Wednesday, August 20, 2008

What is Free birthing? please help answer the question!


In recent months I have heard this term used more frequently. This is a new phenomena for me, "Free birth" or "Free birthing". I am guessing it is the same as an unattended birth, meaning that there is no health professional present. Is this a correct assumption?

These are open questions in an effort to get some answers from the women who choose this option so that i can understand what freebirthing is, you don't know if you don't ask.

What is freebirthing?

What makes women decide to have a freebirth?

How common is freebirthing? Is it becoming a more favourable choice for women?

Are our midwives and obstetricians not meeting the needs of women?

How many women do you know who have had a free birth? or contemplating a free birth?

If anyone knows the answers to these questions, please feel free to comment.

17 comments:

Lisa Barrett said...

Free birthing is birthing without a medical professional. Some decide to do it just with family or alone, some do it with a doula who attends births at home. It is getting more popular. check out purebirth.com.au and Joyousbirth.info for more details.

infomidwife said...

thanks Lisa. What do you think about this option?

Lisa Barrett said...

Being a midwife myself of course I think the best way to birth is with a known midwife. However making judgements about freebirth would just be as bad as the people who make judgements about homebirth with an Independent midwife, so I support it. I've helped with paperwork and I've offered assistance when nec. Obviously for women birthing alone there would be no point calling a midwife if there was a complication, you'd need an ambulance, but I have for example helped a woman who was in labour for longer than she expected so rung for advice. I just went to see her for some moral support and her baby was born beautifully.
As long as women can accept the responsibility for their decisions then they should birth however they feel is right.

infomidwife said...

is it a common occurance?

Lisa Barrett said...

Not really in this state, it is more common in others especially NSW and Queensland. There aren't any freebirthing doula's here at the moment so all the women in this state birth with family. Doula's that attend births are becoming more normal around Australia so I'm sure it's only a matter of time before someone sets up here.
I understand that they are non medical but I feel I am too. What we wouldn't want is a situation where collaboration with a midwife isn't possible because there is angst so I keep an open mind.

infomidwife said...

I think it is a tragedy that a woman feels that she has to birth without a midwife - If the woman is fully informed and has made a decision about a homebirth knowing full well the consequences of her action and has been given independant information relating to her birth choice (when it may be considered a high risk situation or our of the norm) and still decides to have a homebirth, that decision needs to be respected.
I think, we as midwives let women down by not supporting thier choice. What also is a tragedy is that their is no support network for those midwives (Independant)who decide to support that women's choice. Maybe we need a system simlar to that of the UK a supervisory network, that will provide support for independant midwives.

infomidwife said...

is the Doula's role purely as emotional support? not taking the role or place of a midwife? and how much do they charge? I wonder when they start supporting the women, is it only in labour or the pregnancy?

Lisa Barrett said...

some women feel that a midwife offers too much interferring and a doula only offers emotional support. Doula's have a ante and post natal service.
I also feel that women who birth totally unassisted and birth with a doula two different issues.

Laura Jane said...

Thanks for bringing this issue up Pauline.

Its an interesting extension of women's empowerment and our loudly touted confidence in women's ability to birth without medical interference. We promote a non-medcialised and natural birth, but are shocked that women will take the next step away from us as midwives too.

I agree with you that it is sad that a woman is so distrustful of any health professionals that she would choose to birth with no back-up at all. But is it distrust or extreme bulletproof empowerment? And I am interested and challenged (not offended, but in a thought provoking way) by Lisa'a comments that she supports planned Freebirth, from a non-judgemental perspective. I can certainly see where she is coming from. We do empower women that natural birth is possible and should be the norm, including in the home environment. I will need to think about it some more.

I have certainly read accounts on blogs by women who have freebirthed at home, including twins where baby one was breech (with photos). The accounts make for natural, but sometimes hairy reading, but the woman's husband was calm and sensible and figured things out.

