Friday, 18 July 2014

JOINT POST: On “free birth”. Tempted? Not tempted?


A woman gives birth unassisted at home. 
LaVergerrayCherie-birth, credit Lisa J. Patton, available by Creative Commons license


"Free birth”, or “unassisted birth”, can be defined as the decision by a pregnant mother to give birth unattended by medical or health professionals. This isn’t the stories we all know of babies arriving in hospital car parks or in the lift. It’s not a planned home birth when the midwives get stuck in traffic and the father ends up having to catch the baby. This is a decision to give birth in a place of your choosing with the people you want to be there. Maybe even alone.  A birth without medical supervision or intervention but not without a certain level of risk. In this joint post, Chrissy from AttachmentFeminism and Francesca from FeministMum tell us their opposing views: “tempted” and “not tempted”!

Tempted…

Both of my children entered the world in a hospital room.  The eldest met his first breath via my vagina with the aid of ventouse, and the second was ‘cut free’ (as my three year old likes to tell me) in a planned caesarean section after refusing to turn head down from the transverse position. But leaving aside my own births, let me first tell you why I support a woman’s right to have a free birth and, in the right circumstances, would consider one myself.

Firstly, the concept of free or unassisted birth can sometimes be a little misconstrued.  Whilst some women want to go into a dark and quiet place by themselves or outside to birth in nature, for many an unassisted birth can just mean being left in one room while attendants wait in another room.  The mother has help at hand should she need it, but can also have the peace to birth by herself if she is cool with that and all is progressing within the spectrum of normal.

Secondly, a big misconception is that women are not forearmed with the facts about the birth process before they choose a free birth.  Images of swollen-bellied hippies skipping into the forest to give birth, having done no prior research, some clovers in their hair for good luck. In reality, since most women are aware that things can and sometimes do go wrong before, during and after birth, they educate themselves on the most common ‘if’ scenarios.

Thirdly, women’s bodies are designed to give birth.  That’s not to say that all women have a difficulty-free labour and delivery but I believe it’s every woman’s right to have the opportunity to do it herself, before medical intervention at whatever level is introduced.  That’s not to say that all women will want to, but they should make that decision for themselves. Birth is a natural process that can be hugely positive and empowering.

Personal to me is the concept of the cascade of intervention. One of the reasons I ‘opted’ (cringe) for a planned c-section with my youngest was because I felt that the cascade of intervention that was probable, if not inevitable, with a transverse lie at 39 weeks would ultimately lead to the same outcome as if I planned it to begin with.  I wanted to feel in control with birthing, and whilst on an operating table one is not really in control, to be able to take the decision after weighing up the risks of both options meant I felt confident going into that surgery. I recognise that free birth in a low risk pregnancy allows women to take charge of their own birthing experience. 

The hospital environment itself can have a negative impact on natural birthing. For some mothers,  labouring for the second or third time or more, previous birth trauma can be a reason for choosing to attempt an unassisted delivery.  Being in hospital itself – or even being in a setting where the implication is that medical intervention is just around the corner – can be a pretty uncomfortable feeling for some people.  Not feeling in control, being healthy in a place designed to help sick people and the implication that something is ‘wrong’ can affect mothers in ways that we have to dig deeper to really understand.

So I advocate for free birth for women who want it and whose pregnancies have been free from complications which may make unassisted delivery a dangerous option.  I absolutely support every woman’s right to medical aid during labour and birth if she needs it, and by that I mean for every woman in the world.  We are very lucky in the UK that we have a free health service that will aid us when things don’t go as planned, and I don’t deny that for a second.  But I also want women to be fully educated about what their bodies can do, and to live in a system that facilitates that rather than scares women into thinking medical intervention is a given.



So NOT tempted…

Let me say first that I am very much in favour of women taking control of their birthing experience, be that by choosing a homebirth, a birthing centre, labour ward, or even for some, theatre. Hypnobirthing, epidural, whatever works for you. In my case, I was hoping for home births but ended up having two straightforward but not very empowering births in hospital birth centres for logistical reasons. 

But, the idea of “free birth” totally terrifies me. It’s a lovely image, baby just arriving into a calm, cosy space where his or her parents feel relaxed and at home.  A space without uniformed professionals standing by to interfere. But I can’t help feel that this image doesn’t reflect the reality that when birth does go wrong, it can go very wrong!  

Let’s be honest, the progress in Western medicine means that fewer women die in childbirth, fewer babies die in childbirth, fewer mothers and babies have lasting birth injuries.  Worldwide, a million babies a year don’t survive their first day and Save the Children’s #First Day campaign wants every birth to be attended by a trained midwife equipped with sterile equipment and medicines. Is that a misguided move on the part of this international charity or is it actually what women, who don’t have the luxury of free quality healthcare, want more than anything else?

According to free birth advocates, it is possible to get hold of the equipment you need to administer oxygen to your newborn if you need it and train yourself in various aspects of midwifery.  You can buy sterile instruments. You can feel that you are limiting the risks. But actually, what about a mother haemorrhaging? Or shoulder dystocia where the baby gets stuck? If not dealt with immediately, these situations are likely to be fatal.  If you have your partner or a friend there to assist, is it fair to put them in a situation where they may feel utterly helpless if things go very wrong?

It feels sad that birth has become so medicalised in the UK and pregnant mothers feel so dis-empowered within the system, that women feel that they need to reject what modern medicine has to offer in its entirety.  I get that, I really do. When the hospital books you in for an induction a week after your due date when you are only 8 months pregnant so you are “in the diary”. No discussion as to whether that is something you will want or need.  When the midwives are too busy to attend to you because they are short-staffed. When your partner is sent home just when you really need him to be at your side because it’s ward policy.  

But despite this, most of the time, women in the UK get through pregnancy and childbirth with no lasting damage to themselves and with a healthy baby at the end of it. And it is our dedicated and experienced midwives, obstetricians, neonatal nurses and healthcare assistants that we have to thank for that. Compassionate, experienced professionals who have the time, energy and resources they need can help us have the empowering and safe birthing experience we deserve.

NICE now advises that women with low-risk pregnancies having their second child should be routinely offered a home birth with midwife support. We need access to experienced home birth teams across the country to make it an option for every woman who wants to deliver her baby in the familiar environment of her own home.  A birth, where she feels safe and comfortable, with experienced attendants standing by. Surely it is better to work with the system to make lasting improvements that benefit everyone than encourage women to opt out and take a risk to themselves and their babies that they don’t have to take?

Francesca, Feminist Mum 


What do you think about "freebirth"? Crazy or not such a bad idea? Would love to have your thoughts on this. 


21 comments:

  1. Having been a low risk mum with everything going for her who ended up in a very scary situation during birth I find the idea of free birth very worrying. As someone who has studied human anatomy and evolution I also find it completely unnatural. The way humans give birth is quite different to other mammals, a necessary compromise that allows us to walk upright, (we are not perfectly designed, we're the best possibly compromise) as a result, while other animals go off and give birth alone, humans in all societies seek the best help they can get, be that an experienced older woman or a properly trained midwife.

    There are a great many problems with hospital birth and I can completely empathise with women wishing to avoid it, but it seems that rather than trying to fix those problems, those who are most vocal on birth issues instead encourage women to turn their back on modern medicine entirely. Fine for those who actually do have a straightforward birth but what about everyone else?

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