unassisted childbirth

While unassisted childbirth does not include the use of medical personnel or birth attendants in a professional capacity, the birthing woman may still wish to have other people present at her birth. This might include her partner, close friends of the mother, the grandparents-to-be, or other family members. These people may take on various roles such as minding the other children in the family, preparing food, making sure the mother remains undisturbed by phone calls, etc.{{Citation needed|date=April 2009}}

A woman giving birth and her partner may wish to be alone together for the birth of their child. Some couples who choose unassisted childbirth consider the birth to be a consummation or extension of their married life.{{citation needed|date=May 2022}} In terms of wanting to have an ecstatic or orgasmic birth, a high degree of privacy is desired. Others may simply consider birth to be an intimate bonding time between the spouses and their newborn child.{{Citation needed|date=April 2009}}

Some women choose to give birth completely alone. They may retreat to a room alone at the time of the birth and then bring their partner in afterward; or they may remain entirely alone in their home or another location. Women who choose a solo unassisted birth may see birthing as an intensely private process, or may feel they have all the resources they need through their intuition.{{cite web|last1=Bay Area News Group|title=Extreme home-birthing, alone and unassisted|url=http://www.eastbaytimes.com/2014/01/28/extreme-home-birthing-alone-and-unassisted/|website=East Bay Times|date=28 January 2014 |publisher=Digital First Media|access-date=1 June 2017}}

Giving birth without any health care provider supervision.{{cite journal|last1=Cooper|first1=T.|last2=Clarke|first2=P.|title=Birthing alone: a concern for midwives?|journal=Midwives|date=2008|volume=11|issue=4|pages=34–35|pmid=24902266}} Sometimes used synonymously with "unassisted birth", and sometimes used to describe any birth without medically licensed professionals present, regardless of who else may or not be in attendance in a supportive role.

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With respect to medical prenatal care, two broad categories are recognized by unassisted childbirth proponents:

Many women who are planning an unassisted birth choose to have professional prenatal care as part of their birth preparation. This may include regular prenatal visits with a doctor or monitoring by a midwife. Seeking the assistance of a doctor or midwife may allow for discovering risk factors that might make an unassisted birth inadvisable, such as placenta praevia. Professional prenatal care may also help identify risk factors that could be managed so that the unassisted birth can continue as planned. Rather than keep to a traditional prenatal care schedule, some women may also selectively choose prenatal care.

Some women who choose UC also choose to have a medically unassisted pregnancy; i.e. they do not visit a doctor or other birth professional for prenatal care. There are potentially life-threatening consequences of having no medical follow-up in case there are complications.

The National Center for Health Statistics reports that of the 4.1 million babies born in the United States in 2004, more than 7,000 were born at home without a midwife or physician attending. It is unknown what portion of these births, roughly equivalent to a sixth of 1% of the nation's annual total, occurred by choice.

It is not currently known how many women in Australia give birth at home by choice without medical assistance. Home births in Australia represent 0.25 percent of all births, with the majority of these done with the assistance of a midwife.{{cite news |last1=Kara |first1=Lawrence |last2=Dunlevy |first2=Sue |date=6 Apr 2009 |title=Four dead in home birthing including Joyous Birth advocate |url=https://www.news.com.au/dailytelegraph/story/0,22049,25294178-5001021,00.html |url-status=dead |archive-url=https://web.archive.org/web/20090407134958/https://www.news.com.au/dailytelegraph/story/0,22049,25294178-5001021,00.html |archive-date=7 April 2009 |access-date= |work=The Daily Telegraph |publisher=}}

