Objective • Prioritising normal birth has led to harm in some instances in the UK • Australian organisations have also promoted normal birth in maternity practice • The negative impact of normal birth appears less well understood in Australia • The study explores this impact of normal birth promotion and the quality of clinical incident investigations Design • Survey-based research design Setting • Online survey Population or Sample • Australian maternity health care providers Methods • Open and close-ended questions on the survey • The survey received 1278 responses • Data analysed using SPSS software Main Outcome Measures • Perceptions on bias against or delay in interventions • Perceptions on systemic attempts to reduce caesarean rates • Perceptions on clinical incident investigations and the engagement of women in these processes Results • Promoting normal birth may by introduce bias against or delay interventions • Attempts to reduce caesarean section rates may reduce the agency of the woman to choose how she births • Incident investigations appear to be independent and improve outcomes for mothers and babies • Women with birth trauma appear to lack support and follow up postnatally Conclusions • Current regulatory standards for maternity services may need to be re-evaluated • Key performance indicators for maternity services need to change to reflect core ethical and legal obligations around informed consent