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Furore over Australian obstetrician who wants consent forms for vaginal births

An eminent Australian obstetrician and gynaecologist has caused a furore with his views that women should have to sign a consent form confirming that they understood the risks of vaginal birth over caesarean.

The Guardian reports that Professor Hans Peter Dietz, an internationally renowned pelvic floor expert, has been the subject of numerous complaints to his employers, the Nepean Hospital and the University of Sydney. Dietz's remarks regarding the competence of midwives and his remarks "were so sexist and condescending that some attendees were in tears and conference organisers vowed never to invite him back".

According to the report, three health professionals said Dietz told attendees at medical conferences that women should be forced to sign a consent form if they wanted to give birth vaginally, to confirm that they were aware of the risk that their bodies might be left with tears and other complications if they did not get a caesarean instead.

The director of midwifery studies at the University of Technology Sydney, Dr Christine Catling, attended the Annual Obstetric Malpractice Conference in Melbourne in August 2018 and was asked to speak about midwifery continuity of care and the management of large babies.

While on a panel, Catling spoke of the importance of not scaring women if there were concerns about vaginal delivery and to instead discuss different options and risks. Dietz stood up and interrupted her. “He declared that it was his job to scare the bejesus out of women,” Catling said.

She said Dietz then said that the practice where he previously worked in New Zealand had changed policies since he left, which meant around 50% of women were now seen by midwives rather than obstetricians, a change he said would affect the quality of documentation.

“I grabbed the microphone and said that there was no reason that the documentation would be affected as the midwives are competent at their jobs,” Catling said. “It was then that he stated that midwives are incompetent.”

“The next day I found the conference organiser in tears in the bathroom after she had asked him to pay some respect to the speakers,” Catling said. In a subsequent email between the event organiser and Catling, the organiser said she had been involved in the conference since its inception.

“I have never encountered a delegate/speaker who is so extreme in their views and was not aware of this prior to the event,” she wrote to Catling. “I will not be including him in any of my events moving forward. There is no place for aggression and disrespect at our events.”

Also, it was reported that Dietz had sent an email to committee members of the NSW medical union stating the workforce was “increasingly vulnerable because it’s increasingly female and not exactly prepared for adversity because school and uni are ‘safe spaces’ (sic).” “Suicides are one result,” he wrote. “Inability to cope with everyday nastiness is another.”

Bashi Hazard, a lawyer and the director of Human Rights in Childbirth, said she was invited by the Australian and New Zealand Journal of Obstetrics & Gynaecology to contribute a piece about Dietz’s stance that all women should sign a form saying they understood the dangers of vaginal birth before choosing to give birth that way.

“My legal argument was how can women consent to what is a natural bodily function they can’t control?” she said. “You can’t force women to do that.”

Hazard said she sent the article to some lawyer peers and consumers for their feedback before sending it to the journal for review and publication. She was shocked to receive a response from the journal accusing her of breaching their guidelines by disseminating the article widely ahead of publication.

“I found out one of the people I consulted with on the article took the article without telling me and gave it to Dietz, which would have been fine,” Hazard said. But he then forwarded it to other people, she said, which had led to the journal’s response.

The university declined to answer specific questions from Guardian Australia, but said it was “aware of certain complaints” about Dietz and was “making inquiries as a matter of priority”.“We are unable to make further comment while the process is ongoing,” a spokeswoman said.

“While our academics are entitled to express their own opinions, and would defend their right to do so, we consider recently reported statements from Dr Dietz to be unacceptable and in conflict with the university’s own position, policies and practices. We are absolutely committed to our ongoing work to achieve a positive workplace culture and gender equity in Stem, including medicine and health.”

[link url="https://www.theguardian.com/australia-news/2019/nov/08/sydney-obstetrician-said-women-should-sign-a-consent-form-for-vaginal-births"]The Guardian report[/link]

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