Tuesday, January 5, 2010

An interesting perspective on Freebirth:

Basil from my garden:

Surfing the net as I do, I often come across some very interesting stories...this one made me think more about how some women feel about Freebirth...(birthing without any health professional present) however even though I can understand the choice these women have made... I still can not comprehend the fact that women will choose to birth without a midwife.

this quote was taken from: Women giving birth at home without midwives
When Jennifer Margulis went into labor with her fourth child, she sent her husband off to take the kids to school, then waited at home for her body to do what she felt confident it had evolved over millions of years to do on its own.
There was no rushing to the hospital, no midwife, no EMTs. Just Jennifer and her husband, home alone, giving birth.
"I think a lot of people think a woman who would want to have an unassisted birth would be a little bit crazy," said Margulis, who holds a Ph.D. in literature, and is a contributing editor for Mothering Magazine. "I think I may have had that reaction as well. I am definitely not a crazy person. I am a very educated, thoughtful and caring person. I am not a person who takes a lot of unnecessary risks. The whole point is it is not risky if you do your homework."

I would really like to know what 'homework is done' I am sure that there is a lot of information.... but if it takes a Bachelor of Midwifery student 3 years to learn how to be a competent Midwife and a Registered Nurse a further 12 months as a post graduate course or 18 months if in Europe to be a competent midwife - how is it that women think all it takes is a bit of homework to be able to recognise when things are going wrong with a birth where medical intervention may be required for both the woman and baby......

I appreciate that many women may have fallen foul of medical intervention which has scared them.....however I firmly believe that Freebirthing is not the answer.... a more collaborative approach is required with more flexibility from our health professionals and hospital system.... rather than a fear factor or paternalistic approach.

I would like introduced into Australian legislation the clause that is in British legislation which makes it illegal for a midwife to refuse to care for a woman....so women who choose to have a homebirth and they may be considered "high risk" are supported by a midwife... and the midwife is protected by the legislation and has support from her supervisor of midwives ( we would have to introduce a similar system here) and all care is clearly documented if required for legal reasons, therefore protecting the woman, baby and midwife...

I have been practicing midwifery for many years... and I have to say that every birth is unique, special and at times unpredictable.... however I am so acutely aware of what is normal that when things begin to become abnormal it is like a sixth sense for me.... how do women who are freebirthing understand this or even begin to think they know when often times it can be a total surprise.... the difference being that if recognised early enough help can be close at hand....Yes I also am a firm believer of a woman's body knows what to do and how to do it.... but as we all know this doesn't always go the way it is meant to do... years ago we had a much higher childbirth morbidity and mortality rate and why was that, in a nutshell, women hemorrhaged and infection was high on the list. This has been reduced why, because we are better educated, we know more (through research) and have better treatments. This brings with it higher expecations.... that everything will be normal.... and yes 90% of the time it is.... but I would not want to be in that 10%.

A sad reflection is that Freebirth is on the increase, although it is difficult to prove this fact. This therefore means as health professionals we are failing women and not respecting their choice, we need to re think this whole position....

Please help me understand why some women think it is best to have a freebirth...


Pam said...

I watched a documentary based in the UK on 'freebirthing'. I soon realised though that a number of women were NOT in actual fact 'freebirthing' without any assistance it was that they had a woman or partner or husband with them that they trusted completely but were without any medical training whatsoever, so to me it wasn't 'freebirthing' without assistance it was just birthing with non qualified person present!

Laura Jane said...

Thanks for opening this for discussion.

I agree that it is a sad indictment of the lack of trust shown towards women, as manifested by the highly interventionist approach, that has resulted in women feeling backed into the corner that is Freebirth.

Pam's take on the unattended Vs no trained person present still does not answer the question about why women do freebirth.

Like you, I am developing the sense of when things are about to go wrong, indeed I have seen a spontaneous intrapartum event turn to a real life-threatening emergency in 10 seconds, and I would NOT want to be the woman unattended, or with a non-trained person in that case.

Blood loss is REAL, shoulder dystocia is REAL and training in emergency techniques is vital for the first line of response to these issues. I always hope never to use them, in fact nothing gives me greater pleasure than to see an easy spontaneous birth where I have done 'nothing', but I am so grateful that they kick in if the need arises.

flowers said...

I understand why women have freebirths.

Firstly, I think many women have been unable to find health care providers who fit their needs. Ones who are able to let go of their ego and let the mama be giving birth. Midwives are becoming more and more "touchy" and fear litigation themselves. I have met many midwives who do things purely based on fear of being sued.

