Episode 7: Informed, Supported, Confident with Dr Catherine Bell, Birth Advocate: The Birth Map

Dr Catherine Bell | Birth Map | PhD Researcher, Birth Advocate and Managing Director, Maternity Choices Australia

Dr Catherine Bell is the creator of the Birth Map, a birth advocate, science communicator and PhD researcher, and she is also the Managing Director of Maternity Choices Australia, where she is working to roll out the Birth Map nationally and eventually globally. She came to this work through her own birth experiences and through years of hearing women say, “I wish I had known” and “Nobody told me,” which led her from a birth plan template to a book and then to a PhD that is now helping shape national policy.

Catherine entered motherhood expecting continuous support and a midwife by her side from start to finish, but her own birth experience revealed how quickly communication and information can break down at the moments that matter most. Her first birth was largely positive, but after her daughter arrived, when the placenta had not yet been birthed and the baby needed transfer to another hospital, she and her partner were left trying to navigate a stressful situation without the knowledge they needed to advocate for themselves. The Birth Map grew out of that experience.

To understand whether the Birth Map actually worked, Catherine undertook a PhD using Realist Evaluation methodology, recruiting 32 women across Australia in different models of care, giving them the Birth Map at around 12 weeks gestation and following their experiences through pregnancy, birth and postpartum. What she found was that the Birth Map could facilitate communication, enhance experience and support decision making, but not on its own, because the tool can only build half the bridge.

From that research, three tenets emerged: being informed, being supported and being confident. To be informed means more than receiving information, and instead having support to make sense of it in the context of your own values and circumstances. To be supported means experiencing genuine relationship-based care rather than fragmented, time-limited appointments. To be confident means what Catherine calls Supported Maternal Decision Making, because the decision belongs to the mother and needs to be supported, not shared.

Across all the stories, models of care and outcomes, what shaped whether a woman felt at peace with her birth or carried it as trauma was not simply what happened, but how it happened. Whether she felt heard, whether she understood, and whether she was truly in the decision all made a difference.

SHOW NOTES

Catherine’s origin story: entering motherhood expecting continuous support and discovering what was missing [00:11]

• The chaotic moments after her first birth and what she and her partner didn’t know to do [01:17]

• How the Birth Map evolved from a birth plan template into a book [03:07]

• Why she called it a map and not a plan, and why that distinction matters [08:01]

• The visual difference between a birth plan and the Birth Map: linear versus networked pathways [06:44]

• Why partners are drawn to the map format and how it gives them a tangible role [09:51]

• The decision belongs to the mother: what the Birth Map does that a birth plan cannot [10:35]

• The PhD: what she was testing and why Realist Evaluation was the right methodology [15:27]

• The high-risk participant who moved from planned homebirth to hospital care and still found agency [20:22]

• The carpet bag metaphor: why handing over responsibility leaves women vulnerable [27:42]

• The three tenets: Informed, Supported and Confident [30:41]

• Why she uses Supported Maternal Decision Making instead of shared decision making [41:37]

• The neighbour story: a birth map that briefed a last-minute support person [33:53]

• The woman who called her own caesarean with confidence and moved to that pathway with joy [44:17]

• Going with the flow in a medicalised system carries more risk than most women realise [58:43]

• The Bendigo consent case and what it tells us about why consent as a framework is failing women [01:00:11]

• It was not what happened. It was how it happened [46:55]

• What’s next: rolling out the Birth Map nationally and globally through Maternity Choices Australia [01:01:55]

  
  

CONNECT WITH CATHERINE

birthmap.life

Instagram: @birthmapping

Maternity Choices Australia: maternitychoices.org.au

MENTIONED IN THIS EPISODE

• The Birth Map: a structured decision-making and communication tool for birth preparation. birthmap.life

• The Game of Birth: a visual decision-making tool mapping physiological, medical and caesarean pathways using statistics from the Mother Baby Report

• Realist Evaluation: a research methodology developed by Pawson and Tilley asking what works for whom, in what circumstances and why

• Sensemaking: the process of building understanding of various options before making a decision, drawn from Karl Weick’s work

• Supported Maternal Decision Making: Catherine’s preferred term replacing shared decision making, placing responsibility clearly with the woman

• Matrescence: the developmental and identity transformation of becoming a mother

• The BRAIN acronym: Benefits, Risks, Alternatives, Instinct, Nothing — a decision-making framework used in the Birth Map

• The Bendigo consent case: a landmark Victorian case in which a woman’s lack of consent to vaginal examination was tested in court

• Maternity Choices Australia: working with Catherine to implement the Birth Map approach in Australian maternity services

• Allowed to Birth: The Journey of a Global Midwife — Canberra screening 16 September, Dendy Cinemas. Catherine is on the panel.