ACC figures show only about a quarter of the expected number of claims have been lodged in the past two years
A specialist physiotherapist says health professionals need to do more to get claims registered, and to prevent injuries in the first place
An outdated attitude that mums should “suck it up” when suffering birth injuries is causing women decades of unnecessary pain and discomfort, experts and advocates say.
ACC has released updated numbers showing just 15,521 claims have been lodged for maternal birth injuries in the last two years href="https://www.nzherald.co.nz/nz/acc-reveals-proposed-changes-to-cover-birth-injuries/Q5VHDKVD53A27GEVDOCYQM4SYU/" target="_self">since legislation providing cover for such injuries came into effect in October 2022.
The figure is a far cry from the estimated 56,000 that were expected to be helped across this period, and some are putting it down to societal attitudes.
An ACC spokesperson said 97% of the claims have been accepted. Of the declined claims, 180 happened before the legislation change and 197 were declined for other reasons.
There were 121 claims awaiting assessment as of the start of November.
Birth Trauma Aotearoa founder Kate Hicks said part of the reason she suspects not many claims are being lodged is because women have been taught to put up with birth injuries.
“The message we get as new parents is ‘oh, that’s just normal, everybody feels that. That’s birth, that’s what you need to expect‘,” she said.
Birth Trauma Aotearoa founder and chief executive Kate Hicks says attitudes around birth injuries need to change.
“That’s one of our jobs as an organisation, changing those deeply entrenched attitudes.
“Many māmā are met with attitudes of ‘oh, just suck it up, mums have done this for millennia’.
“That’s really damaging and it’s silencing, so part of our job is kind of working on shifting those attitudes, really letting mums know that they don’t have to just suffer in silence.
“They absolutely deserve that support.”
Symptoms such as incontinence, general pelvic discomfort and pain during sex can often be treated and cured.
“A lot of people have been surprised that they can get treatment for these injuries, that’s really because they just didn’t know that care was available under ACC.”
Hicks wanted people to know ACC covered a wide range of services under the scheme, including not only medical treatment, but also counselling, home help, and childcare if needed.
She encouraged women to lodge claims, saying symptoms might not show up until months or years later.
“It’s just like if you break your leg playing rugby or whatever, so utilise it as much as you can.”
Meanwhile New Zealand’s only specialist physiotherapist in pelvic health, Dr Melissa Davidson, believes not enough is being done to prevent maternal birth injuries in the first place.
“I don’t think we’re doing enough in the injury prevention space. We are for falls, we are for rugby injuries, but we’re not for birth injuries,” she said.
ACC began offering cover for maternal birth injuries in late 2022. File photo / 123RF
Davidson pointed to international research showing a “hands-on approach” during crowning could significantly reduce serious injuries by at least 50%.
This approach involved physically supporting the perineum and the baby’s head as it is born to help reduce injury to the mother.
Davidson said approaches like this, as well as keeping women well informed about interventions ahead of birth, could help prevent injuries from happening.
Davidson, who has 33 years of experience as a physiotherapist, now exclusively treats pelvic health patients.
“We don’t see as many as we would like to see,” she said.
“We’ve got a lot of women who are entitled to have their injuries registered [with ACC] so that they have that coverage and they’re just not being given that opportunity at the moment.”
Davidson said the health professional caring for the woman at the time of birth should be registering a claim for them, and this was often not happening.
“I’m a firm believer that it’s a woman’s right to have any injury registered because she may need help with it later in life, and I think that that’s really important that she’s given the opportunity to know that that’s her entitlement.
“If they need to open a stitching kit or do anything, that means a claim should be registered.”
Davidson said many women suffered with their injuries, thinking it was normal.
Dunedin mum Vienna Sutherland suffered an injury while giving birth to 1-year-old Ivy.
“There’s a lot of things that are common but they’re not normal and they’re treatable.
“We’re depriving those women of that right to treatment and to have full, functional, pain-free lives.
“I’ve got lots who’ve been having pain for 30 years with sex because of scarring.”
She sees women who have psychological stress tied to their injuries, or mums who cannot run after their kids, carry a laundry basket or jump on the trampoline years after childbirth.
Others have lost much of their sensation during sex, or have been told they can never lift more than 5kg again.
She wanted women to know many of the injuries they had learned to live with could be easily treated, and they did not have to accept this as the new normal.
In fact, a “large proportion” of injuries were a simple fix.
“They don’t have to go around feeling like their vagina is falling out.”
She encouraged women to seek an assessment from a pelvic health physiotherapist.
“It’s intrusive and it’s a private area, but the physios that work in this area, we’re a bit of a weird bunch . . . we deal with wees, poos and sex every day, all day.
“We’re quite used to seeing everything under the sun, nothing surprises us. ”
Davidson was a strong believer in empowering women and teaching them about what they were entitled to.
“When a woman knows that somebody is able to support her and work beside her and help her, it’s life changing.”
Dunedin mum Vienna Sutherland has shared her experience lodging a claim with ACC under the changed rules.
Sutherland suffered a third-degree tear on top of an episiotomy while giving birth to her daughter, Ivy Scorgie, about a year and a half ago.
“Pretty much straight away at the hospital they were like ‘you’re going to need physiotherapy with that tear‘.”
The obstetrics team took care of all the paperwork and lodged the claim for her, and it was not long before Sutherland received a call to set up her physio appointments.
“I didn’t have to deal with any of that,” she said.
She encouraged other mums to do research before the birth about what services are available.
She has requested ACC funding for counselling for birth trauma, and only recently realised this was something she could access.
“I just want other women to be supported,” she said.
