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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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