In a landmark decision for intrapartum care, the Supreme Court of Victoria in Gawthrop v Bendigo Health [2026] VSC 157 held Bendigo Health liable in assault and battery, as well as negligence, after a vaginal examination was performed without the patient’s free and voluntary consent.
The plaintiff, Larissa Gawthrop, had a background of childhood trauma and had also witnessed her sister’s distressing birth experience. These circumstances contributed to her strong preference for a “low-intervention” approach to the birth of her child in 2020. Consistent with that preference, she and her husband enrolled in Bendigo Health’s “Mamta” program, a midwifery continuity-of-care model designed to support women throughout pregnancy, labour, and birth.
During the antenatal period, the plaintiff prepared a detailed birth plan in which she specified that she did not consent to vaginal examinations unless it was for an urgent medical reason and informed consent was provided.
When she arrived at the maternity ward believing she was in active labour, she was attended by nurse and midwife Ms Debra Alexander, who was not her designated Mamta midwife. It was not disputed that Ms Alexander had read and understood the plaintiff’s birth plan. Despite this, she repeatedly requested that the plaintiff undergo a vaginal examination.
A central issue in the proceeding was whether the plaintiff’s eventual agreement to the examination constituted valid consent. During labour, the plaintiff experienced severe back pain and requested analgesia. Ms Alexander informed the plaintiff and her husband that pain relief would not be administered until a vaginal examination had been performed. She also advised that the plaintiff would not be admitted to the ward, and that her Mamta midwife would not be contacted, unless she consented to the examination.
Importantly, there was no urgent medical necessity requiring the procedure at that stage. Faced with the prospect of being denied admission, pain relief, and access to her preferred midwife while distressed and in active labour, the plaintiff reluctantly agreed to the examination.
The Court held that this agreement did not amount to genuine consent, but rather submission in circumstances where the plaintiff believed she had no real alternative. Justice O’Meara emphasised that consent in the medical context must be voluntary, informed, and freely given, and cannot be procured through pressure, coercion, or threats relating to the provision of care.
The Court also observed that the plaintiff later consented to further vaginal examinations performed by her Mamta midwife, and subsequently declined another requested examination during labour. This demonstrated that she was capable of making informed decisions about her treatment when she was able to exercise a genuine choice.
Ultimately, the Court concluded that the examination constituted battery as valid consent had not been obtained. Bendigo Health was also found negligent for failing to comply with appropriate standards of informed consent and for disregarding the plaintiff’s clearly expressed wishes regarding her care.
This decision confirms that medical consent is only valid when given freely and voluntarily, not under pressure, coercion, or conditional access to care. It reinforces that patient autonomy must be respected in maternity settings even where choices depart from standard practice, and that consent is not valid if obtained through leverage such as withholding admission, pain relief, or support.
This case can be read in full here: Gawthrop v Bendigo Health [2026] VSC 157 (27 March 2026)
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