A 2021 qualitative study conducted in Poland{{Cite journal |last=Baranowska |first=Barbara |last2=Wergzynowska |first2=Maria |last3=Tataj-Puzyna |first3=Urszula |last4=Crowther |first4=Susan |author-link4=Susan Crowther |date=October 2013 |title="I knew there has to be a better way": Women’s pathways to freebirth in Poland |url=http://dx.doi.org/10.1016/s1871-5192(13)00389-2 |journal=Women and Birth |volume=26 |pages=8 |doi=10.1016/s1871-5192(13)00389-2 |issn=1871-5192 |via=Elsevier Science Direct|url-access=subscription }} examined women’s pathways to freebirth using semi-structured interviews, with the goal of understanding why women were choosing to give birth completely unassisted. The authors note there was “great diversity of pathways to freebirth” seen from the participants. However, all participants reported negative prior experience with maternity care where the women had felt there was a mismatch between their needs and the care they received. Women were more likely to report traumatic experiences about hospital births than midwife-attended home births, but there were negative experiences reported with both. Two themes identified were “persistent and unnecessary use of medical technology” and “rudeness and lack of respect” from providers. All the women interviewed in this study believed that medical intervention had complicated their previous birth experience. Additionally, all interviewed described their freebirth as “positive and empowering” due to an increased feeling of autonomy and the participation of support people.

In response to the recent growth in interest over unassisted childbirth, several national medical societies, including the Society of Obstetricians and Gynaecologists of Canada,{{Cite news|url=https://www.ctvnews.ca/canadian-doctors-warn-against-freebirthing-1.245955|title=Canadian doctors warn against 'freebirthing'|date=21 Jun 2007|newspaper=CTV.ca|url-status=live|archive-url=https://archive.today/20130115091339/http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20070621/freebirth_070621?s_name=Autos&no_ads=|archive-date=15 January 2013}} the American College of Obstetricians and Gynecologists,{{cite news|last=Jacang Maher|first=Jared|url=http://www.westword.com/2007-05-10/news/baby-s-day-out/print|title=Baby's Day Out|date=8 May 2007|publisher=Denver Westward News}} and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists,{{cite news|last=Davies|first=Hannah|url=http://www.news.com.au/couriermail/story/0,23739,21838181-5003426,00.html|title=DIY birthing|date=3 Jun 2007|publisher=Courier-Mail}} have issued strongly worded public statements warning against the practice. Professional midwives' associations, including the Royal College of Midwives{{cite news|last=Press Association|url=http://www.yell.com/health/information/midwives-warn-against-%27freebirths%27?location=Ballymoney,%20County%20Antrim&broaderLocation=|title=Midwives warn against 'freebirths'|access-date=19 Apr 2009|publisher=Yell.com}} and the American College of Nurse-Midwives also caution against UC.

Unassisted childbirth has been linked to substantially elevated rates of both maternal and neonatal mortality. One of the few, and perhaps the only, formal investigation of the mortality rates associated with the practice was conducted by the Indiana State Board of Health in 1984, among members of a religious community in Indiana. The investigation found a perinatal mortality rate 2.7 times higher, and a maternal mortality rate 97 times higher than the state average. In this community, pregnant women receive no prenatal medical care and deliver at home without medical assistance. This community avoids not only prenatal medical care but all medical care.{{cite journal| title = Epidemiologic Notes and Reports Perinatal and Maternal Mortality in a Religious Group -- Indiana | journal = Morbidity and Mortality Weekly Report| volume = 33| issue = 21| pages = 297–8| date = June 1, 1984| url = https://www.cdc.gov/mmwr/preview/mmwrhtml/00000345.htm| access-date = 29 Apr 2009| pmid = 6427572| author1 = Centers for Disease Control (CDC)}}

Unassisted childbirth comes with serious risks. If something comes wrong during labor, the mother and child might need assistance from trained medical staff.{{Cite web|url=https://www.nbcnews.com/news/us-news/she-wanted-freebirth-no-doctors-online-groups-convinced-her-it-n1140096|title=She wanted a 'freebirth' with no doctors. Online groups convinced her it would be OK.|website=NBC News|language=en|access-date=2020-02-22}} According to the president of the American College of Obstetricians and Gynecologists, Thomas Purdon, twenty percent of all previously normal pregnancies turn into complications and high-risk situations during the course of labor that could result in serious adverse outcome to mother and baby, including death.{{Cite news| last = Hutter Epstein | first = Randi| title = When Giving Birth, Opting to Go It Alone| newspaper = The New York Times| date = 7 May 2002| url = https://www.nytimes.com/2002/05/07/health/womenshealth/07BIRT.html?ex=1021735419&ei=1&en=5c3649a5f3fa6d8f| access-date = 19 Dec 2009}}

OB-GYNs do not recommend home births, even when attended by a medical professional, if the mother has hypertension or when a breech birth is expected. A 2010 meta-analysis of existing research concluded that planned homebirths had a three times higher mortality rate for babies.

