Firstly, I’d like to just address the issue of terminology regarding birthing without medical assistance; While the term Unassisted Childbirth (or UC – coined by Laura Kaplan-Shanley in the book entitled Unassisted Childbirth) is commonly used these days to refer to a birth that is planned and occurs without medical assistance, the term ‘freebirth’ seems to be generally preferred by freebirthers themselves, as they consider their experience to be one that is ‘free’ or ‘freeing’, whereas the term Unassisted Childbirth implies that childbirth ought to be assisted by someone, and that the mother cannot or should not be doing it by herself.
Also the idea and term of ‘assistance’ is further muddied by differing opinions on what constitutes ‘assistance’. The desire for a birth that is not medically assisted does not necessarily mean that the birthing mother does not want assistance of any kind, she just does not want it from the medical profession. Many freebirthers do desire assistance, either from family, friends, or a doula, to help support them both practically and emotionally through the intense experience of birth.
For this reason I shall use the term ‘Freebirth’ rather than ‘Unassisted Childbirth’ (UC) here…..
Regarding the Medical Management of Birth
Many women choose to freebirth as a direct response to the mass assumption, acceptance and experience of birth as a medical event. This section deals with issues that arise for freebirthers regarding the medicalisation of childbirth…Trauma from previous medically managed births
Many women cite this as one of the main reasons for choosing to freebirth.
While initially, this may be seen as a choice that comes from a place of fear, many women who choose to freebirth after previously traumatic medical births find the freebirthing experience to be incredibly healing and empowering. Often the trauma that may still have been present from a previous birth is greatly healed by a subsequently empowering birth.
And many women find as they journey through pregnancy, as they prepare themselves practically, emotionally and mentally, that they come to their birth not afraid, but confident and empowered, informed and prepared. Freebirthers understand that they are taking responsibility for their own health and safety, as well as that of their child, and so are often incredibly thorough in their research and preparation for birth.
Detrimental environment and presence of HCP’s
Many freebirthers do not wish to give birth in a medical setting, as it does not feel safe or comfortable for them. This may be the clinical and cold setting of a hospital labour ward, or it may even include the use of medical equipment brought with, laid out and used by midwives in a home birth setting.
One of the most common reasons for wanting to freebirth is the birthing mother’s desire and need for total privacy whilst birthing. A desire not to have the intensely intimate process of birth disturbed by strangers coming in and out, observing, commenting, suggesting, directing, co-ercing or enforcing a certain birth scenario.
Often this choice is to ensure that no-one enters the birth space who may come with their own fears around birth, which may then get projected upon the birthing mother, which may in turn affect her birth choices and outcomes. It has been many a woman’s experience that HCP’s themselves can bring an energy of panic and fear into a birth space, due to their own anxieties and lack of trust around the natural process of birth. This can then have an incredibly detrimental knock on effect upon the psyche of the birthing mother, which can then stall her labour and prompt the need for medical interventions.
Often a freebirthing mother will only want those present whom she loves and trusts. This may include her partner, members of her family, her children, close friends, and sometimes a doula. She will have taken the time to consider carefully whether the presence of any or all of these people will be of help or hindrance to her in her birth. And in the case of having a doula present for practical and emotional help during birth, they will have taken the time during pregnancy to get to know one another, to come to a place of deep understanding of one another, of mutual trust and respect in supporting the birthing mother to have the type of birth she desires.
And sometimes a freebirther will choose to give birth totally on her own, as she does not want the distraction of any other person around her, even her loved ones.
Risk Assessment – Freebirth vs Medically Managed Birth
Most freebirthers would generally acknowledge that no matter how, where and around whom you birth, there are always going to be risks involved in giving birth. No birth can ever be guaranteed to have a 100% safe outcome. With that said, it is then up to every individual mother-to-be to weigh up the risks of all the various options she has to choose from. This choice is an incredibly personal one, and will be greatly influenced by the beliefs and experiences of the individual. Within this context, there is no one-size-fits-all birth that will be the perfect birth for every woman. The best birth will be the one where she feels safest. For some women, this will be under the care of HCPs. But for others, the very presence of these individuals is enough to totally shut down the labour process.
In relation to Risk Assessing various pathways of birth, most freebirthing women have a lack of faith in the medical model of managed birth. They may trust some aspects of it, but not others, or they simply may not subscribe to this philosophy of health and well-being at all.
Some of the most common practises within a medically managed birth that freebirthers take issue with the safety of are;
• The use of any kind of non-emergency intervention (vaginal examinations, cervical sweeps, breaking of waters, induction, foetal monitoring, use of foreceps/ventouse suction, caesaerian section).
