing. It took us, what, 75 years to get to this state with birth? It's going to take us a hot minute to turn it around. So I've got the time.
Mel:
[36:31] In terms of how and when you guys meet, do you have regular times that you get together for strategy planning and what does that look like?
Amy:
[36:40] Yeah, again, like most of us have got young children, so it could be evenings on Zoom. We've got a big group chat that we're in a lot and it's like, oh, we've had this idea. How do we do this? How do we do that? And people jump in and out when they can. And then we've had a few strategy sessions where we've actually hired a room and we try to utilize local crèches around the place. I don't work other than this. So there's just no money there for them to go to daycare. And I kind of don't want them to. I like them around. So we try to utilize local craches and where they've got meeting rooms available. And we put the kids in the crache for a couple of hours and we all meet and have a coffee and go, right, what's some work that we're going to do here? What's our strategy looking? What's the next 12 months looking like? And people take individual tasks away and get it done. So it's slow. There's no full-time hours. I miss the full-time hours, but it is what it is.
Mel:
[37:29] And, you know, you've got that little chat, that ongoing background chat. Is there any kind of like universal Australia-wide consumer organisation chat group? No. Okay, so it's not like you're all aware of each other's movements and kind of working together in this unified goal and pulling resources or anything like that?
Amy:
[37:48] No. And a lot of the, I think because we have to advocate all in our individual areas with our local MPs. The the most recent unification that we've seen was with the home birth insurance issue and that was just phenomenal and that's all like based in instagram right so when we open our birth link instagram it's like that's the chat you know the feed of all these people doing these amazing things um so we collaborate like of things like that on a wider issue and we get lots of questions and we ask each other lots of questions of like hey we've got this problem can you help us but there doesn't seem to be like a wider connection and you've actually just reminded me of a woman from South Australia who messaged me a few weeks ago and I said I was going to call her and I haven't. So if you're listening, I'm sorry, I'll call.
Mel:
[38:32] Oh, yeah, give her a call. Because there was things, these bigger issues that require lots of hands and lots of voices, I think can only be addressed with a good collaborative effort. And that's what we saw in 2010 there was the Mother of All rallies where everyone came together, the organisations were unified, the Australian College of Midwives were there. It was a massive turnaround for insurance for home birth midwives and that was just so beautiful to witness this collaborative gorgeous effort and I just want to acknowledge Justine Keynes who was this powerhouse in the consumer advocacy realm and how beautiful and generous she was with her time and her knowledge and how kind she was to people it just struck me as how warm she was and as a newer group on the scene what have you noticed about the consumer advocacy culture yeah what has your experience been yeah complicated um
Amy:
[39:43] The first layer of it is obviously like the trauma that we spoke about before. And there's lots of people in this space that are still, you kind of meet them and talk to them and you can feel it radiating off them because it's still so fresh and it's so raw. So that's one kind of complication of it is there's a lot of fragile people working in this space. The other half of it is that though we're fighting for a common goal, we've all got different methods of how we get there. And that doesn't necessarily always align. so that was something that I learned quickly and has been a complication of it because I think there's a big group of women in Australia that want to burn the system down they don't think that we can fix the system they think it's you know a hopeless cause and everybody should be free birthing and they should be empowered to do so but I try to make sure that I'm meeting people where they're at. And we've got a long way to go before birth is not a big terrifying thing anymore. I think the system has got a lot of changes that it needs to make. And we've got this big ship that we've got to try and turn around and turn back to women. But we've got to respect that people want to give birth where they want to give birth. And what we fight for is choice of what do you want, where do you want to give birth, when you want, with who you want and how you want. and trauma-informed care is something else that we fight for and consent.
Amy:
[41:08] This is the cornerstone of what we're looking for. If we meet these kind of three things, we're going to lessen the amount of trauma. And physiological birth doesn't necessarily mean that it's trauma-free and having a traumatic experience doesn't just have to be in a hospital. You can have a birth that people dream of and it can be the most traumatic experience of your life.
Mel:
[41:31] So you're highlighting that each consumer organisation has a bit of a different focus and philosophy around the aim of their advocacy?
Amy:
[41:42] Yeah, definitely. I think people want different things but at the end of the day I think we all want consent and choice.
Mel:
[41:50] Yeah, so perhaps unifying on the things that you absolutely all agree with. Okay, so I have two final questions. So I have two final questions. And the first is what advice would you have for women who are or people, anyone really that have to be a woman, who are hoping to get involved in a consumer advocacy group?
