Safer Care Victoria Releases The Respectful Maternity And Newborn Care Framework

Article originally appeared in AMA VICDOC, Autum 2026, 25/06/2026. 

Introduction 

In recent years, there has been an increase in freebirths in Victoria. A woman’s decision to freebirth may be influenced by a range of factors, including concerns of unnecessary intervention and an increased risk of birth trauma within the hospital system.

On 6 January 2026, Safer Care Victoria released the Respectful Maternity and Newborn Care Framework (the Framework). The Framework was developed in response to the Victorian Maternity Taskforce’s report and recommendations to strengthen maternity care across the state. The Framework guides clinicians on how to respond to situations where a woman has declined medical advice and treatment but there are concerns about the woman’s health or that of her baby.

The Framework

During labour and birth, a woman may make choices about her care that is contrary to what is clinically recommended, and which may lead to harm to the baby. However, while such situations can be emotionally and ethically difficult for health practitioners, under Australian law a foetus does not have separate legal rights from the woman and the woman’s choices must be respected.

Under the Framework, where there is evidence of clinical deterioration of the mother or baby, clinicians are advised to clearly explain the clinical circumstances, the urgency and rationale for treatment, and the impact to the mother and baby’s health. If the mother does not consent to the treatment, clinicians are advised to:

• Respectfully inform the woman that they will provide care without intervention, but that permanent harm may not be avoidable
• Reduce the number of clinicians in the room where possible
• Ensure a team is on standby to provide care immediately if the woman changes her mind
• Appoint a scribe to document all conversations and care
• Notify senior obstetricians and midwives.

The Framework emphasises that responses from clinicians must remain supportive and respectful, the woman’s self-determination should not be questioned, and coercive approaches should not be used.

Once the baby is born, the rights of the newborn crystallise and clinicians have a duty of care to escalate concerns if the welfare of the baby is deemed at risk. In extreme circumstances, if the parents are withholding consent to medical treatment that is urgent, a court can override parental consent and authorise the treatment. However, clinicians continue to have a duty of care during the postnatal period to provide women with all relevant information to support informed decision-making.

Furthermore, the Framework reiterates that documentation is critical to risk management. It states that care and decisions must be documented as close to the time of delivery as possible and all relevant assessments, interventions, outcomes and patient responses should be recorded. 

Key takeaways

Health practitioners providing maternity care may come across challenging situations, especially where a woman makes a choice about her pregnancy or newborn care that does not follow medical advice. Victoria has introduced a new framework, providing health practitioners with more certainty as to how to appropriately respond in such situations.

Originally published 25/06/2026.