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Parents know that they are not the experts in pregnancy and birth and that the consequences of any problems that may arise can be catastrophic. Families have come to fear birth justifiably in light of the messages they receive from some health professionals, media and social networks reinforcing the belief that 'childbirth is inherently risky', a 'difficult' process from which mothers and babies need to be rescued. We live in a 'no risk' society in which technology-intensive childbirth is equated with high standards of care employed in the best interest of women and babies. Australia is a society that has embraced the introduction of high technology across all aspects of life including childbirth. Implementation of the primary maternity care reforms will not be without challenges. In announcing the reforms the government has responded to a decade of pressure from numerous reports, commissions and inquiries recommending wide scale change in how maternity care is to be delivered in Australia. The reforms are expected to provide the right balance between primary level care and access to appropriate levels of medical expertise as clinically required. It is argued the removal of uncomplicated childbirth from routine obstetric influence will reduce the numbers of women receiving expensive obstetric care and interventions in the absence of clinical need. Primary maternity services are based on the understanding that 85% of pregnant women are capable of giving birth safely with minimal intervention. In 2009 the Australian government has announced a major program of reform with the move to primary maternity care. The silent voice of one consumer group (women happy with their obstetric-led care) in the consultation process has inadvertently contributed to a consensus of opinion in support of the reforms in the absence of the counter viewpoint. Unified consumer influence advocating a move away from obstetric -led maternity care for all pregnant women appears to be synergistic with the ethos of corporate governance and a neoliberal approach to maternity service policy. The rise of consumer influence in maternity care policy reflects a changing of the guard as doctors' traditional authority is questioned by strong consumer organisations and informed consumers. Resultsįindings from this critical discourse analysis revealed extensive similarities between the discourses identified in the submissions with the direction of the 2009 proposed primary maternity care reform agenda. MethodsĪ critical discourse analysis of selected submissions in the consultation process to the national review of maternity services 2008 was undertaken to identify the contributions of individual women, consumer groups and organisations representing the interests of women. The reform agenda represents a dramatic change to maternity care provision in a society that has embraced technology across all aspects of life including childbirth.
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In 2009 the Australian government announced a major program of reform with the move to primary maternity care.