The UC movement grew out of, and is an extension of the natural childbirth movement, pioneers of which include Grantly Dick-Read, Robert A. Bradley, and Fernand Lamaze. Influential proponents of UC include Marilyn A. Moran,{{cite web|url=http://www.gentlebirth.org/archives/plesbrth.html|title=Books and Newsletters about VBACs, Unassisted Birth and Pleasurable Husband/Wife Childbirth|last=Moran|first=Marilyn A|publisher=gentlebirth.org|access-date=28 Apr 2009}} Jeannine Parvati Baker, and Laura K. Shanley. The Free Birth Society is one influential freebirth advocacy group; it sells online courses and private consultations. The founder of the Free Birth Society and the organization's instructors do not have medical training.File:Jeannine Parvati Last Year.png

Parvati Baker, a yogini, writer, poet, herbalist, and "spiritual midwife", coined the term freebirth to describe UC.{{Citation needed|date=February 2020}}

Shanley, a writer, poet, and self-styled birth consultant, is the author of the book Unassisted Childbirth (1993), which helped popularize the practice. Inspired by the writings of Dick-Read, Shanley, who has no formal training in gynecology or obstetrics, gave birth to all five of her own children unassisted and with no prenatal care.{{cite web|url=http://www.medicinenet.com/script/main/art.asp?articlekey=51649|title=Giving Birth the Old Way|last=Grayson|first=Charlotte|date=15 Apr 2002|publisher=WebMD Inc.|access-date=21 Apr 2009}} Four of them survived; Shanley's fourth child, born four weeks premature in her bathroom, died a few hours later of a heart defect, pneumonia, and sepsis.

Reasons and motivations for choosing to give birth unassisted range greatly from mother to mother; those most frequently cited in unassisted childbirth literature and advocacy sites include{{Citation needed|date=April 2009}} the belief that birth is a normal function of the female body and therefore not a medical emergency.{{cite web|url=https://www.theguardian.com/commentisfree/2007/apr/05/comment.health1|title=While women in the developing world are dying in childbirth, why are we fetishising doing it at home?|last=Bennett|first=Catherine|date=2007-04-05|work=The Guardian|access-date=2009-07-10}} Other beliefs are that most interventions commonly used by the medical profession during birth cause more harm than good in a normal birth, that the mother will be more apt to follow the natural flow of her individual birth in an undisturbed birth setting, thus enabling her to find the optimum positions or techniques to birth her child safely, and the view that birth is an intimate, sexual, and potentially orgasmic experience,{{citation needed|date=May 2022}} and the belief that privacy is essential for enabling this erotic dimension.

Advocates believe that unassisted birth gives rise to a significant increase in maternal feelings and the mother's ability to bond with and take responsibility for the welfare of her child. Some followers are unable to find a birth practitioner willing to attend their desired home birth. In many areas of the United States, there are no midwives or physicians available to assist at home births. Likewise, the woman may find her specific case presents difficulty in finding a willing practitioner, as is usually the case with a vaginal birth after caesarean section (VBAC).

