Sunday, August 12, 2012

Unassisted Childbirth, sometimes the only 'Choice'?

Unassisted Childbirth (UC) refers to birth in which the mother delivers without professional assistance (such as from a midwife or OB) and has also been referred to as 'freebirth'; this does not mean the mother and her partner have not prepared for labor and birth, just that they do not have a licensed professional present when the baby is born.

Some women labor and deliver completely alone while others may be emotionally and physically supported by their partner, a friend/family member or a doula. There are a multitude of reasons why women choose to birth unassisted and some women choose to do so because this is the best choice for them, but for too many women, they have to have a UC in order to have their baby at home.

In the U.S., 99% of births occur in the hospital, however the numbers of women choosing home birth are growing. Most home-births in the U.S are attended by midwives, however, many states still have laws that prohibit midwives from attending home-births and the women that choose to stay at home must birth unassisted. Furthermore, many mothers that plan to have an unassisted childbirth are choosing to do so because one or more of their previous births entailed a negative or traumatic hospital birth experience, such as a c-section and they are looking to avoid this experience again.

Take the rather common example of a woman who has had one (or more) c-section deliveries and the doctors in her area tell her they will not 'permit' a VBAC (vaginal birth after a cesarean), so if she delivers in the hospital, the baby will be delivered by major abdominal surgery. This woman may choose to have a home birth, but if she lives in one of 10 states that still has regulations against midwifery practice outside of hospitals, then she will have to consider delivering at home, unassisted by a licensed professional.

Women will choose to deliver unassisted for many different reasons and all women deserve the right to choose, but there must be access to safe birth choices for all women and midwife attended birth is a safe option! When so many women are confronted with a choice between major abdominal surgery (just to have a baby!) or birth alone without the oversight of a caring and knowledgeable professional, such as a midwife, I wonder... what kind of choice is that?

In addition, childbirth as a rite of passage entails that some women will feel safe and empowered to birth alone, we should not take this away from them. For many of these women their birth will open them to a new depth of respect for themselves and love for their family. In the event that complications do arise and these mothers decide they need medical assistance, they should be treated with the dignity and respect as any other patient.

A post from Self-Directed Childbirth, describes a beautiful example of an unassisted childbirth in a hospital, which gives me confidence that the medical model of birth is slowly shifting and women will continue to have greater access to a multitude of choices in childbirth and respect when they decide what is best for them and their baby. However, this is not what is normally experienced and more women than before are considering birthing alone in order to avoid the interference frequently caused by medical birth professionals, sometimes even from midwives! 

There are a number of safe birth options for women to choose from and we should not discourage or punish mothers who have a desire to birth their babies at home, even without assistance. In particular, however, we need to ensure that all mothers who choose home birth have the legal choice to be attended by a midwife. Trying to prevent home birth by outlawing midwifery practice outside of hospitals will only force some women into delivering unassisted at home. This could lead to injuries or deaths that are completely preventable in our developed health care system. Instead we should look to the other successful and empowered models, such as that in the UK, where laws require midwives to attend women wherever they choose to labor, no matter the location.

I envision a system where women that choose to deliver in a hospital can still have access to the privacy and respect that is found most often in home-births and women that choose to deliver at home can do so in any state with the support of a trained professional midwife. Women are not looking to endanger themselves or their children, rather they are looking to have the most fulfilling birth experience as both a woman and mother.

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