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Medical Health Aged Care, Women

EXPERT ALERT – Women’s health reform: What progress has been made; what still needs to change?

La Trobe University 7 mins read

Dr Hannah Slootjes  
Dr Hannah Slootjes is an occupational therapist, and a researcher in women’s health, wellbeing, motherhood and matrescence (the transition to motherhood). Her work focuses on gender-responsive care for women and girls across the lifespan, including how pain and other health challenges can affect wellbeing and participation in everyday life.  

Topics to discuss: 

  • What progress has been made during the first year since Victoria’s Women’s Pain Inquiry, and what gaps remain.
  • How the federal Senate inquiry provides an opportunity to take a broader, lifespan approach to women’s health and wellbeing, beyond individual conditions or reproductive events.
  • Why women’s health concerns, including pain, can be normalised or dismissed even when they significantly affect wellbeing and participation in everyday life.
  • Why gender-responsive healthcare needs to consider women’s circumstances, choices, relationships, responsibilities, identity, work and participation alongside clinical treatment.
  • Why affordable access to allied health and multidisciplinary care is important across women’s health, including during the transition to motherhood.
  • How cost, work, caring responsibilities, travel and fragmented services can affect women’s ability to access care, particularly in rural and regional communities.
  • How healthcare services, professional education, research, funding and organisations can better support gender-just healthcare for women and girls. 

Dr Slootjes is available on [email protected] or via media adviser Jess Garbutt on 0481 383 817 or [email protected]. 

Quotes attributable to Dr Slootjes: 

“There has been meaningful progress during the first year. The Victorian Pain Standard now sets out what women should be able to expect when seeking care, including being listened to, believed and involved in decisions. The completion of the 20 Women’s Health Clinics, establishment of the Kids and Teens Pelvic Pain Clinical Network, expanded access to procedural pain relief and investment in research and workforce development are important steps forward. 

“The question now is whether these reforms are changing women’s experiences of care. We need to know whether women are getting earlier recognition and diagnosis, effective pain relief, affordable multidisciplinary care and practical support to improve their quality of life and participation in everyday life. 

“The medical model still dominates maternity care and childbirth and sets too many of the boundaries of perinatal health services. A woman can be considered medically well and still struggle with pain, continence, trauma, exhaustion and the work of caring. Occupational therapists and other allied health professionals already support women through these changes; however, our roles are under-recognised, under-funded and difficult to access. 

“There’s a difference between growing the market for women’s health and improving women’s access to care. A woman can buy a fertility test online yet struggle to find an allied health appointment she can afford. In regional communities, or when women do not have kin or family support, the price of that appointment can include petrol, time off work and someone to look after a child or parents. 

“Access to gender-responsive sexual and reproductive healthcare is essential for wellbeing and quality of life. However, medical dominance of women’s health becomes a problem when fertility, childbirth and prescriptive medical treatments define women’s health. A woman living with a migraine may have a prescription and still be unable to work 9-5. Who can she turn to for help to keep her job?” 

 

Professor Jane Mills 
Professor Mills is Dean of the La Trobe Rural Health School and Pro Vice-Chancellor for Health Innovation (Regional). Professor Mills can discuss women’s pain and women’s health from a health workforce, education and regional healthcare perspective, including what is needed at both state and national levels to translate growing attention on women’s health into better care. 

Turning attention on women’s health into better care 

Topics to discuss: 

  • Why growing state and national attention on women’s pain and women’s health needs to translate into lasting improvements in healthcare, education and workforce capability.
  • The need to equip health professionals to recognise and respond to women’s pain and broader women’s health needs through education, training and ongoing professional development.
  • Why improving women’s healthcare requires both appropriate services and a workforce with the capacity and capability to deliver them.
  • The additional barriers facing women in rural and regional communities, including workforce shortages, distance and access to specialist services.
  • How state and national approaches to women’s health can ensure improvements reach women regardless of where they live.
  • The role universities can play through research, education and developing the future health workforce. 

Professor Jane Mills can be contacted on [email protected] or via media adviser Jess Garbutt on 0481 383 817 or [email protected]. 

Quote attributable to Professor Mills, subject to approval: 

“It is encouraging to see women’s health receiving greater attention at both state and national levels. 

"The challenge now is turning that attention into lasting change by ensuring our health workforce has the knowledge, skills and capacity to respond to women’s health needs, and that women can access high-quality care regardless of where they live. 

“Digital innovation and AI-assisted healthcare has enormous potential in rural healthcare, but it needs to be designed and implemented in ways that work for clinicians, patients and health services.” 

 

Associate Professor Laura Whitburn  
Dr Whitburn's research focuses on women's experiences of labour pain and how the social and care environment can shape those experiences.  

Topics to discuss: 

  • Why labour pain is more than just a number on a scale and why understanding what pain means to each woman matters. 
  • How feeling safe, supported and listened to can shape the experience of pain during labour. 
  • How clinicians' language and communication can influence fear, expectations and experiences of pain. 
  • The 'nocebo effect' - where negative expectations created through communication can intensify pain or distress. 
  • Why respectful, clear communication should be a core part of pain care. 
  • The challenge of turning recommendations and new pain-care measures into consistently better experiences for women. 
  • Ensuring improvements reach women who face additional barriers to accessing or navigating care.  

Dr Whitburn is available on [email protected] or via media adviser Jess Garbutt on 0481 383 817 or [email protected]. 

Quotes attributable to Dr Whitburn: 

"Labour pain isn’t just a number from zero to 10. It’s a changing experience shaped by what the pain means to the person, whether they feel safe and supported, and what options are available to them. 

