Safer Care Victoria’s new maternity guidance asks clinicians to stay away from “fear-based language”.
Clinicians in Victoria have a new framework on respectful maternal and newborn care which includes directives to “remember that the woman has a legal right to accept or decline any aspect of care” and to “trust the woman’s capacity to make decisions that are right for her”.
The guidance, which was released earlier this month, was developed specifically for scenarios where a pregnant woman chooses not to follow clinical recommendations.
The “RESPECT” framework itself asks clinicians to: recognise the woman’s right to decide, enlist appropriate interpreters when needed, share balanced information, provide time and space for decisions, enable questions, check understanding, trust the patient and make documentation as necessary.
It follows several years of public discourse about homebirths and freebirths, including the 2025 death of a social media influencer from a postpartum haemorrhage.
At the same time, there has also been discussion of birth trauma and “obstetric violence”.
A 2025 NSW parliamentary inquiry found that close to one in three women characterised their birth as traumatic, and one in 10 women felt they had experienced behaviour from clinicians that made them feel “dehumanised, powerless and violated”.
Specific actions detailed under the RESPECT framework banner include staying away from fear-based language, pausing to allow time for women to process information and discuss with support persons and structuring information from most common to rare outcomes.
“Clinicians must create environments that uphold, not grant, women’s decision-making authority,” the new framework said.
“Woman-centred care supports autonomy, dignity and better birth experiences.”
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In situations where a woman requests an intervention that does not align with evidence-based practice, the framework notes that clinicians may benefit “from team debriefing, clinical supervision and opportunities for deep reflection”.
The guidance also notes that it is “uncommon” for women to continue to take a pathway of care that differs from recommendations in deteriorating clinical circumstances. Where this does happen, it recommends “timely escalation and senior clinician input”.
Royal Australian and New Zealand College of Obstetricians and Gynaecologists president Dr Nisha Khot told Nine Newspapers that the Victorian guidance would help clinicians navigating complex situations.
“There is more and more of this friction,” she said.
“Women are struggling with it, and clinicians are struggling with it.”
