Is Freebirth safe? And my musings on recent press about Freebirth.

A few people have asked my thoughts on this so here goes...

In case anyone isn't sure, Freebirth is birth in the absence of any medical providers. There is some argument whether it is still a considered a Freebirth if there is even doula present, but I would argue it still is.

People might choose Freebirth for a variety of reasons...

- Just because they want to, it was a natural decision and that was always going to be the plan. Freebirth would be their plan A, even if all the other options were available to them.

- A choice made from trauma or obstetric violence they experienced in a previous birth (This could be a hospital birth or a home birth with midwives present.)

- Or because they want a home birth and the home birth service is patchy so they choose to Freebirth as a plan B if no midwives are available.

Do I think Freebirth should be illegal? No. Absolutely not. I believe that autonomy during birth is vital and a human right, and if we start taking that away we are in real handmaids tale territory.

Is Freebirth safe? The answer to that is, we just don't know. We don't have data on it. There are sadly poor outcomes in all settings, and in some cases those poor outcomes are caused by overmedicalisation and iatrogenic harm in the hospital. We have good evidence that home birth with a midwife is a very safe choice, but we just don't know with Freebirth. And we can't even lump all Freebirths into the same category. Some Freebirthers also choose a 'Wild Pregnancy' with no scanning, testing or midwife appointments, while some might choose to still participate in some or all of those services. So the 'safety' of those two camps and everything in between is very subjective.

The problem isn't Freebirth itself. The problem is dogmatic beliefs and cult-like mentality.

The organisation being looked into here have VERY extreme beliefs. For them there is NO room for nuance and the idea of accessing medical help during labour in ANY circumstance isn't just frowned upon, it is actively scorned and judged. For me THIS is the real problem. The idea that under no circumstances should you accept any sort of medical help, is of course and extremely dangerous ideology. Yes, MOST of the time birth works perfectly well on it's own, but there are some circumstances where medical support can be lifesaving, or just make things a whole lot better for women and babies.

My problem is the idea of putting Freebirth on a pedestal as the ONLY good way to give birth. In fact, putting birth in a hierarchy at all is problematic. What is good for me might not be good for you, and vice versa. FBS were also making bucket loads of money out of their birth keeper trainings and memberships, which openly ridiculed or ignored anyone who ended up accepting medical help, and silenced voices of families who had had a negative experience in a Freebirth.

As a doula, I am in total support of Freebirth, if it is coming from a place of knowledge and responsibility. We can't get away from the fact that an undisturbed physiological birth is now hard to achieve in hospital, I hear stories all the time from people who were coerced, traumatised and in some cases physically

harmed during hospital births, I can see why those people are not up for putting themselves in that situation again, and with a lot of trusts not having strong continuity of care home birth teams, this isn't always a good option either.

The idea of responsibility and 'blame' around birth is so interesting too, and one I would always discuss with any client considering a Freebirth... At hospital you are somewhat handing over responsibility to your care provider, and in the event of a poor outcome, there would (rightly) be no pointing the finger at you saying 'well you chose to give birth in a hospital where we know that medical interventions can cause harm and the NHS is overstretched etc', but choosing a Freebirth is an act of radical responsibility, because in the event of a poor outcome (even if it was something totally unpreventable) there would be blame and guilt placed on the parents heads for choosing that path. I'll say it once and I'll say it again, there is no risk free option. There is no completely safe option. It is about choosing what 'risks' or chances you would rather take, and making sure your decisions are coming from a place of information and confidence and not fear.

In short, for me there are many people for whom Freebirth could be a very valid and powerful choice. But Freebirth Society, and shaming people into thinking Freebirth is the ONLY way, and making them feel weak if they choose medical support, is just as bad as the group at the opposite end of the spectrum who think everyone should have a highly medicalised birth and that homebirth is dangerous and irresponsible.

For me it all comes down to NUANCE.

I also have a personal history with the idea of Freebirth. When I was pregnant with my second baby (after a magical first home birth and very keen to avoid hospital) our local trust had a patch at best home birth service. I spent my whole pregnancy toggling between freebirth if there were no midwives available, and going in to the birth centre. Ultimately I decided if no midwives were available to attend me at home, I would go in (very begrudgingly.) This was down to a few reasons; 1. I didn't want to make a decision out of fear rather than power. 2. I felt like utter shit for most of my pregnancy and I didn't feel I had it in me to spend the time and energy I would have wanted to in the planning of a Freebirth. I would have wanted to do a lot of mental prep and learning in order to feel safe birthing unattended. But it really was a close call for me. I ended up going into the birth centre (as predicted there were no midwives available) and had a great birth experience. But I will say, there is nothing like a home birth.

If you are mulling over the idea of a freebirth, book in for a power hour with me! Let's talk it through and work out how you really feel and I can help you made a plan A,B and C that you are comfortable with. If you are Nottingham or Derby based I offer in person support, and online for elsewhere!