We have all seen superb births by primips, and occasionally we see an emergency such as shoulder dystocia or PPH, whether due to a bad tear or the like. These emergencies are usually resolved in a timely fashion by the actions of a trained midwife (note, I don't think Doula's are trained in these emergencies), but I would not like to think of the consequences for an unattended woman or couple. I well recall the 18 y.o. primip I attended who laboured spontaneously and calmly birthed a 4kg baby with an intact perineum, but who sustained bilateral upper anterior wall tears that pumped out 2L of blood in 5 minutes. That's a significant amount of blood to lose, probably before anyone even thinks of calling an ambulance. Would she have survived waiting for an ambulance?

So - Does that make me a scaredy-cat? Or someone with a healthy respect for birth who loves to see it all go right and be able to leave it all up to the woman, but is ready, through thorough training, in case it doesn't?

Lisa Barrett said...

Hi Laura, it's not so much about being a scardy cat but about you letting women be responsble for their decisions if they so wish. Medical means, heart rate, bp, ve etc etc. It is confronting to feel that we are supporting natural birth and others still think we are medical. I hardly ever do a VE or bp in labour and some think I'm medical. I always feel I can't win, too radical for the system, too registered to be totally natural.

infomidwife said...

Hi Laura,

thanks for your comments, I have to say that I do not think it has anything to do with being a "scaredy-cat" you are quite correct when you say ..."rather than a healthy respect for birth.." and allowing the woman to choose her way of birthing.

I wonder if you were a girl scout? remember the motto "always be prepared" and to do that we as midwives need to work within our scope of practice, code of ethics, conduct and competencies.

"go midwife trust your gut"

infomidwife said...

Hi Lisa, thanks for the comment. It is interesting to note that you consider it medical to do heart rate, BP & VE - but I do not consider midiwves to be medical - rather than health professionals -certainily not medicos. It is all in the interpretation of words.

Another interesting point is that the WHO recommends to untrained birth attendants in normal labour, that they do BP and temp 4 hourly in labour, pulse 1 hourly or more if concerned.

Yes I agree with you that there are betters ways of assessing progress in labour rather than always doing a VE.

It is a difficult place to be ".. too radical for the system, too registered to be totally natural.." maybe the answer is re-defining to women what medical is!

Lisa Barrett said...

Hi Infomidwife. I didn't mean I thought it was too medical but that it was the opinion of people who decide to birth with a doula at home instead of a midwife:)

infomidwife said...

Oh gotya Lisa, see it is all in the interpretation.

Lorraine said...

Hi Lisa
Other then the woman not giving consent why would you not do a BP in labour?
A BP in labour may be the first time that pre-eclampsia is diagnosed.
Eclampsia still kills many thousands of women around the world and the practice of checking women's BP in the antenatal period and in labour has virtually wiped out this devastating condition in most western countries.
It is part of our professional responsibility as a midwife to be the "guardians" of the normal but to also recognize and report abnormalities. Sadly millions of women every year still die during childbirth because of lack of care during pregnancy and birth. Are the women that choose a free birth just relying on luck? I think that a relationship built on trust with the woman and a midwife that intervenes only when necessary is the safest way to birth. It does sadden me to think that women feel they can't trust us as midwives to serve them

Lisa Barrett said...

Hi Lorraine, I certainly do bp antenatally and would in labour if I was worried at any time. There is no point in any routine behaviour and there is actually no evidence to back up the over servicing done on antenatal care- by this I don't mean NO antenatal care. WHO figures also say that 3% of pregnant women will get pre eclampsia and a further 2% will go on to get eclampsia. There are more indicators than just BP if a woman's condition is changing and if a woman is labouring well why would you disturb her for a bp that you know isn't necessary.
This is not lack of professionalism as I see it. Or lack of care or hoping for the best. Clinical decisions come in more forms that, should she be induced or should she be monitored.

I agree with you that the best outcomes are gained with a known midwifery care provider however if women chose to free birth it is totally their responsibility.

Anonymous said...

I have become more aware of "freebirthing" over the past 12 months. It seems to me that this practice is gaining momentum (or maybe it just has a new "fashionable" name) in response to the lack of options women who do not want to birth in hospital have.

It seems that while we live in a society that advocates free choice, the health system generally advocates free choice but determines what those choices are. Is this truly free choice - i don not think so.

Hope that makes sense.

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