Fiona Martin (Reid, Liberal Party) Share this | Link to this | Hansard source

As a parent of four children, I know that bringing new life into the world is beautiful and life changing. However, for one in three Australian mothers, this experience is tainted by birth trauma. Giving birth has caused these women to endure physical injuries as well as mental distress, which they continue to live with daily. Today I present a petition to reinstate the MBS item for abdominoplasty surgery for women with abdominal tearing caused by pregnancy, a medical condition known as diastasis recti.

The petition read as follows—

This Petition of Certain citizens of Australia

In 2016 Medicare withdrew the item number for abdominoplasty following pregnancy, without any public or clinical consultation. However, the Medicare benefit remains for significant weight loss. Pregnancy can cause similar abdominal injuries to obesity; injuries that cause debilitating long-term back pain and/or urinary incontinence. This negatively impacts the day-to-day quality of life for many women across Australia, affecting their ability to be physically active mothers. A study published in the Journal of Plastic and Reconstructive Surgery: March 2018 - Volume 141 - Issue 3 - p 637-645, titled "Abdominoplasty Improves Low Back Pain and Urinary Incontinence" showed abdominoplasty significantly improves the incidence of chronic lower back pain and urinary incontinence in postpartum women. Women who seek abdominoplasty for purely cosmetic reasons should not be covered by Medicare, however those Australian women who suffer significant functional issues associated with their pregnancy injuries should be given Medicare assistance for life-changing abdominoplasty surgery. There are many operations performed for relief of chronic pain and instability incurred by sports injuries that are reimbursed by Medicare. Abdominoplasty associated with repairing pregnancy injuries should be considered in a similar light, in that it is a procedure that addresses pain, instability and function issues.

We therefore ask the House to adapt the Medicare benefit for abdominoplasty surgery to include women requiring corrective surgery to improve instability, pain and functional issues associated with pregnancy injuries, thereby improving the quality of life of many women across Australia.

from 13022 citizens

Petition received.

This petition has been considered by the Petitions Committee and is found to be in order. The principal petitioner is a constituent who contacted me after I spoke in this place about birth trauma. Ms Kerrie Edwards of Drummoyne, New South Wales, who personally suffered abdominal tearing after giving birth to twins, has collected over 13,000 signatures on this petition.

Abdominal tearing refers to tearing, stretching or rupturing of the abdominal muscles caused during pregnancy. Women who have multiple births or larger than average babies are more likely to experience this type of injury. It can cause chronic lower-back pain and urinary incontinence that impacts a woman's quality of life, her mental and physical health, her ability to care for her children, the decision to have more children and her capacity to return to the workforce. For some women it even impairs their ability to lift or carry their own children.

Abdominal separation in pregnant and postnatal women is first treated through physiotherapy, where the condition may resolve naturally; however, evidence has shown that this treatment has limited success in severe cases. Recent studies have shown that abdominoplasty surgery has high success rates for this type of injury, but for many women this life-changing surgery is out of reach. Some women are accessing their superannuation to pay for this surgery while others are taking out loans. In some cases women have to save for decades to afford the surgery, which can cost upwards of $15,000.

In 2016 Medicare withdrew the item number for abdominoplasty surgery following pregnancy. The reason? There was insufficient evidence to justify the MBS item number at the time. Since then a number of quality research studies, including Cochrane reviews, have been published. One Australian study has shown a statistically significant improvement in lower-back pain and urinary incontinence at both six weeks and six months after abdominoplasty surgery with the rectus repair in 214 patients. There is now good evidence indicating that abdominoplasty surgery improves lower-back pain, urinary incontinence and quality of life for birthing mothers with diastasis recti.

An evidence-based standardised assessment would be required to make sure that only suitable candidates access surgery through the Medicare Benefits Schedule. For instance, only women who are at 12 months post delivery should be considered. This would rule out patients who respond to physiotherapy treatment. I'm advised that calipers could be used to measure the inter-recti distance, followed by an ultrasound for those who screen positive, which will limit the use of the MBS item to those candidates in true clinical need of surgery.

Unfortunately, abdominoplasty surgery has received a bad reputation as tummy tuck surgery, but this surgery has value in repairing abdominal injuries for functional reasons. In this context it is not cosmetic. This is why the Medicare benefit remains available for those suffering abdominal injuries following significant weight loss. This petition calls for this existing MBS item to include postnatal women with abdominal injuries alongside those who have injuries caused by obesity.

No woman should have to live with severe abdominal injuries, chronic pain and incontinence. This surgery restores the dignity and quality of life to women living with birth trauma. It's important that we continue to improve perinatal care in Australia. When we do so we improve women's health, we support Australian families and we boost women's participation in the workforce.

House adjourned at 20:00