Also, try finding a health provider who will let you go into spontaneous labor past 12-13 days. Many midwives say they will, but they won't. You start getting pressure to intervene and drama ensues at the end of your pregnancy. I have had two babies born perfectly healthy way past my edd. One was 15 (plus another two of labor ) past my edd and that was with my midwife pressuring me to no end to sweep my cervix and break my waters. The second one I had to seek out a midwife who trusted me. I trusted her also. I went 22 days past edd and had a healthy baby, healthy placenta, no signs of postdatism and a wonderful birth experience.

I was living in a major metropolitan area with great midwifery laws and I could afford to seek out the person I needed.

Now I live in a small community, with homebirth midwifery about to become legal and only two practicing midwives. One will not let you go past 42 weeks. The other will. What if she didn't? What if I lived somewhere where I could not receive the care I needed?

Long story short I think there are a percentage of people choosing freebirths because it is a truth that resonates with them and I think there are a percentage of people who choose it b/c they lack access to the care they are desiring and believe they are better off alone than birthing with someone they either do not respect, trust or like.

Also, I want to note that you credit your self with that "sixth sense", but do you not think a mother has an even more intuitive sixth sense while birthing?

I do not choose freebirths, but I do understand why women are choosing/considering them.

Anonymous said...

My first freebirth was a result of not being able to find a midwife who would attend my VBAC homebirth, even though I have VBACd successfully several times previously, even with twins and a classical Cesarean incision. The local hospital as well had a NO VBAC policy - I refuse to have a repeat c-section when there is no valid reason for it, especially after my body has proven it can do it.

I appreciate that you acknowledge that a woman's body knows what to do and how to do it. Please consider that women also have that "Sixth Sense" you speak of,especially in regards to their own bodies during pregnancy & childbirth.

My experiences with those who choose to freebirth is that they are women who are intelligent & sensible, with a large amount of instinct,trust in themselves and knowledge of their own bodies. Their reasoning range from not having access to another choice to spiritula reasoning to just simply having a strong,practical DIY Ethic. All unassisted births I know of firsthand have been well-planned, with well-formed backup plans in place in case that sixth sense kicks in (just as an attending midwife would in the event of an emergency during a planned,attended homebirth.)

Anonymous said...

)*spiritual* .ugh,typos)

InfoMidwife said...

Thanks Pam for dropping by...there are many definitions for "Freebirthing" or "Unattended childbirth" - they basically mean the same, no health professional present... yes they usually do have their partner maybe a doula but no health professional - in short no qualified person present...so the meaning is not literally no one else present....

InfoMidwife said...

Thanks flowers for your comment and yes i understand that in the States your intervention rate is higher than here.... however there are many similarities...I totally agree that there are some midwives who have an ego problem or who practice 'safe' or 'in fear of litigation',
It is good to hear you have had some positive experiences with midwives… and yes times are changing even here in Australia we are in threat of loosing Independent Midwifery.
Yes I do credit myself with a ‘sixth sense’ however this is not a natural occurrence… it is due to having years of experience as a midwife, from watching, listening, being with woman during her birthing process and continued evidence based education. This is what allows me to judge the current situation together with the woman and listening to what it is she wants…..

InfoMidwife said...

Nice to hear from you jupitersinclar; Yes I acknowledge that some women have a very good understanding and a spiritual sense of their body…. I have known women to tell me when in labour that they can feel their cervix dilating….how wonderful to be so in tune with yourself….however I have to disagree in terms of having a ‘sixth sense’ in respect to knowledge and what to do when it all goes pear shaped and the stress hormones take over….. as I discussed above in flowers response… yes birthing is a natural phenomenon, or instinctual - like breastfeeding is instinctual…. But both mother and baby have to learn how to breastfeed it does not occur naturally… it is a learned experience… and how do they learn by watching their mothers, aunties, sisters, friends doing it…. That is the art we are losing the art of passing on the stories of traditional natural childbirth….supporting woman to woman, of how great our bodies are, how they have the capacity to birth normally….to trust yourself…. and how to best cope with contractions. From woman to woman, mother to daughter…etc.. then I could say women have a ‘sixth sense’ because they have watched, shared, experienced, learned the art of birthing…….but throughout the ages women have always been supported by midwives…… ‘with woman’…… I feel very disappointed that women are choosing to go it alone…. Which I fear will be detrimental for the woman, baby and midwife…….and future generations….

InfoMidwife said...

So I ask you flowers & Jupitersinclare.... what is the answer?

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