“Words can hurt, especially when someone is in pain and vulnerable. A hurried 'tell us when you need something for the pain' or 'you’re not coping' can prime someone to expect threat, increasing fear and potentially intensifying pain or distress. That’s the nocebo effect, where negative expectations can worsen someone's experience. The pain is real, but language can influence how it is experienced. Choosing words carefully, explaining what is happening and checking how those words are landing are all part of good pain care.” 

 

Professor Leesa Hooker 
Leesa Hooker is a Professor of Nursing at the La Trobe Rural Health School and researcher with the Judith Lumley Centre, with expertise in maternal and child health, women's sexual and reproductive health, health services and the healthcare response to women experiencing violence and trauma. 

Postpartum pain and the gap in women's healthcare after birth  

 Topics to discuss: 

  • Why women's healthcare can fall away after childbirth
  • Persistent postpartum pain and physical health issues
  • Pelvic floor and continence health
  • The limitations of relying on women to navigate fragmented services themselves
  • How Maternal and Child Health services could provide a longer-term health safety net
  • Family violence and reproductive health as part of postpartum healthcare 

Regional access to women's healthcare 

Topics to discuss: 

  • Additional barriers facing women in rural and regional areas 
  • Access to women’s sexual, reproductive and maternal healthcare 
  • Regional health workforce issues 

Professor Hooker can be contacted on [email protected] or via media adviser Jess Garbutt on 0481 383 817 or [email protected]. 

Quotes attributable to Professor Hooker:  
"Current service provision implies that women's recovery concludes with hospital discharge or at a single six-to-eight-week postnatal check. This is woefully inadequate. The birth of a baby should not mark the end of systematic healthcare for women who give birth. 

"Governments should provide women with a longitudinal maternal healthcare safety net across the first postpartum year. The existing Maternal, Child and Family Health (MCFH) workforce provides a strong foundation on which to build it. 

"Australia has evidence-based postnatal care recommendations and an existing, free universal community-based MCFH service and infrastructure. The policy gap is the absence of a nationally consistent mechanism, workforce capability and resourcing to connect the two. 

"To address this policy gap, governments should recognise the highly qualified and well situated MCFH nurses as a core postpartum maternal health workforce. 

"A nationally consistent postpartum maternal health model should also be established, extending across the first 12 months after birth and beyond and integrating it with existing universal MCFH services." 

 

Professor Lisa Amir 
Professor Amir is a medical practitioner and Principal Research Fellow at the Judith Lumley Centre with a longstanding interest in women's health. Her work includes breast and nipple pain and the use of medicines by breastfeeding women. 

Lisa made submissions to the Women's Pain Inquiry on breast abscess management and in the current Senate inquiry into women's health.  

Breastfeeding and postpartum health: pain, medicines and research gaps 

Topics to discuss: 

  • Pain and physical health problems experienced during breastfeeding and postpartum.
  • Why pregnant and breastfeeding women have historically been excluded from clinical research.
  • The ethical dilemma of prescribing medicines to pregnant and breastfeeding women when there is limited evidence about their use.
  • Why safely including pregnant and breastfeeding women in research is important for improving the evidence available to women and clinicians. 

Professor Amir is available on [email protected] or via media adviser Jess Garbutt on 0481 383 817 or [email protected]. 

Quotes attributable to Professor Amir: 

"After giving birth, women experience huge changes in their bodies. Their breasts enlarge as lactation begins and they may experience nipple pain and damage as they learn to breastfeed. They may instinctively lean forward to put the nipple in the baby's mouth, instead of finding a comfortable position leaning back and holding the baby close to their body enabling a better experience for both mother and baby.

"In Victoria, 96 per cent of women start breastfeeding in hospital. About one in five women experience mastitis, or breast inflammation, and some of these women develop a breast abscess. At the moment, management of breast abscesses in lactating women is haphazard and we are calling for a more coordinated approach.” 

 

Professor Helen McLachlan
Professor McLachlan is Head of Midwifery at the School of Nursing and Midwifery and an internationally recognised researcher in maternity care. A nurse and midwife, Helen's research focuses on continuity of midwifery care and improving outcomes for Aboriginal and Torres Strait Islander women and families. Helen led the COSMOS trial of caseload midwifery and the largest of its kind globally. She is currently leading research into midwife continuity for socially vulnerable women. 

Continuity of care: what we already know works  

Topics to discuss: 

  • The evidence showing midwifery continuity of care can improve outcomes and women’s experiences of maternity care.
  • Why having a known midwife or small team throughout pregnancy, birth and the postnatal period can improve trust, community and coordination of care.  
  • Why access to continuity models remains uneven, including for First Nations women, people with complex needs and those living in rural and regional areas.  
  • What is needed to take models with a strong evidence base and make them more widely available.  

Professor McLachlan is available on [email protected] or via media adviser Jess Garbutt on 0481 383 817 or [email protected]. 

Quotes attributable to Professor McLachlan: 

“Continuity of midwifery care gives women the opportunity to develop a meaningful relationship with a known midwife throughout pregnancy, birth and the early postnatal period. Through this relationship, women develop trust and confidence, feel supported and listened to, and are better able to approach birth knowing the person caring for them. It is not simply about having the same midwife present at birth; it is about the value of an ongoing relationship that supports women throughout their maternity journey. 

“The COSMOS trial, led by La Trobe University, was the world's largest randomised controlled trial of caseload midwifery. It demonstrated that continuity of midwifery care can improve important birth outcomes. Women who received caseload care were less likely to have a caesarean birth, more likely to have a spontaneous vaginal birth and significantly more satisfied with their care.  

"These findings provide strong evidence that continuity of midwifery care should be available to all women. It is time to move beyond demonstrating its benefits and towards ensuring universal access to this model of care." 

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