• The use of pharmaceutical drugs within labour and birth (none of which have been proven to be safe for mother or baby).
• Early cord clamping, which deprives the newborn baby of much of its total blood volume (which is still in the umbilical cord and placenta), This may increase the chances of; baby needing resuscitation, post-partum haemorrhage and problems delivering the placenta.
• Removal of baby immediately after birth (for weighing, washing, and other medical interventions that may be needed due to the side effects of a medically managed birth).
Put simply, the freebirther generally wishes to avoid the potential cascade of medical interventions, due to the associated risks to physical, emotional and mental health of mum and baby.
Lack of continuous care and lottery as to which midwife you will get.
Unfortunately in our current health system, the underfunding and understaffing of maternity services within the NHS means that most women will not get continuity of care with the same midwife. They will also not be able to pick the midwife who provides their ante-natal care, or who will attend them in birth. For most women, the desire to build a relationship with a midwife who you click with, trust and respect, cannot unfortunately be met within the NHS maternity services. While many women are lucky enough to get wonderful midwives to attend them during birth, many do not, and for freebirthers, this midwife lottery is too great a risk to take a chance on.
Desire for, but lack of available finance for an Independent Midwife.
For some freebirthers, the ideal scenario for maternity care would be that offered by Independent Midwives; the opportunity to pick the midwife who you feel a good connection with, the opportunity to have thorough one-to-one care throughout pregnancy, all the while building a good solid relationship and mutual understanding of the birthing mother’s needs and desires for her birth. Most Independent Midwives are more open to alternative birth models, and have the luxury of time on their side that most NHS midwives would love but do not have. Time to spend with the mother prior to birth, time to be patient during birth, and time to really care for her and babe after birth. Unfortunately, this top class service comes with a price tag that is quite simply out of financial reach for many women. And so this can lead some women to consider freebirthing as their next favoured birth option. While some birth ‘experts’ worry that this route to freebirthing is born out of fear, more often women who come to freebirth from this direction end up massively empowered, as they take the responsibility for their birth into their own hands, thoroughly researching birth and its implications, often far more than mothers who have a midwife to care for them, who essentially takes on the responsibility for the health and safety of mother and child.
Due to the new regulations coming into force in October 2013, Independent Midwifery will effectively become outlawed. Many anticipate that this will swell the numbers of women who choose to freebirth.
Personal preparation in case of quick labour
For some mothers who have had very fast labours in previous births, freebirthing may be considered within the possibilities of a wider birth scenario; of birthing in hospital or having an assisted home birth. This freebirthing preparation can help mum to feel at ease on a practical level, as well as mentally and emotionally, just in case baby arrives before medical birth assistance does!
Birth as a Personal and Family Journey of Natural Process, Trust, Belief and Empowerment
Many freebirthers plan this type of birth as they wish to allow the journey of pregnancy, labour and birth to be a natural and intuitive one. A journey where a mother can totally tune into herself and her baby, in order to fully experience the beauty, joy and power of undisturbed natural birth.
Where she can listen to her body and trust its signals, allowing labour to unfold at its own pace. Where she can be the one fully in control of her body and her birth.
Where she can bring her baby Earthside, without the distractions of other peoples ‘expertise’, opinions and agendas.
Freebirthers often have differing opinions on birth to the mainstream medical perspective; based upon their own personal political, ideological, social and spiritual beliefs, choices, lifestyles and philosophies of life.
Here are a number of statements that encompass a range of freebirthing ideals;
Birth does not belong in a medical setting
Birth is not intrinsically pathological
Birth is a deeply intimate, emotional and for some, spiritual experience
Birth flows smoothly if unobserved, like birthing mammals
Birth flows smoothly if the body is allowed to labour in its own good time
Birth flows smoothly if we can trust the body’s perfectly orchestrated hormonal journey
The pain that may be experienced will not be unbearable, and I will be able to deal with it and/or find my own preferred methods of alleviating it.
Birth is a Rite of Passage that will empower me into the next chapter of my life
I believe and trust in a birthing woman’s instinctive ability to birth without assistance
There are many things that a freebirther may desire from her birth that she may believe she will not get in a medically assisted birth;
Desire for total autonomy over her own body
Desire to use non-medical, natural, complementary or alternative forms of birth assistance without interference or unwanted opinions from HCPs (e.g. herbs, essential oils, birthing pool, crystals, vibrational essences, homeopathy, reflexology, reiki, acupuncture, hypnosis etc)
Desire for a non-technological and non-pharmacological birth (and pregnancy) (eg. no scans, monitoring, measuring, timing, forceps, ventouse, drugs, surgery etc)
Desire to feel like the most special person in the world, rather than just another woman who is taking too long to push her baby out
Desire to attain a deeper connection with her own instincts and baby within pregnancy and birth, and to be able to trust those instincts without deferring to a ‘higher authority’
Desire for deeper, more intimate bonding with baby by having an instinctive, unobserved and natural physiological birth, as well as no interference or removal of baby from mum immediately after birth.
