Being an enthusiastic natural birth proponent, I’m a member of a good number of Facebook groups for moms interested in natural birth. In one of the home birth groups I’m a member of, women began to discuss having an “unassisted birth” (also known as a “freebirth”). My interest piqued by craziness on the Internet, I did a quick Google search (don’t look at the Wikipedia page if you’re at work or around wandering eyes). An unassisted birth is just what it sounds like: a birth, usually at home, alone or with one’s partner, not attended by a professional midwife or doctor. If you’re thinking “Boy, that sounds dangerous!” you’re right. A leading blogger of the “Freebirth” movement in Australia, Janet Fraser, buried her stillborn baby girl in 2009. The baby in all likelihood would have been born totally healthy had she had a home birth attended by a licensed midwife or in a hospital with a doctor and nurses present. The death spurred an inquest in which the coroner concluded “the child had died because the only people she had elected to be present at the birth — her partner and her best friend — could not deal with the complications of a cord entanglement.” That birth story, which happened in March 2009, has never appeared on the Joyous Birth website, still run by Fraser.
This case is an extreme example of members of this movement of women who, for any number of reasons, plan to have their children without the assistance of medical professionals. Being an super professional journalist absolute voyeur, I joined every Facebook group I could find on Unassisted Birth to give you insight into these women and their motivations. Here are some things I learned, in list form, of course:
1. Money Is a Factor
Not surprisingly, many women in the group explain that they are having an unassisted birth because they cannot afford to have a midwife attendant at their home birth. Most home birth midwives’ services aren’t covered by insurance and none are covered by Medicaid, leaving women with the choice of a hospital birth or an unattended one. Others state that they have no medical insurance, which would make an out -of-pocket hospital birth astronomically expensive for even a middle class family. The United States is the most costly place to give birth in the world, with the average vaginal birth clocking in at $30,000 and the average C-section costing $50,000.
2. Fear of Unnecessary C-Section
This is a very valid fear, grounded in exploding C-section rates across the country. In 1970, the C-section rate nationally was 5.5 percent; according to the latest data available, the rate is now 32.8 percent. The World Health Organization (WHO) recommends an upper limit on C-sections at 10-15 percent. Despite the relative safety of VBAC (vaginal birth after C-section), many hospitals and providers refuse to provide their patients with the option. Women who have had a prior C-section in the state of California, for example, have a 5 percent chance of having a vaginal birth after C-section. If a woman has had a prior C-section, or lives in a state or near a hospital with an exceedingly high C-section rate, she may become open to the prospect of a home birth to avoid a major unnecessary abdominal surgery, which comes with its own risks of complications and dangers. If there is no midwife available or affordable nearby, women may turn to unassisted birth to ensure their avoidance of a C-section.
3. Limited Access to Home Birth Midwives
Home birth midwives come in different forms: certified nurse midwives (CNMs), certified professional midwives (CPMs) and lay midwives. Each type of midwife has its own set of qualifications and regulations surrounding the kind of care they can give per state. Some states, like Missouri, have in the past made it exceedingly impossible for home birth midwives to operate legally. Without access to licensed midwives, women in rural areas or in states with exceeding amounts of regulations against midwifery turn to unassisted birth. Unfortunately, most insurance companies refuse to cover the services of home birth midwives, leaving women to fight an uphill battle for a “gap exemption” or simply pay thousands of dollars out of pocket for the birth they want.
Up until this point, I think I’ve been pretty charitable. Here’s where I stop.
4. Many Try to Crowd-Source Medical Information
This is a recurring theme I’ve seen in a lot of Facebook groups of moms. Most women advise posters to just call their doctor. But what do you do when you don’t have a doctor or a midwife? You rely on doctor Google. It is truly frightening the kinds of questions women ask in Unassisted Birth groups, and chilling how the answers of women who cannot even spell are taken seriously and to heart. If someone can’t spell “mucus,” it’s a safe bet they aren’t qualified to answer your medical question.
5. Medical School in Cliff-Notes Form?
I’ve seen the question “is there a childbirth for dummies?” several times between the many groups I’ve joined in the last several weeks. My friends who have become midwives or doctors spent years of their lives in school and in training to become childbirth professionals. It’s remarkable that so many think that a decade of medical training can be summed up in layman’s terms in a book short and easy enough for someone with no medical training to comprehend.
7. Many Don’t Seem That Concerned About the Baby’s Health or Well-Being
Many of the questions surrounding how to safely have an unassisted home birth seem to revolve around stopping bleeding, what materials to have on hand, the legality of unassisted birth, and how to obtain a birth certificate. I have yet to see a question along the lines of “how can my husband or birth attendant be trained in neonatal resuscitation?”
8. They’re Often Hostile to Possible Horror Stories
Not surprisingly, those in the Unassisted Birth camp have no interest in hearing about the many, many things that can go wrong during a birth where there isn’t anyone medically on hand to tackle potential emergencies. On the Joyous Birth website, the blog run by Janet Fraser, not a single mention of her stillborn daughter can be found, even five years after her death.
9. Hostile to Other Forms of Modern Medicine
Unsurprisingly, if women are willing to undergo pregnancy and birth without the help of a trained medical professional, they often don’t find it necessary to consult one in other matters as well. The fear and distrust of vaccines in the natural parenting world is well-documented, however there are also many other mothers and fathers who avoid doctors altogether. It is not uncommon to see parents in extreme natural parenting groups and Unassisted Birth groups casually mention that their 10-year-old has never seen a doctor. Many others seek medical advice unrelated to pregnancy on these boards, and inquire about how to legally avoid taking their children to pediatricians while enrolling them in public school. “Big Pharma” is a phrase often tossed around; however, even I was surprised to see one commenter casually refer to the “cancer industry” and how to avoid its “conventional treatments.”
10. They View Birth as Sexual
This was a strange one. My husband was present for the birth of our daughter. He even held my leg as I pushed (though truth be told neither of us were that comfortable with it; the midwife who attended my birth just sort of handed him my leg and said “hold this”). I always sort of half joke that I’m amazed that he was ever able to even look at me again after seeing me give birth. I would have to go through about a thousand adjectives before I settle on “sexy” to describe childbirth. However, many women in the Unassisted Childbirth movement view birth as the completion of the sexual act that brought them there nine months prior.
11. Disgusting Imagery
An unfortunate side effect to being a member of all of these Unassisted Birth groups of late has been the weird and disturbing “art” and images that have made their way into my newsfeed. I recently saw one of a baby “expelling natural fluids” without the use of a bulb. Because apparently even a bulb is also dangerous and evil. Someone posted a picture of a woman sitting in I-don’t-even-want-to-know-what after having given birth in her bathtub. All in the name of “art.” And with that, go forth and enjoy your day!