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The Baby's Coming, Don't Call the Doctor

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Do you think you could go for DIY childbirth?

woman giving birth

Ronda Kaysen: Joya had her first two babies in a hospital with a doctor attending and an epidural to numb the pain. The third time around, she was determined to do things differently. She and her husband sat their families down one evening and told them their plan: They'd give birth at home alone, without a doctor or midwife present. They'd have a free birth.

"It's not often that you have a baby," Joya, 33, told momlogic in a telephone interview. "I really felt that I had given the experience away by being in the hospital."

Joya is part of a small but growing number of women who are choosing to forgo medical intervention entirely -- no doctors, no midwives, and often no prenatal care -- for childbirth. They call the choice "free birth," or UC, short for "unassisted childbirth," or DIY, for "do-it-yourself," and find support from other free birthers in online chat rooms and websites.

Childbirth and pregnancy are a natural process, they insist, not a medical one, and the female body is designed to birth babies. Health care practitioners only interfere with that process, causing more complications than they prevent. If a woman is left alone to her own devices, she will know what to do.

"Birth is a natural process that's designed to work best if it's not interfered with," said Danielle Saxon, a 28-year-old nurse in Mississippi who gave birth to her second son in an unassisted home birth in 2008.

Her oldest son, Kai, had been born at a hospital and she found the experience terrible. "I just felt like I was being intruded upon constantly during birth. It was a violation of my body and my privacy," she said.

Saxon, who's studying to be a nurse practitioner, lives in a rural part of Mississippi, and the nearest midwife is more than an hour away. Her options for her second child were limited -- have the baby at the hospital with a fetal monitor and pitocin drip, or have it at home alone. "I really didn't feel like I had a choice," she said.

Her husband, Chad, was skeptical and nervous. Throughout Saxon's eight-hour labor, he asked her repeatedly if she wanted to go to the hospital. "He was not really on board, at first," Saxon said.

It is difficult to know just how many women are birthing babies alone, although free birth advocates insist the practice is more widespread than most people think. Of the 4.2 million babies born in 2007, about 8,000 were reported as being born at home without the presence of a midwife, according to the Centers for Health Statistics. That number reflects babies who could have been delivered by a hapless cab driver, a paramedic, or a woman at home with nothing but her husband and her dog.

Laura Shanley, the 52-year-old author of Unassisted Childbirth, is a central figure in the free birth movement. She delivered five babies in unassisted home births, the first one in 1978, and insists that many women misreport free births for fear of prosecution -- so the numbers are hard to track.

Shanley, who lives in Boulder, Colorado, describes her births as short, painless, and relatively uneventful. One was a breech -- the baby came out feet first, and she just stood and waited for the rest of him to emerge. For another birth, she delivered the baby completely alone while her husband was out and the other kids were napping. When the kids woke up, she put the new baby in the stroller and the family walked to the library together.

"I never felt like I was alone. I had inner help," Shanley said.

Joya described getting a "crazy strong" endorphin rush during her first free birth. It was so thrilling that she had trouble staying patient through her next pregnancy. "Waiting to get to labor was a challenge because I was excited about getting to experience it again," she said. Her son Ketan was born in 2007.

The idea of an unassisted birth does not sit well with the medical community, to put it mildly.

"I try really hard to keep my blood pressure under control," said Dr. Suzanne Gilberg-Lenz, an OB/GYN and momlogic advisory board member. "But I find the arrogance really offensive and the faux-macho feminism hideously narcissistic. Neither of these characteristics are indicators of good parenting, which is, of course, the ultimate goal of giving birth to an actual, real, live baby -- not another accessory or notch on the belt."

Possible risks? Try maternal hemorrhaging, infection, vaginal tears that don't heal properly, babies losing oxygen to the brain, and maternal or infant death, say medical experts.

"If everything goes right, it's great, but if you're that rare person for whom something goes wrong, it's 100 percent on you," said Eileen Beard, senior practice advisor for the American College of Nurse-Midwives.

Indeed, things don't always go as planned. This spring, Janet Fraser, a vocal free birth advocate in Australia, lost her baby during an unattended home birth. Well-known for her fiery comparisons of caesarean sections to rape and episiotomies to genital mutilation, the news that she delivered a stillborn sparked international outrage. She was skewered by the press and blamed on the blogosphere for the baby's death, even though no charges were ever brought against her.

Fraser could not be reached for comment.

Shanley, whose fourth baby died shortly after birth, also bore the brunt of media scrutiny when she wrote about it in her book. "The personal attacks come," she said. The coroner determined that the baby died from a congenital heart defect, and Shanley feels certain that no intervention could have saved her baby's life.

As for other cases where a baby died in a free birth, "There may have been times when a baby might have been saved had they been in the hospital," she said. "But babies can die because of intervention, too ... what about the babies that are dying in hospitals?"

Saxon of Mississippi is expecting her third child in October, and plans to have another free birth. She says she worries that things could go wrong, but what mother doesn't? Her husband has warmed to the idea -- and she's stocked the house with sterile scissors to cut the umbilical cord, flat-sided dental floss to tie off the cord, herbs to help expel the placenta and stop the bleeding, and plenty of clean towels. "Really all I needed was stuff from Wal-Mart," she said.

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34 comments so far | Post a comment now
dean September 17, 2009, 7:24 AM

Good luck with that! I will take my drugs please….