Amy:
[42:14] Yeah. Okay. So it depends on where you are. I would first look for other consumers in the local area and see if your values align and see if you're fighting for the same thing, because starting this from the ground up is very difficult and very time consuming and not necessarily what you need to do to become an advocate. The other half of it is that the hospitals need the feedback. What we found, even with the stories we collected, only 22% of the women gave feedback to their hospital. So they were willing to tell me and stranger on the internet their story, but they didn't want to tell the people that were necessarily responsible for it. And that makes it really hard to enact change when you don't have the feedback. So biggest thing is that getting involved with your local hospital where you've given birth, there's usually maternity advisory groups, other things like that. There's obviously the complaints and feedback that you can give to your hospital. And that can be a really great place to start, particularly in the current climate.
Amy:
[43:11] In the stratosphere, birth trauma is a term that we now hear frequently and obstetric violence is a term that we hear frequently. I remember saying it to someone about five or six years ago before I had kids. They had just recently given birth. I've always been a bit of a birthy nerd, so I was just like, oh, wow, did you experience any obstetric violence? They went, what? But now most people know the term. I think you can leverage off the back of that and use that most of these organisations want to help and they want to do it right, but they might not necessarily know what they're getting wrong. So providing that feedback and engaging with them on a one-on-one is great. And just the other biggest part and one of the rules that we have is to always take a buddy. So when you go and you meet with these hospitals or these organisations or MPs, take someone with you because it's good to have their support and it's good to bounce off of each other and there's always strength in numbers. Like we are stronger and better together. So we've got to stick together to try and, you know, find that success. So they're kind of my biggest bits of advice. And if you're in another state and you're not sure, send me a DM. I'll help you.
Mel:
[44:17] I think everything needs a knowledgeable person to start with. And my last question, well, it's kind of one and a half last question and it's a bit juicy, but you're a business analyst. And so in your opinion, what can consumer groups do to amplify their current activities without having to increase their time and financial efforts?
Amy:
[44:43] That's a hard one. Some of these tasks just do take time. you know, it is just difficult. But I think trying to find that common solution and that common goal is where we're going to find success. And working together, women really have a tendency to divide amongst ourselves. I think we've just been conditioned that way over time. And when I was having some complications, my husband turned around to me and said, women don't need to be divided to be conquered. You do it yourself. And it really pissed me off that he was right. I was really cross. And I keep seeing it over and over again. I'm like, we're dividing ourselves again. So I think that unity is where we're going to save the most time and the most effort of working together and working for that common goal. And also then trying to find how your solution and your problem could be the same as somebody else's, even maybe at the hospital level. When you meet with them and you talk to them about the issues that you're.
Amy:
[45:42] Try and think about it from their point of view, like always try and challenge your own thought and challenge the way that you are relaying the information and how it might be received and put yourself in their situation and maybe try and find some solutions that work well for them. At the end of the day, hospitals are still businesses. They want to minimize their risk and they want to make money. So if any of the solutions that you have to the problems that you're facing can help them save money and minimize their risk, they're going to be interested in it. So rather than saying you need to look after women better and you need to do this and you need to do that, try and flip it on its head and think about if you provide these services or more continuity to your women, they're going to have a better experience and they're going to walk away with less trauma and there's going to be less financial implication for the hospital and things like that. So trying to frame your arguments in a way that is palatable for the person that you're speaking to is going to save yourself a lot of heartache essentially.
Mel:
[46:43] So being strategic and also not allowing the patriarchy to win in a sense that, as you said, women take each other down.
Mel:
[46:54] And that takes time and effort away from a collective effort to raise each other up. Yeah. And this is actually also what I've witnessed for myself, is that the challenge to provide your service and offer your knowledge and skills to the world, I personally am only really opposed by other women and other birth workers and other midwives. I don't think that any man has directly impacted on my work in this space. And I would hazard a guess to say that your experience is the same, Amy, is that the biggest, biggest challenges that we face in this space are actually from other people in the space. And we're actually shooting ourselves in the foot. and nobody has to worry about us because actually we won't succeed if we continue to breed a culture like that because we'll self-destruct and women are great at dragging each other down and self-destructing and have to make a conscious effort to actually collectively build each other up so that our efforts are productive but that's not going to happen if you're focusing your efforts at taking other people down. And that's certainly what I've witnessed actually within consumer organisations.
Mel:
[48:21] I've been the victim of consumer organisations at time, not probably in the same extreme as I've seen other people, but certainly some choice words and abusive messages.
