Dr WOODRUFF (Franklin - Leader of the Greens) - Mr Speaker, the Greens very strongly welcome this motion for a select committee to inquire into reproductive, maternal and paediatric and perinatal mental health services in Tasmania. I was thinking when I was preparing some thoughts about this that these issues of women's reproductive, maternal, perinatal and paediatric health are at the same time at a gendered issue and not a gendered issue and I will explain why I mean that.
It is a historical and current fact that women's health is not resourced, researched or prioritised in the way that men's health is. It is a fact from an historical condition called the patriarchy that women's health is not seen as worthy or necessary of research, resources or priority. That is because our society and most patriarchal societies on the planet - and there are matriarchal societies that have a balance like Aboriginal societies do - see women's business as the role of women not to be part of the public domain. It is a private domestic domain that does not come into everyday community life. It is certainly not worthy of conversation in parliament. It is not worthy of a particular space in the hospital. It is women's responsibility to look after our bodies, our birthing, the caring of children, and it is not something that is about public life.
In our modernised health system in 2023 it sounds very strange saying those things. Being a woman in parliament I would like to think I am an anachronism as I stand here saying this, but unfortunately it is not the case. What we are seeing - in British societies since the early 1530s - is the long lag of the fight between female midwives and the male medical profession for control over women's bodies. So far, the men have beat women, but the women have been fighting back now for a couple of decades. We have been constantly moving and exerting the right for everyday functions of women's bodies, which is essential for human life on Earth, to be respected and given its central importance in society, as we all need it to have beautiful, healthy, functioning communities.
In the 1530s midwives were branded as witches. The very first woman who was hanged as a witch in England was a midwife. She was hanged because of the practices she was practicing and because she was a threat to the development of the medical guilds at the time. I happen to know about that because my husband's grandmother wrote a book about it in the 1970s. She wanted to know the story of feminism and decided to look at the first woman who was hanged for witchcraft and that was her story.
When I was a younger person I considered going into nursing, a beautiful, fantastic career and one that I occasionally wish I had taken up. I was put off at the time because the only opportunity as a young woman to get medical nursing training in the Sydney region was to go and live in essentially a convent-like situation, locked up in the nurses' home where you were not allowed out after hours. There was no drinking, no smoking, no sex, no drug taking, no men around -
Ms O'Byrne - My mum tells stories of sneaking out windows down long ladders.
Dr WOODRUFF - Yes, exactly; it all happened but just not legally. Women were locked up to do the job of being trained to look after women and out of the way. I decided that I was not going to be able to fit into that mould. So, we have had this fight and women have been winning, but the resources and the systems have not kept up with what society demands. We are talking about services and experience of life that affects 100 per cent of Tasmanians, because everybody is born once. We all have mothers who bear us, we all have mothers who experience ante-natal, post-natal experiences, we are all in a childhood of nought to five, and have particular experiences that set us up for life.
It is the relationship that we have with our mother, the support that women have for their mental health in the peri-natal phase of just before birth and in the year after birth that is critical for the lifelong development of healthy children, who become healthy adults.
If women do not have the support for breast feeding and for proper feeding, then children will not get the benefit of breast milk, the protective factors for a whole range of childhood diseases and adult impacts. It is a fantastic start in life to a functioning immune system, it is strongly related to being protected against allergies, strongly protected against childhood ear diseases and a range of other reasons but it takes a lot of support for some women to be able to breast feed. It takes a lot of care for some women bearing children. One in five women will have a mental health problem in that period. Some women do not recover from that unless they are given intense support.
Not only everyone in Tasmania is affected: 86 per cent of women in Tasmania will have at least one child in their lifetime. Nearly every woman is impacted by the quality of the experiences. We hear more and more of the lifelong impact of those experiences being traumatic. Birth trauma, which is a recently developed term, describes a set of experiences unfortunately many women have had where decisions are made during the birth process that are non-consensual, when interventions are not explained and consent is not asked for. The impact of that trauma can have a lifelong effect.