Lara September 17, 2009, 9:37 AM

I’m not sure how I feel about “Free birth” because I’d be terrified something would go wrong. On the other hand, I was in labor for just under eight hours with my third (first twinge to delivery) and probably could have done fine at home.

As for skipping the prenatal care intentionally? That’s absolutely idiotic. With all the things that are preventable with basic prenatal care, not having any is criminal negligence as far as I’m concerned.

Amy Tuteur, MD September 17, 2009, 12:25 PM

Unassisted childbirth could more appropriately be called stuntbirth.

Stuntbirthers like to pretend to themselves and others that this is how birth happens in nature (no, across all times, places and culture, birth is assisted), that birth is so deeply personal and “sexual” that a couple must experience it alone (really? then why are you posting a video of it on YouTube for all the world to see?) and that it is safe. The entire practice would be nothing more than a punch line were it not for the fact that it kills babies, in fact a startlingly high proportion of the babies whose mothers were ignorant enough to embrace this stunt.

Tragically, unassisted childbirth has no benefit for the baby and poses very serious risks. It is a form of medical neglect based on appalling ignorance and extraordinary selfishness and self-absorption. In short, it is nothing more than a dangerous stunt.

Pamala September 17, 2009, 12:48 PM

A friend of mine is doing an unassisted home birth. At first she was going to use a midwife but she’s so stupidly hippie that even the midwife was too modern for her so now she’s doing it on her own by herself. I hope all goes well. She has three other children, one of which had issues after birth, so I don’t know why she’d just assume she can do it by herself. With the past three she did have a midwife at the very least. It’s all very dangerous in my opinion.

Kristen September 17, 2009, 5:53 PM

I guess what frustrates me about free birthing people is that their is A LOT of historical evidence for how DANGEROUS giving birth can be. Women used to die every day in childbirth. Babies would come out either dead or with a lot of problems because there was no medical attention. People need to really look at the danger of this.

Me September 17, 2009, 7:12 PM

Its just me but if “free birthing” is all about not wanting Dr. interference then have it in a hospital, tell the medical staff that they are to stand by but you want no drugs & no interference, that way you can suffer in pain on your own, if you feel you need to, and you can bleed to death on your own if you feel that makes you “a better person” but at least if the baby is in distress it can be saved and helped (& hopefully placed with a family where sanity and common sense rule!)

C September 18, 2009, 9:55 AM

As a medical professional who works with babies and children with brain injuries, I would like to ask people to accept the assistance of a midwife. I do like the idea of looking at birth as a natural experience and not a medical one, but when a baby is in distress, intervention can save their lives!

Oh, and I would have bled out if I didn’t have my baby in the hospital (which would have killed both of us!)

mercaties September 18, 2009, 6:44 PM

Personally, for me I have a seizure disorder so this isn’t even an option for me. But what I can’t understand is why so many women are willing to do this. GOD forbid something went wrong during labor. Are you equipped to deal with a medical emergency? Are you going to be able to handle it if your baby comes out not breathing? What if your baby get’s stuck is your husband really qualified to give you an episiotomy? The list of possible complications can go on and on. Yes, the same complications can happen at a hospital but at least the chances of your baby surviving are good. I’am so sick of hearing these natural hippie women say, chilbirth is natural. You now why women very rarly die from childbirth anymore? Because most babies are born with the assistance of a Doctor or midwife nowadays.

Rebekah September 19, 2009, 1:55 AM

Dr. Amy. Always on a mission. A mission to spread lies about homebirth. I’ve researched many of your “facts” since I first learned of you and many times have found that you are usually doing one of two things. You either take the route of blowing certain aspects way out of proportion. Or you flat out lie. All in the name of attempting to make homebirth look BAD. And while you are working busily to try and rip apart the reputation of homebirthing, hospital births (with their many, many unnecessary interventions, c-sections, and alarming rate of deaths) continue to look worse and worse.

Chrissy September 19, 2009, 8:50 PM

Rebekah, I would like to know your sources because my research as shown the opposite.
There’s a reason why most mid-wives have medical training.

common sense September 22, 2009, 12:55 PM

Why would anyone be so selfish to risk the life of their precious child or let alone theirs? Giving birth is an amazing experience to have, but don’t let it be a tragic one.

Lisa September 22, 2009, 3:28 PM

The maternal death rate is higher in hospitals than it is for homebirths. I don’t know the statistics on unassisted childbirth vs. assisted homebirth, but to broadly say that it’s safer to birth in the hospital is just wrong. It is a lot more nuanced than that.

SesshoumarusGirl September 22, 2009, 5:52 PM

Ah this again!

Women have the right to end a pregnancy, right? So, she also has the right to give birth how she wants, period. If women really want to do this and take responsibilty for it, then have at it. Your body, your choice.

However, it would be GREAT if the medical community embraced midwives and encouraged low intervention birth, that way women wouldn’t feel like they have to squat in their bathtubs to have some say over what is done to their bodies.

The birth its self is just as important as the outcome: healthy mom, breathing baby.

lilikindsli September 29, 2009, 10:19 PM

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Globals October 2, 2009, 9:55 PM

all good things

Kristine October 3, 2009, 7:47 AM

I completely believe in a womans right to choose how she births. But really, I don’t agree with UC simply because there ARE nuances you might not recognize, things that need to be watched. Things wonderful, skillful, respectful & knowledgeable midwives are trained to see. You can hire a very non interventive midwife, but I just feel that you should have someone with you that can respond IF the need arises and simply be there if it doesn’t.

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