As an obstetrician working in regional Australia, I am familiar with the reality of birth trauma and how it affects birthing parents. But recent media coverage has made me reflect on the “debate” that has emerged around the issue.

In May, the Courier Mail published an article headlined: “Doctors slammed for ‘sticky beaking’ into births”, describing claims by the Maternity Consumer Network of a “turf war” between midwives and doctors, the latter of whom were “bursting in” to birth suites at Brisbane’s Mater hospital.

This was followed a week later by another story in the same paper, with the headline: “Fears labour ward culture is fuelling suicides and baby deaths”. The story claimed a “growing rebellion against obstetricians” was creating a toxic atmosphere in birthing suites, with top specialists fearing tensions were “fuelling doctor suicides and putting babies at risk”.

The president of the National Association of Specialist Obstetricians and Gynaecologists (Nasog) was quoted as saying obstetricians had “higher than average” doctor suicide rates and instead of devaluing them, we should acknowledge they are “doing their best to ensure a happy and safe birth for both mother and child”.

The Maternity Consumer Network responded on Facebook: “So, regardless of your wants and needs for birth, drs say you should always put their needs in front of your own. They even had the hide to throw around the suicide card. Can’t win with the patriarchal medical model, if you don’t do what they want, they’ll either pull the dead baby card, or the dead dr card.”

There is no doubt suicide affects obstetricians acutely. Just last month, Canberra obstetrician Peter Scott died by suicide. His family told a public memorial that he had been feeling unsupported in the wake of an “extremely traumatic” event during his work at the Canberra hospital. But the issue is complex.

In another article – a book excerpt published in the Australian last month headlined “Drugging women for childbirth should be a crime”, author Antonella Gambotto-Burke made the argument against routine obstetric intervention (“obstetric anaesthesia was so toxic it changed my baby’s brain” … yet “she could speak at five months”); after publication she clarified in an email to the Guardian that she believes freebirthing to be “extremely dangerous”.

The Maternity Consumer Network claims on its Facebook page: “Many women feel they have no other option than to freebirth to escape the abuse and trauma of the hospital system.”

Perhaps this is true, but freebirthing also comes with risks. And rogue clinicians in the hospital system can only make the entire system abusive and traumatic if they make up the majority.

I don’t believe this is the case. I see my colleague midwives, nurses, doctors – I could name dozens here – all passionately committed to going every extra mile for their patients. These make up our majority, and compose the “system”.

One of the biggest problems in reporting on birth trauma is that the scientific studies into the issue are more nuanced than the bald statistic (that 1 in 3 women suffer birth trauma) so often quoted would suggest.

According to the Gidget Foundation Australia, “1 in 3 women in Australia describe their birth experience as traumatic”, buta survey of 1,067 women in Queensland showed that 45.5% of respondents reported a birth event that involved trauma, as defined by specific clinical criteria. The criteria were met when, for example, the women suffered a substantial degree of fear, anxiety over their own safety or the safety of their baby.

The survey also made two other significant observations: 43.3% of women had met the DSM-IV criteria for a traumatic event before their birthing experience, and 91% of women had experienced a potentially traumatic event. That is, while you could say nearly 5 in 10 women according to this survey had experienced birth as a traumatic event, a similar number had experienced life as a traumatic event prior to their birthing experience. Furthermore, 3.1% of women suffered post-traumatic stress disorder.

Another study in Canada involving 6,421 women found that 9.3% had a negative (or “somewhat negative”) birth experience. Nearly 91% had a non-negative experience, 54% “very positive”.

If I look around – among my family, friends and patients – I cannot see that 1 in 3 of the mothers among them have suffered permanent trauma from their birthing experiences. I am easily convinced, however, that a large number of them did experience significant anxiety, pain, and fear in labour. Labour is intrinsically painful, distressing, and the greatest challenge many women and their partners will ever face.

But even if one in three (let’s say nearly one in two) women suffer trauma during their birthing experience, 90% will still deem their time in hospital to have been a positive one, and 97% will have no lasting trauma.

This is the message we should be articulating. We should acknowledge the pain of the minority, and do all we can to make up for the sins of the system we belong to – but let us also celebrate the joy of the majority, and be grateful for the calibre of our people, and for our hearts.

This modern milieu we have encased ourselves in is distressingly harsh, critical, condemning.

We have trauma, yes. And we have joy. We forget the latter and emphasise the former not only at our own peril, but also at the risk of alienating our patients. Some of us unfortunately help to create or exacerbate birth trauma, but most of us, most of the time, help to dissipate it.

Women will experience fear and anxiety over their impending labour and births, but they should not fear us. Midwives and doctors are not people they should have to assert themselves against. We serve them, and each other.

• This article was amended on 5 May 2023 to clarify Antonella Gambotto-Burke’s position on obstetric intervention during childbirth, and to state that she believes freebirthing to be “extremely dangerous”.

• Kae Sheen Wong is an obstetrician practising in regional Australia

• In Australia, the crisis support service Lifeline is 13 11 14. In the UK and Ireland, Samaritans can be contacted on freephone 116 123, or email jo@samaritans.org or jo@samaritans.ie. In the US, the National Suicide Prevention Lifeline is at 800-273-8255 or chat for support. You can also text HOME to 741741 to connect with a crisis text line counselor. Other international helplines can be found at befrienders.org