Amy:
[48:37] But you know what? Over the top of that is how do we look to everybody else when that's happening? We look hysterical. And women throughout history have been whittled down to she's just a hysterical woman. So when we start fighting with each other and dragging each other down and doing all of this stuff we we're just reaffirming how we're seen by the patriarchy really we owe it to ourselves to do better because we know better and we can get crazy and we can get angry and we can be aggressive you know I'm a very aggressive woman but I try to make sure that I own how I feel and how I act like we've still got a long way to go before women have the right place in society you know and we're respected for being women and that we're we're different and that's okay and women have strengths and men have strengths as this we are two halves so I think that is a really big portion of it is making sure that we're acting in a way that we're always proud of and we're not cutting each other down and that we're supporting each other and I've noticed that through my entire career. When I was 19, my manager at the time walked me to a gym on my lunch break and said, do you want to join? I think you would benefit from your health to maybe lose 10 kilos.
Amy:
[49:54] Then I was told that I dressed too masculine at work and that I was too aggressive and too this. I used to really protect myself from other women. If you told me 10 years ago I would be doing this work, I would have laughed you out of the room because this was not a space that I felt comfortable in and so yeah that that's really important to me is that we build each other up and that we don't fall into these bad habits of fighting against each other because maybe we can't fight against the people that we really want to fight and that's the system.
Mel:
[50:27] And that is what inspired me to invite you on to do this particular episode is that I do think that empowered women empower other women and confident women build other women up and that women who are hurt, hurt other women.
Mel:
[50:44] And so I love that you had a philosophy of let's be open and generous with each other rather than having some kind of competitive vendetta against, you know, other people in the space. So I think this really highlights the amazing, amazing work and the amazing change that consumer advocacy groups have had in the in-home insurance issue, the birth trauma inquiry.
Mel:
[51:16] I mean, the list is endless. That's just only what would be quite publicly known. But in the background, all of you, every consumer organization is taking steps to maintain their momentum, to keep in contact with the right people, to keep lines of communication open, to maintain relationships that build bridges. This is like tireless constant work and it's actually often thankless because although people could say wow you did an amazing job like on a social media post you guys aren't really getting much more from this than the the joy of seeing some results and the occasional pat on the back from the community to say nice work and so I just want to acknowledge that it's just a level of humanness that's so just admirable because it's virtually thankless.
Mel:
[52:15] You guys. And the complexity is, is that we're all people, some people are damaged people, and this can make it harder to get results. The other thing that struck me as we were talking is change in maternity care is not going to come from the top down. It won't come from politicians who are petitioning. It's usually this ground up approach. This is how we've seen change in maternity care through history is not through top-heavy politicians or policy change. It actually starts from the ground up and it moves upwards. And this is, I mean, consumer groups are vital. We would not be in a position of the birth trauma inquiries, even the mainstreaming of language like birth trauma and of violence, the understanding of the issues within maternity care.
Mel:
[53:08] That is largely due to the work of consumer advocacy groups. And so this is a complete, like in this episode is in worship of consumer groups and a petition to keep going and go in unity and together as women so that we can be so much more productive than you already are. So Amy, I just want to thank you for your time and for your balanced input into this space for also bringing in your business mind to this and really explaining this in a way for everybody to realize what goes into it. Can you also tell us where can people go if they're believing in your work, if they want to contribute financially? Is there a way that they can do that?
Amy:
[53:56] At the moment, we've only got one raffle on, but in the new year, hopefully there'll be ways that they can come and donate towards our organization or support us in other ways. If anyone wants to volunteer their time as well. If this is something that you're interested in or passionate about, we've got so many little projects on the go that just require time and effort to put them together. So that is probably the biggest way that people can support us now and other consumer groups. So this is something you feel called to do. Reach out to who is local to you and see how you can be involved because it's quite taxing and I know a lot of people have been in this industry for a long time and they need to be able to have a break at some point. And that means that there needs to be new and fresh people coming into this space as well. So that would be the biggest point that I'd make is if you have the time or the ability, it could be anything. So if you feel as though you've got something to contribute, reach out because we and every other group would love to have you.
Mel:
[54:55] Yeah, and that's the other point is there's often some really hefty leadership that happens in these consumer groups. And if that person steps down, that can sometimes just be the end of all the activity. So there has to be successes and people who are coming up being trained and mentored in these advocacy strategies so that the work can continue.
Amy:
[55:18] Yeah.
Mel:
[55:19] Thanks so much for being here, Amy. That has been this episode of The Great Birth Rebellion.
Amy:
[55:25] Thank you. Amazing.
Mel:
[55:27] Hey, that was so good. To get access to the resources for each podcast episode, join the mailing list at melaniethemidwife.com. And to support the work of this podcast, wear the rebellion in the form of clothing and other merch at thegreatbirthrebellion.com. Follow me, Mel, @MelanietheMidwife on socials and the show @TheGreatBirthRebellion. All the details are in the show notes. We'll see you next time.
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