The “power imbalance and abuse of trust in the birth space” women experienced “can result in birth trauma,higher rates of postnatal depression and post-traumatic stress disorder (PTSD),” the paper said.

Midwives who witnessed traumatic births also described feelings of “helplessness,fear and powerlessness” and could also reach the diagnostic criteria for PTSD.

Obstetrician and senior lecturer Dr Daniella Susic said the findings in the report were “a black mark against all maternity care providers”.

She said obstetric violence,which is recognised by the United Nations as a form of gendered violence,“happens at the hands of both genders”.

Susic said she had witnessed instances where women felt like they had not had the opportunity to consent to procedures,contributing to 29 per cent of women in NSW reporting they have experienced traumatic birth.

“This cuts to the heart of myself,and comes to the notion of how can we do it better? It comes down to how we educate our maternity care providers across both disciplines[midwifery and obstetrics] to work together,” she said.

Lawyer Bashi Kumar Hazard,the legal director of Human Rights in Childbirth,said she had handled complaints about women being restrained by security while procedures were done to them and who were locked in rooms until they complied.

She said lack of consent for episiotomies and repeated vaginal examinations,which were done to comply with hospital protocols regardless of whether they were medically necessary every four hours,were common and extremely distressing.

Melbourne woman Bodhi,a registered nurse,said she had specified to her doctor she did not want an episiotomy during the recent birth of her son,August,but was given one during a vacuum birth.

“It was very quick,they[medical staff] were talking to each other,but they didn’t really talk to me,” she said.

“One of the doctors just said,‘I’m just going to sew up the snip we gave you’. I was like,‘Wait,what are you talking about?’

“They had their hands inside me assuming I had had an epidural[pain relief],but no one actually asked me whether I had,I had only had the gas.” She said she remained angry about her treatment.

Sydney woman Emilia Bhat said despite telling her doctor,while greatly distressed,that she could feel stitches being done on a tear and needed more anaesthetic,she was ignored.

“I was telling the obstetrician to stop,but she didn’t listen to me. I was just shocked – I was screaming to stop,and she didn’t care. My midwife had to tell her to stop,” Bhat said.

“I was screaming and yelling saying,‘I can feel it. This isn’t right.’

“I talk to other women,and it was also common for them;you don’t get adequate pain relief when sutured after birth,” she said. “There is very,very little regard for your pain in these medical procedures.”

A spokesman for the Royal Australian and New Zealand College of Obstetricians and Gynaecologists said women should receive accurate and evidence-based information about the benefits and risks to enable informed and timely decisions about modes of birth.

“Choice is important within maternity care,and clear information about each option should be available to all pregnant women,” the group’s statement said.

“Many women report difficulties in accessing reliable,comprehensive,evidence-based information about the risks and associated outcomes of vaginal birth,instrumental birth and caesarean sections.

“Consequently,there is a risk of decision-making based on poor or minimal information which could contribute to adverse outcomes for both the mother and the baby.”

College board director Julie Hamblin,the chair of the organisation’s Informed Birth Working Group,said:“Quality maternity care is fundamental to the health of every community. It should be guided by the best available evidence and delivered with the individual woman as its focus.”

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