Monday, September 16, 2013

Freebirthing: is giving birth without medical support safe ?

With independent midwives being outlawed next month, many expect a rise in women giving birth at home without medical help. But does ‘freebirthing’ result in happy, intervention-free labours? Or is it a dangerous practice that risks babies’ lives?

Sarah Currie is just days away from giving birth, so when we meet our conversation turns, naturally enough, to the delivery. She is planning a home birth; we talk about where it might take place (she thinks the sitting room), about pain relief (she’s going to walk around) and how long the labour might last. One thing we don’t talk about is the midwife, because there won’t be one. Currie, 27, decided a few weeks ago that she wanted to have her child without medical assistance.

If that sounds mad, bad or dangerous (or perhaps all three), then hear her out. Two years ago, Sarah, who lives in Peterborough, gave birth to a daughter called Anabella-Grace (her older children are Jack, seven, and Eleanor, three).

She’d been planning a hospital birth, as her previous two had been, but towards the end of her pregnancy she became interested in home birth. The midwife said she wasn’t considered “safe” for it because her first child was born by caesarean section. But Sarah looked at the research and decided she was willing to take the risk, which she thought was very small.

She booked a home delivery and called the midwives, as agreed, when she went into labour. “But the person who answered the phone said the community midwives were already at a birth so no one was available. She asked if I would come in to hospital. I had my heart set on a home birth, and everything was going well. No one had warned there might not be a midwife. So I said: ‘I’m staying put.’”

The labour progressed well, but less than 10 minutes before her baby was born, a team of paramedics arrived. “They didn’t interfere,” Sarah says, “but it could have been very different. Some paramedics might have freaked out; they might have tried to get me to do something I didn’t want to do. And they changed the atmosphere, because an ambulance arriving in the middle of a normal birth isn’t ideal.”

When Sarah got pregnant with her fourth baby and was told there was a distinct chance the same thing might happen, she looked into her options. “I read up on unassisted childbirth, or freebirth. It seemed to me that the risks weren’t high, assuming you had a healthy pregnancy and no underlying health conditions.

So I decided to go for it. I was absolutely committed to a home birth “ being in your own space makes all the difference, as far as I’m concerned – and that was my priority. If the health trust could have promised me a midwife, I’d have opted to have one; but as they couldn’t, I thought this was the best way of getting the birth I wanted, with no uninvited paramedics this time.”

Few babies are freebirthed in Britain – the best guess is that there might be somewhere between 20 and 30 a year – but there’s evidence that it is on the increase. The Nursing and Midwifery Council issued a statement on the practice last year, pointing out that a midwife has no “right” to be at a baby’s birth, and that any decision to freebirth should be respected; it prefaced its position by saying that freebirthing was rising in popularity.

Laura Shanley, author of Unassisted Childbirth, who runs a US-based website on freebirthing, says her site is busier than ever, with plenty of interest from the UK. “It’s become much more of a topic than it used to be,” she says. “And in the US there are states where assisted homebirth isn’t allowed, so women have no choice but to freebirth if they want a home delivery.”

That’s not currently the case in Britain, but there is a change coming here that may inflate the freebirth figures. Independent midwives, who have long supported women who want home deliveries and who, unlike NHS midwives, can guarantee availability on the day, are effectively being outlawed: they have been unable to sort out an insurance deal, and from October it’s going to be illegal, under EU legislation, for any healthcare professional to practise without insurance. There are about 170 independent midwives in Britain, and they attend around 3,000 births each year. It’s distinctly possible that at least some of the women who would have opted for a home birth will instead decide on an unassisted delivery.

The Guardian