New Lambton's April Hagan lives with the scars of birth trauma.
A decade ago, the birth of her son Leo in a public hospital caused her "lifelong injuries".
"I have a three-compartment prolapse. My bowel, bladder and uterus are all protruding into my vagina," Mrs Hagan said.
The 37-year-old shared her story to mark Birth Trauma Awareness Week.
Mrs Hagan said she was "forced to have a vaginal birth when I should have had a caesarean".
"They used forceps in my delivery, which in hindsight should not have been done because Leo was facing the wrong way," she said.
"They also didn't perform an episiotomy [a surgical incision made in the perineum]. That all contributed to my injuries being a lot worse than they should have been."
To coincide with the week, Birth Trauma Australia released a report that estimated more than 1.1 million women in Australia live with birth injuries.
The report said many of these injuries remain "under-recognised, under-treated and under-reported".
It found that birth injuries and ongoing conditions cost Australia an estimated $17.5 billion a year, including lost labour market costs, lasting physical, mental and social consequences and effects on household finances.
Birth Trauma Australia called for a national best-practice model for perinatal care, 12 months of funded postnatal care and expanded Medicare support to improve access to treatment and recovery.
Amy Dawes, chief executive of Birth Trauma Australia, said tens of thousands of women experience physical injuries from birth every year.
Ms Dawes said this included perineal tears, pelvic floor trauma and nerve damage.
She said injuries sometimes occur "from what are considered uncomplicated vaginal births".
"These are not minor complications. For many women, they are life-changing conditions that affect their physical and mental health, relationships, work and family for years.
"Yet despite this, too many women still struggle to access the care they need and deserve."
Mrs Hagan said she had "good days and bad days".
"I have days where it's painful to stand up for longer than a couple of hours. Periods are very painful," she said.
"I'm used to it now because it's been 10 years. Mentally I've gotten a lot stronger over the years, as I adjusted to the injuries."
However, she had "a layer of anger" that remained.
Before having her first baby, she was "a very active person".
"I was heavily into the gym. I met my husband at the gym," she said.
"Now I can't run or jump. I can't lift heavy weights. I couldn't lift my baby when he was little."
She still deals with the aftermath today.
"It can only take a little trigger or something unexpected to affect me. I deal with panic attacks, which can be brought on by memories of what I went through."
Mrs Hagan said she was open about her injuries "because I want other women to know what can happen".
She gave birth to Leo on Boxing Day in 2015.
"I was due on December 13, but didn't go into labour naturally," she said.
"I had to be induced. That started on Christmas Eve. Christmas Day I was in hospital. I finally gave birth on Boxing Day night."
She said there was a "lack of qualified staff around to assist".
"I believe that had a huge impact. I trusted all the health professionals in the room that day. I had no reason not to.
"In hindsight. I wish I had questioned things a lot more."
Her second child, six-year-old Mickey, was born through an elective caesarean in the private sector.
"The caesarean I recovered from. The vaginal birth I never did," she said.
A Hunter New England Health statement said it had strengthened maternity services in line with statewide reforms since the birth trauma inquiry in 2023.
This included a focus on "continuity of care, trauma-informed practice, improved communication and consent processes in maternity care".
"Every woman's experience of pregnancy, birth and early parenthood is unique," the statement said.
Maternity teams in the Hunter work every day to "provide compassionate, respectful and woman-centred care".
"Women are encouraged to discuss their individual circumstances, preferences and care options with their healthcare team throughout pregnancy," the statement said.
"We continue to listen to women and their families and learn from their experiences to improve maternity care."
