· In short: A fifth hearing of the NSW Birth Trauma Inquiry has heard from a woman who experienced 'obstetric abuse'.

· A doctor told the inquiry people's 'expectations' are not always realistic when it comes to labour.

· What's next? Medical experts call for more trauma support and midwives to help expectant mothers.

Mothers have given tearful accounts of being ignored and mistreated by hospital staff at the fifth hearing of a New South Wales inquiry into birth trauma.

As Tamara Leetham retold her traumatic experience of birth she struggled to hold back tears, but her words were clear.

Ms Leetham told an Upper House committee her labour started at home before she was transferred to hospital by her midwife.

She said she was given a general anaesthetic without consent and underwent an emergency caesarean section.

"The obstetrician was screaming at me to stop pushing," she told the inquiry.

Ms Leetham said her baby was ideally positioned for vaginal delivery when the decision was made to pursue a caesarean.

"My body was pushing involuntarily. Instead, I was made unconscious and [as a result] my baby, my spouse and I traumatised.

"My midwife says she regrets taking me in and her notes read, 'I've just witnessed obstetric abuse and I could not do anything to stop it from happening'."

Alexandra Crichton used her evidence to share her experience of pregnancy and birth as a single woman who had undergone IVF.

She told the inquiry her daughter was healthy but was having trouble feeding after being born.

Ms Crichton said she was verbally threatened by medical staff when she wanted to leave hospital.

"I wasn't mentally well. I didn't want to be in hospital. It was really stressful to be there and then you get them saying to me 'well, if you discharge, we will report you to child protective services'," Ms Crichton said

"But, because I was a single woman, who'd done IVF, I didn't have a lot of support at all. I think they just saw red flags."

Wollongong mother Mary Van Ryke travelled to Sydney to give testimony about her experience of having eight miscarriages, some while she was in the public hospital system.

She said a lack of dedicated area for women experiencing miscarriages meant that while she was miscarrying her first pregnancy she was forced to sit next to heavily pregnant women in the obstetrics and gynaecology area.

"I sat there for two hours surrounded by pregnant women and their support people witnessing them going in and coming out," she said.

"I was getting more and more distressed."

Witnesses also told committee members about the lack of or inconsistency of perinatal support. 

The inquiry heard that some dedicated programs had been shut down, defunded, or were hard to find. 

Kristyn Begnell, a former consumer representative at a Sydney health service, gave evidence that many new mothers felt broken by their experiences. 

"When encouraged to complain about their treatment in hospital, many women declined for fear of how lodging a complaint will impact the care they received, others simply want to avoid any further contact with the people who harmed them," Ms Begnell said. 

Defining trauma 

The inquiry also heard from a panel of women's health experts, who gave evidence about the link between traumatic birth experiences and the increased risk of postnatal depression and anxiety. 

Director of the Australian Longitudinal Study on Women's Health and Centre for Women's Health Research at the University of Newcastle, Deborah Loxton said a consensus was needed on the definition of birth-related trauma.

"Identification of risk factors would be important to understand what puts women at risk," Professor Loxton told the hearing. 

"Understanding what helps once trauma has been experiencing (sic), what are the thing that were in place, the nature of the social support. We've heard about the things that don't work and that's a really great." 

She said the committee had access to a strong data set within the thousands of submissions lodged to the inquiry that detailed what worked for women and what didn't.

'Healthy baby, health mum'

The head of urogynaecology at Sydney's Westmead Hospital, Jenny King, also gave evidence.

"I think a lot of this stuff is to do with expectations," Dr King said.

"There's that whole expectation that you'll be able to manage the situation and in fact labour is in fact a very cruel midwife, really.

"You have to accept that unexpected things will happen." 

"The way I was trained, healthy baby, healthy mum. That's all you want out of the day, but it's not now, it's about my experience. So if your experience doesn't match to your expectations, which it very often won't, you're disappointed."

Dr King said improvements were needed in perinatal care and she believes more midwives would help address issues with continuity of care.