Endometriosis is a crippling condition for many women. We do not have good numbers on the percentage of Australian women with endometriosis. The best recent estimate I could find was that about 6.5 per cent of women aged between 40 and 44 have it. The fact that we do not have those numbers demonstrates that doctors, predominantly male doctors, do not accept that it is a problem with women having pain during menstruation or any part of the menstrual cycle. For many women that pain can mean they cannot function for a week, a month or for longer.
I am thinking of words from Amanda Duncan, who gave a beautiful campaign speech about endometriosis. She has been a champion midwife and a registered nurse. In 2021 she said that erectile dysfunction has been considered more of a health priority than many other chronic gynaecological conditions. How terrible it is when a man cannot enjoy sex. Penile pumps have been created for men post prostatectomy and there are obviously people with time out there on their hands to think of these things. Where is the equivalent level of dedication to make sure a woman can still enjoy sexual pleasure with endometriosis and pelvic pain? Not just sexual pleasure but able to function on a daily basis, to go to work and live life in the community. Endometriosis is just one example of many of women's so called issues that are health issues that occur in up to 50 per cent of the population.
To be able to talk about women's issues and men's issues is only because women's bodies have not been the body that has been studied, researched, investigated, autopsied upon which drugs are tried. It is still the case that we do not have information about pregnancy and drugs because drug companies have not done any research on the impacts of their drugs on women who are pregnant. It is an incredibly important time to know what the impacts of taking a drug will be.
These matters are not the subject of what this inquiry seeks to investigate but it demonstrates a social understanding that we are coming to of how women's health is not being attended to on the issues. This inquiry is seeking to look at how the services are functioning for women on those issues. How are the differences in those services operating between regional and rural Tasmania and between our main cities? How is Tasmania stacking up relative to other jurisdictions on the mainland? What are the issues for women who are socially and economically disadvantaged? How are they different? How should this Government and future governments respond to them?
We support the investigation into this area. One of the outstanding features I have noticed of this Government over the last 10 years is an abject failure to do any planning for recruitment and retention of staff in the hospital system and the health system. That is very clear among nurses and midwives and the shortages in that area are extreme, more extreme in some parts of Tasmania than other parts.
We are coming to the edge of a cliff. It is concerning that midwives and nurses have not been given the priority that they ought to because without these health professionals, women would be in a terrible place. We need more than ever health services for women around reproductive matters, childbirth and the perinatal period that do not pathologise the process. There is nothing unhealthy or sick about having a baby. There is nothing unhealthy or sick about having changes across the reproductive times of women's lives.
We need to have safe, caring educated people, preferably women, who are the professionals providing that work. That is not rocket science; it is not something new in the world. It is actually reinventing the wheel, going back to how humans have always operated successfully as communities. The more we prioritise, resource and make worthy the investigation and focus of our health system on these matters - reproduction, birthing and early-age children - the better society will be into the future.
We need to act now, to think for the future. We need to be planning for increasing the attachment between a child and the child's mother. That is good for the mother and the baby. It is good for the baby growing into an adult. It is good for the family to have children attached to parents and bonded in a way that support in the early years can strengthen the family. All of the evidence in the education system is that it all comes together, not just from the health point of view but from the education point of view, if we have that focus on the nought to-five age. If we prioritise the families, the parents and the children and the relationships and help them be functioning units, then many of the things we are trying to work in the 12- to 18 year-old age group will evaporate. So much of it starts with parents not being supported in the beginning.
We welcome this inquiry. I am interested to hear what the Labor Party has to say about the comments the minister has made. Our view is that it is an urgent matter to get on with this inquiry. We accept that the Liberals are not in a robust situation and are stretched for backbenchers but it is much more important to look at the work of the House than to look at the convenience of the Government and its backbenchers' time. It is just a matter of get on with it, do the work; you have made your bed, you lie in it.
This is the work of the committee. I do not accept that having four members on a committee makes it a functioning committee. That is too small because if two people are not there, as happens, there is no flexibility. It is also not a diverse committee. I do not accept that is a reasonable excuse for wanting to cut the numbers of the committee.
It should be up to the committee to decide if it cannot meet the suggested deadline of April. If it cannot, the committee can seek an extension, which is a normal practice. We should not overly prescribe the work of the committee now. If the members who have moved it think that is a time that can be worked within, the Greens will support that. We welcome this motion for this committee. Thank you, Ms Dow.
