Let’s talk freebirth

Amanda Patterson-Crowley

I read an article recently by Celia Silvani in Stylist about her journalistic experience “infiltrating” online forums dedicated to freebirthing. While I don’t appreciate the sensationalist tag line, or some of the authors choice of words, which felt discriminatory, the article ended on a strong note, “It’s legal and right for someone to decide to freebirth, and until the healthcare system earns their trust, people will continue to find solace and support in unmoderated, private places.” 

We’ve written previous blogs about the responsibility the media has reporting on how women and birthing people are faring in the UK right now. As Doulas, we know that some of the hardest work we do with our clients is to unpack and understand their preconceptions of how birth works, from the choices they have, to not accepting care they don’t feel comfortable with, and asking (read:demanding) the care they deserve, especially for marginalised and low socio-economic people. 

Freebirth is a contentious issue, as the article states several NHS Trusts and The Royal College of Midwives have shared concerns about the rise of freebirthing and the risks involved.  While freebirthing is certainly not risk free, birth itself is not risk free. 

What isn’t always made clear in these articles is that often, the risks of birthing within the medicalised system outweigh the risks of birthing physiologically on our own terms. Until an article is written that can fully balance this reality, it is not entirely unbiased. 

What is freebirth?

Freebirth is the conscious, considered choice to birth outside of the medical setting, without many  or any of the medical interventions offered. It is presented as completely binary, either you freebirth or you don’t, legally however,  everyone has the choice to freebirth, or engage in the system as much as they like. It doesn’t have to be as binary as not engaging entirely, the choice is the pregnant persons, not their healthcare professionals about where they birth and who is welcomed into that space - even if you have had scans or conversations with NHS healthcare practitioners. 

The right to freebirth, and the right to choose a homebirth are fixed in our human rights. Legally, any procedure from the NHS must be consented to by the patient (unless the patient is deemed to lack mental capacity). However, many people are choosing to freebirth or are forced into a setting they did not choose because of a lack of provision of homebirth midwives. As Doulas, when discussing homebirth with our clients, we are discussing the possibility of having to choose to either move, wait and hope, or end up birthing before arrival (BBA) of midwives.

Freebirth is indeed on the rise (we think! there are no stats because it isn’t tracked by the NHS) in societies impacted by the pandemic lockdowns, and how people were forced to birth in those years. But it’s not just that, it’s often women, LGBTQIA+, and marginalised groups experiences of a deeply flawed medical system that has perpetrated violence and trauma on them. 

So, that seemingly simple balance of risk? Not so simple. 

Saying all of this 

We know that most people don’t choose to freebirth carelessly. Doulas know that if a client asks about freebirth, it’s a good, long, detailed conversation about the risks and considerations of choosing it. Most Doulas will maintain the right to call in a medical professional or a paramedic to a birth should they feel the need, making it clear to their client that they have the right to deny care.  But, for some that may mean that a Doula who makes that choice may not be for them. Neither should a Doula be considered a “just in case something goes wrong”, we’re there to provide physical and emotional support during labour, that is our role.

But no, you can’t “meditate” out a retained placenta.

Medicine HAS its place, it absolutely is necessary in some circumstances. But the choice to honour your birth space, your birth choices and decide how, where and with whom you bring a baby earthside is sacred and should not be stigmatised or ridiculed. Requiring medical intervention, or choosing medical birth is just as important a choice. It is essential that women and birthing people retain the right of autonomy over the welfare of their bodies and their babies. Where would we be if we start to question our right to choose our place of birth, or what medical interventions we might need to accept or refuse.

What is the right choice?

Silvani’s article mentions how in the freebirth forums medical interventions are often met with suspicion and contempt, and any choosing medicalised birth risk being ostracised by peers. The internet is a challenging place to find good information, I think this was one of Silvani’s main concerns in her article. We turn to these forums because we don’t trust the information given to us by our medicalised system, their policies are informed by outdated or disproven research, doctors often use coercive and inflammatory, if not downright terrifying language to influence birthing people’s decisions. We feel alone in feeling like we’re outside of an accepted system, and seek like-minded people online. Naturally. Yes there can definitely be misinformation, there are a lot of opinions and different approaches. That doesn’t mean they shouldn’t exist or be policed. 

It means that between two paths of information that may not be right for us, we need to seek out reputable sources and genuinely objective support and guidance. Most communities will have an antenatal educator or Doula who offers free support, in-person or online. Use them!