PURPOSE:
Australian maternity care is fractured, driven by a risk-averse system that has replaced trust with control. Birth is managed rather than supported, and midwives are increasingly constrained by institutional policies that undermine their scope and ethics (Homer et al., 2023).

DISCUSSION:
This abstract challenges the foundation of this system, proposing a return to trust - not as naivety, but as a radical, evidence based act of reclaiming autonomy.

EVIDENCE WHERE RELEVANT:
In 2021, 39 percent of births in Australia were by caesarean section, more than double the World Health Organization’s recommended rate, and the use of forceps continues to rise (Australian Institute of Health and Welfare, 2023). These figures reflect not only over-medicalisation but a failure to prioritise woman centred care (Dahlen et al., 2023). One in three women describe their birth as traumatic, often due to coercion or lack of informed consent rather than medical complication (Reed et al., 2017; Buchanan et al., 2022).

KEY MESSAGE:
This abstract reflects on the journey of two midwives who, disillusioned by these systemic failures, created an independent midwifery model in regional Western Australia. Supporting over 20 full care clients annually, their practice includes bulk billed visits, collaboration with local GPs and hospitals, and student mentorship. This model responds to the gaps left by the closure of rural services and the decline in GP obstetrics, offering not just choice but justice. At the heart of this work lies an ethical dilemma: how can midwives “do no harm” within a system that often causes it? Private practice becomes both an act of survival and resistance, allowing midwives to offer the care they were trained to provide. Rebuilding trust in birth means shifting power back to women and to the communities that support them. It means daring to believe that safe, respectful care is not only possible, it's a human right. Continuity of care - outcomes 2