For many mums-to-be, the “perfect birth experience” is like a holy grail. And the range of birthing options in Australia gives women the power to choose exactly how we bring bub into the world.
From the venue (hospital, birthing centre, home) to who will attend (midwives, doulas, doctors) to the immediate after-birth options (delayed clamping, immediate skin-to-skin), meticulous birth plans are the norm.
Natural, un-medicated, low-intervention births are growing in popularity. But some mums are taking it a risky step further, partaking in a trend known as free birth.
What is a free birth?
A free birth is a birth experience completely free of medical assistance or intervention. It usually happens in the comfort of home. Family members and even a doula may be present. However, from the first contraction to the final push, doctors and midwives are left out of the process. Many free birthing mums also forego prenatal medical care or scans, believing instead in their body’s intuition to know when something is wrong.
Medical professionals are (obviously) strongly against free birth, making it a controversial choice for a pregnant mum-to-be.
What are the risks of free birth?
Even a healthy, complication-free pregnancy can take a turn at the last second. And with no qualified medical staff around to observe the signs of things going downhill, the results can be devastating. According to Dr Thomas Purdon of the American College of Obstetrics and Gynecology, “20 percent of all previously normal pregnancies turn into complications and high-risk situations during the course of labor that could result in serious adverse outcome to mother and baby, including death,” he told the New York Times,
And Australian obstetrician Dr Michael Gannin, former head of the Australian Medical Association, goes further, describing the free birth movement as a “whole different level of stupidity”.
“We understand why women would be afraid of childbirth and not fully understand the reason for certain medical treatments, but to completely reject them is to bury your head in the sand,” Dr Gannin recently told news.com.au.
“There is no other element of health care where people deliberately go out of their way to have a third world experience.” Dr Gannin
This is not to say that every free birth can end in complications for mum and bub. There are many women who free birth, with a happy story to tell at the end. But there are others who don’t. And that, authorities say, is where the problem lies.
Complications for babies:
Babies may be in breech position, experience a range of umbilical cord issues (such as knots, tangling or prolapse), or may even go into foetal distress during labour. While a qualified medical person can recognise these complications and intervene, someone with no medical training can’t.
Other serious complications that can arise include shoulder dystocia, birth injuries, meconium aspiration and placental abruption. All require immediate medical attention in order to give bub the best possible chance at survival. The most common causes of infant mortality following a free birth are brain damage and infection.
Complications for mothers:
For the mum who has just given birth, postpartum issues such as severe blood loss and infection can be common. In a hospital environment, these conditions, though serious, aren’t necessarily life-threatening. But for a mum at home with no medical staff in attendance, the risk is significant.
So the old argument that “our bodies were created to birth babies!” doesn’t really cut the mustard when weighing up such potentially life-threatening complications.
Why do women choose free birth?
Many women who choose free birth do so after a traumatic first birth experience in a hospital. Some choose it for financial reasons. Others choose it simply because they feel medical attention is unnecessary. And empowering free birth stories on social media are probably a factor too.
Yoga devotee and now mum-of-four Ashley Albrand recently free birthed a surprise set of twins in the Costa Rica junge – and blogged about it.
“I allowed baby to flow out in one contraction & we lifted him out of the water & kissed & loved him,” she shared on Instagram.
But the birth of the second twin – the baby that no-one knew was there – didn’t go as smoothly. “She wasn’t breathing but was clearly alive, I used my mouth to suck liquid out of her nose but she didn’t start breathing or crying,” Ashley wrote. Eventually, the baby girl began breathing, but the outcome could have been very different.
In Australia, free birth is predicted to surge in popularity within the next couple of years. Currently Australian non-private midwives are unable to obtain insurance to attend home births. However in 2010 the government provided an exemption allowing them to attend legally without insurance. From 2019, this exemption ends, leaving a lot of home birth-hopeful mums in the lurch.
While a free birth may empower the mum and create a pleasant, relaxing experience (if all goes right), it is unlikely that the benefits outweigh the risks.
In fact, Deputy State Coroner Scott Mitchell described a free birth website that encouraged women to deliver babies without assistance as “propaganda” while investigating the death of a baby in 2012.
Mr Mitchell said in his decision that the Joyous Birth website intended to ”convert women … to the view that medical and hospital involvement in their pregnancies and births is undesirable and contrary to their interests as women and mothers”.
”… they are wrong views, extravagantly expressed and quite insensitive to the harm they may do others, whether [it be] inexperienced mothers, or children like Roisin whose chance at life was so unnecessarily put at risk,” his findings stated.
He was making his findings into the home birth death of free birth advocate – and Joyous Birth founder – Janet Fraser’s baby girl. Roisin died only minutes after birth when Janet, her partner and their friend did not know what to do about a cord entanglement.
A mum considering a free birth ultimately has to decide for herself what’s more important. A memorable birth experience, or a living, healthy baby? Because unfortunately when it comes to birth, one is no guarantee of the other.
Of course, hospital births don’t always go to plan either. See what happened when doctors accidentally cut open a baby’s head during a c-section.