A bit more on unassisted birth…

19405669484_fa79c5974cEarlier this week, I published a blog post which contained the text of an article I wrote several years ago on unassisted birth. A day or so later, although I hadn’t realised before I posted my article, two other related studies were published, and these and my article led to some really interesting conversations. Rather than let this important topic slip back into the darkness, I want to write my second blog post this week on the same subject, to share these studies for anybody who wants to look at this more deeply and to continue the debate which has occurred since I first published my article.

The first of the studies that I spotted is titled, Women’s motivations for having unassisted childbirth or high-risk homebirth: An exploration of the literature on ‘birthing outside the system’.  In their review of the literature, Holten and de Miranda (2016) find that, “Concerns over consent, intervention and loss of the birthing experience may be driving women away from formal healthcare. There is a lack of fit between the health needs of pregnant women and the current system of maternity care. Biomedical and alternative ‘outside the system’ discourses on authoritative knowledge, risk, autonomy and responsibility must be negotiated to find a common ground wherein a dialogue can take place between client and health professional.”

The second article was published in BMC and is entitled Why do some women choose to freebirth in the UK? An interpretative phenomenological study. This qualitative (and freely available) study by Feeley and Thomson (2016) explores what influenced women’s decision to freebirth in the UK. The authors concluded that, “The UK based midwifery philosophy of woman-centred care that tailors care to individual needs is not always carried out, leaving women to feel disillusioned, unsafe and opting out of any form of professionalised care for their births. Maternity services need to provide support for women who have experienced a previous traumatic birth. Midwives also need to help restore relationships with women, and co-create birth plans that enable women to be active agents in their birthing decisions even if they challenge normative practices. The fact that women choose to freebirth in order to create a calm, quiet birthing space that is free from clinical interruptions and that enhances the physiology of labour, should be a key consideration.”


As one of my lovely facebook page-friends commented,It’s a popular criticism to think that freebirthers exist as an isolated phenomena and are acting in a way that disregards safety and responsible parenting. They have come into existence as a response to the disjunctive relationship between authoritarian medical practice and individual client autonomy.”

Another wrote, “In my last pregnancy I felt on the edge of free birth because I felt I had no other choice. I had no support and received bullying tactics from my obstetrician, I wondered whether I’d be safer at home with my husband and an ambulance outside than in the hospital. I’m not a “difficult woman”, I was terrified and alone and being harassed with appointments, phone calls and letters drove me away from the hospital and to another that offered me choice and support. If they hadn’t helped me I would probably have had no alternative than to free birth.”

I know that some people would like to put freebirthers in a metaphorical box along with other groups of people who they see as extreme and ‘out there’, but there’s nothing particularly extreme about many of the freebirthing women that I have met. In fact, some of them remind me of something Caitlin Moran wrote in The Times magazine a few months ago about how, in reality, feminists aren’t radical, bra-burning man haters; they are normal women going about their normal business muttering tiredly, “I’m so tired of this sh*t”.

Same goes, in my humble experience, for quite a few of the women who decide to freebirth. They aren’t poster women for taking risks with your baby. They’re not hippy, chanting, granola-eaters who don’t care whether their babies live or die. Far from it. Some of these women – and their families – feel that their babies will be safer away from mainstream medicine and its drugs, interruptions and interventions. They are normal (inasmuch as any of us want to be called that), caring and deeply committed women who are sick of being told how, when and where they have to give birth, worn down from being told their bodies aren’t up to the job and fed up with being told that professional perceptions of risk are more valid than their own worldview. And yes, tired from living in a world where, the minute you become pregnant, some of those working in the media have the right to tell you what you can and can’t eat, drink and smoke, total strangers seem to feel they are allowed to touch your belly and anyone who has the right bit of paper and a white coat or a blue tunic thinks they can put their fingers inside you anytime they deem it necessary.

It’s not OK.

Let’s not stop talking about this.


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photo credit: Broken Window To The Soul via photopin (license)

4 comments for “A bit more on unassisted birth…

  1. Belinda Flanagan
    March 24, 2016 at 7:45 am

    Great post Sara, I have just interviewed 21 women for my PhD who either by choice or not, birthed their babies in paramedic care or prior to their arrival. As a midwife I was really disappointed that a number of women reported that they were waiting at home as long as possible because they were trying to avoid medical intervention in their birth. Women stated they did not want to be “put on the clock”. Women were really disappointed in the lack of choice they had about their care and reported that they had looked into home birth but could not afford it or it was not available (this is in Australia). Some women also reported that they would prefer to stay home and free birth in preference to going to a hospital. This unfortunately was not only because of obstetric intervention but also because of previous unsupportive relationships with midwives. What a state we have got ourselves in!

    • March 24, 2016 at 11:48 am

      Absolutely, Belinda. I shall look forward to reading your research 🙂

  2. March 24, 2016 at 2:50 pm

    Whilst I agree that many women come to or discover the idea of freebirthing as a result of negative experiences or lack of trust in care providers, there are also women who choose to freebirth because it is the right choice for them. There are women who are not afraid of birth and who believe in their ability to give birth. Freebirth is not always a choice women make out of negative circumstances but rather can be a very positive and intentional choice. It’s a little frustrating that freebirth only ever seems to be discussed in terms of “how we can stop failing these women so that they come back to accepting care”, with usually little or no acknowledgement of freebirth as a legitimate and positive choice that women can make.

  3. March 28, 2016 at 4:11 am

    What a great article Sara. I had never considered free birth at the time of my babies but I can totally understand why women choose this. Especially looking back at my pregnancies and the pressure I was put under to be induced. Both pregnancies I had my due date changed at the 12 week scan. I knew my dates, and was sure each time that I had an additional 5 days before I was ‘due’. I asked for the extra days before medical intervention. Both time I was flatly refused and felt like an insolent child insisting.
    I wanted to nest, I wanted to have a quiet, low lighted, intervention free birth. To me that was safer for my babies and felt right. I wanted to turn to medicalisation only if it was really needed. Not be thrust directly into that bright, stressful environment from the start.
    Both times I felt such anxiety at trying to go into labour before induction day. I tried all the old wives tales and reflexology, acupuncture. The works.
    Luckily for me it worked. I had both babies on induction day, before any medical intervention.
    As per Belinda’s message above I too stayed at home as long as possible before going to the birth centre first time round, purely to avoid the medicalisation of birth.
    Even more lucky for me I lived in UK at the time and was able to home birth for my second child.
    Using Fetal Positioning Techniques each time I ensured baby was nicely aligned with a smooth route out, to avoid any interventions later in the labour and be able to stay in my chosen place of birth.
    Both labours were intervention free which took away the stress factor for me, leading to drug free, quiet, calm births.

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