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November 23, 2025 52 mins
We hear from Tessa Kowaliw (pron. ko-VAH-liyev) about birthing in South Australia since the enactment of the Health Practitioner Regulation National Law (South Australia) (Restricted Birthing Practices) Amendment Act 2013, which regulates who can "manage" women's births.  Tessa has 16 years a maternity services consumer advisor in a wide range of roles, but shares her views here as a well informed individual observer, and not representing any organisation.

The Australian College of Midwives (ACM) and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) recently published a joint position statement calling for the rollout of this legislation across Australia. https://ranzcog.edu.au/news/ranzcog-acm-call-on-health-ministers-to-end-freebirth-deaths.

We discuss: - The important role SA can play for advising legislators and policy makers with 12 years' experience with this legislation
- The lead up to this law and the birthing landscape in SA since 2013
- Where we are now, 12 years on
- The risk of legislating and asking a broken system to apply this 'reasonably', unintended consequences
- A more appropriate roadmap for offering support for women outside the maternity system with the right level of urgency, in particular rebuilding trust and strengthening consumer partnerships
- Tessa and her colleagues' current efforts to compile a 'From SA With Love' info pack of their lived experiences under the restricted birthing practices law with a view to sharing this with interested consumer community leaders, advocates and decision makers interstate (due to be completed by early December)

Contact can be made with Tessa either through this podcast or at tessakowaliw@gmail.com.

(Article mentioned by Tessa: https://www.rachelreed.website/blog/homebirthaustralia
Book mentioned near end of the interview: Tew, Marjorie, Safer Childbirth? A Critical History of Maternity Care, Chapman and Hall, 1993.)


Tessa Kowaliw is a South Australian consumer advisor who has been working with birthing women, and the people and organisations which serve them, since 2009. In the 2010s, she was Coordinator for CARES (a former South Australian not-for-profit consumer group which supported women to make birth after Caesarean choices), she assisted national efforts to activate increased access to continuity of midwifery care under the National Maternity Services Plan (2010-2015), she has lobbied Health Ministers and local services to better address women's needs, and she founded (and still runs) 'VBAC Chat South Australia' - an active Facebook group of over 1.1K members designed to educate and support women and care providers. 
 
Tessa has been a Special Purpose Director with Women's Healthcare Australasia, was a Councillor for RANZCOG for seven years, is co-author on the standard set of outcome measures for Pregnancy and Birth developed by the International Consortium for Health Outcome Measurement (ICHOM), and has presented internationally (incl. Washington, London, Utrecht) on value-based healthcare and 'what matters most' to healthcare consumers. By day, Tessa is a Business Architect and consultant, juggling corporate work around mothering duties, and her enduring passion for improving women's health.

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