Desire to have a natural/alternative third stage of labour (eg delayed cord clamping, lotus birth)
Desire to allow family members (including other children) to attend the birth, which may otherwise be more difficult/unsuitable/unacceptable within a medical setting
Desire for a greater family bond and social education from the shared family experience of childbirth
Desire to facilitate the most empowering personal experience from birth as possible
Desire for the personal sense of achievement of ‘doing it by myself’, ‘delivering my own baby’, or ‘being the first one to touch my baby’
Desire for the shared family experience and empowerment of freebirthing; ‘my partner caught the baby’, or ‘my daughter was my doula’, or even ‘my cat/dog helped me during labour’!
It is also relevant to make mention of the journey of Unassisted Pregnancy (UP) here;
While some freebirthers choose to have ante-natal and post-natal care either with NHS or Independent Midwives, some women choose to have a totally Unassisted Pregnancy as well as Childbirth. This is mainly due to a desire to totally avoid the detrimental influence of the medical establishment upon the body, emotions, mind and spirit of both mother and unborn babe. It is the belief of many freebirthers that the pathological approach taken by the medical model of maternity care, can create a shroud of fear around a pregnant woman. The obsession with testing for deformities and abnormalities creates an assumption or expectation for something to go wrong, or for baby to be imperfect in some way, and this overwhelming idea can plague many a mother-to-be with anxieties and fears throughout pregnancy, which may arguably contribute to her fears then inhibiting her within birth, leading to the possibility of medical intervention and post-natal depression.
Official Obstacles to Freebirthing
While freebirthing is technically legal, it has, unfortunately, been the experience of too many women that those who choose to birth outside of the accepted system are sometimes co-erced, harassed and persecuted by various official bodies, from the medical establishment, to the police and social services. While in the vast majority of cases, these interferences are totally unfounded and actually illegal, the pressure and persuasive influence can be intimidating and can spoil an otherwise beautiful birth journey. In this situation, AIMS (Association for Improvements in Maternity Services) and Birthrights are a freebirther’s best friends, supporting them with information as well as legal advice and advocacy, should their legal rights become trampled or infringed.
Freebirthing women who choose to take responsibility for their births must also consider these wider implications, even though the law supports the choice of women to freebirth, interfering professionals sometimes make it their business to try to enforce their model of ‘care’ upon mother and/or child. There is plenty of information and support for women who wish to freebirth, and it is only by women standing up for and re-claiming their rights to birth as they choose, that we will ever hope to change these old authoritarian attitudes, and re-claim full autonomy over our own bodies.
While some women choose to freebirth totally under the radar, without informing the medical establishment of their pregnancy and birth until after the birth, others choose to interact with maternity care in varying degrees;
Some merely inform the Head of Midwifery of their pregnancy and intention to freebirth.
Some accept or choose to take up ante-natal and/or post-natal care with NHS maternity services and either openly plan to freebirth, or go along with an assisted homebirth plan and then do not call the midwives until babe is born. This is sometimes known as a planned BBA (Born Before Arrival).
Some women openly plan to freebirth with NHS midwives to be on-call, in case they wish to call in the unlikely event of problems.
Some employ an Independent Midwife on a reduced service basis, in order to keep the NHS off their backs and help with official paperwork before and after birth.
Every woman’s needs and desires for birth are different.
Every freebirther comes to her birth with different experiences and expectations for her birth.
And it is up to each woman to choose which path to take, to decide how much or how little care she wants or needs. This is why freebirth is free.
Strength and courage, belief and trust are the necessary ingredients to make freebirthing the most amazing experience of your life!
XXX FREEBIRTH XXX
XXX I AM FREE TO BIRTH XXX
Unassisted Childbirth by Laura Kaplan-Shanley
The Birthkeepers – Reclaiming an Ancient Tradition by Veronika Sophia Robinson and Andri Thwaites
Birthing from Within by Pam England and Rob Horowitz
Gentle Birth, Gentle Mothering by Dr. Sarah Buckley
Recommended websites and online groups
Laura Shanley’s Unassisted Childbirth website
United Kingdom Freebirth/Unassisted Childbirth Group (Facebook)
AIMS (Association for Improvements in Maternity Services)