Controversy over the practice of UC has largely centered over whether it is, as claimed by proponents, a safe method of childbirth. Critics of UC, such as the Society of Obstetricians and Gynaecologists of Canada (SOGC), claim that unassisted childbirth is quite unsafe,{{Cite news| title = Unassisted births dangerous, doctors warn| newspaper = CBC News| date = 21 Jun 2007| url = https://www.cbc.ca/news/science/unassisted-births-dangerous-doctors-warn-1.688538}} and that those who engage in it are "courting danger". A spokesperson for the American College of Obstetricians and Gynecologists issued a one-word assessment of freebirth: "dangerous". The SOGC notes that more than 500,000 women worldwide die annually from complications during childbirth, and that even in developed countries, in which expectant mothers generally receive complete prenatal care, as many as 15% of all births involve potentially fatal complications. In poor countries in which there are conditions of malnutrition and taboos surrounding childbirth or there is a lack of qualified birth attendants, rates of maternal[http://www.safemotherhood.org/facts_and_figures/maternal_mortality.htm Safer Motherhood Fact Sheet: Maternal Mortality] {{webarchive|url=https://web.archive.org/web/20070217224033/http://www.safemotherhood.org/facts_and_figures/maternal_mortality.htm |date=2007-02-17 }} and infant mortality[https://web.archive.org/web/20050414232720/http://www.who.int/whr/2005/chapter4/en/index1.html World Health Organization 2005 World Health Report, Chapter 4: Risking Death To Give Life] and complications such as fistula are much higher, with disparities in death rates from childbirth between developed and developing countries approaching two orders of magnitude.{{Cite news| last = Laucius| first = Joanne| title = Obstetricians alarmed over 'freebirthing'| newspaper = Chek News (CanWest News Service)| date = 22 Jun 2007| url = http://www2.canada.com/ch/cheknews/story.html?id=a8fff231-1b2d-4345-b160-406af3830294| access-date = 2009-02-23| archive-url = https://web.archive.org/web/20111006100053/http://www2.canada.com/ch/cheknews/story.html?id=a8fff231-1b2d-4345-b160-406af3830294| archive-date = 2011-10-06| url-status = dead}} Critics also point out the high rates of complication and death arising from childbirth that existed before the development of modern medicine: between 10 and 15 deaths per 1000 births.Van Lerberghe W, De Brouwere V. Of blind alleys and things that have worked: history’s lessons on reducing maternal mortality. In: De Brouwere V, Van Lerberghe W, eds. Safe motherhood strategies: a review of the evidence. Antwerp, ITG Press, 2001 (Studies in Health Services Organisation and Policy, 17:7–33).

UC proponents have responded to these criticisms by emphasizing that childbirth is not a disease, but rather a natural, physiological process requiring proper nutrition, hygiene, prenatal self-care, and psychological preparation.{{cite web|url=http://www.unassistedchildbirth.com/unassisted-childbirth/what-is-uc/|title=Bornfree! The Unassisted Childbirth Page|publisher=Laura Shanley|access-date=9 November 2013}} They claim that both throughout history and in the impoverished regions of today's world it has not been the lack of medical assistance, but rather conditions of poverty and nutritional ignorance which cause maternal mortality to be a major health issue.{{Citation needed|date=April 2009}} Rickets, for example, is prevalent in daughters of malnourished women, resulting in deformation of the pelvis and an increased chance of hemorrhage in scenarios of anemia.{{cite book |veditors=Gebbie DA, Vogel LC, Muller AS, Odingo RS, Onyango A, De Geus A | title = "Obstetrics and gynaecology" in Health and disease in Kenya| publisher = East African Literature Bureau| year = 1974| pages = 485–98 | url = https://books.google.com/books?id=nyRIAAAAIAAJ}} Proponents assert that the women who plan unassisted childbirth today (many of whom are giving birth to their second or third child, with a 'proven' pelvis), do so with a wealth of information and self-care, and are better prepared than most women who depend on care providers to deliver their child.

Some proponents have also claimed that modern maternal mortality rates in American hospitals are often obscured by being statistically tracked under 'anesthesiology'.{{Citation needed|date=April 2009}} However, evidence suggests that if this is in fact the case, the practice is unlikely to account for more than a small fraction of maternal deaths: one study of maternal mortality records lists the total share of maternal mortality deaths recorded as stemming from anesthesia-related complications as just 5.2%.{{cite journal| author = Panchal, S |author2=Arria, A |author3=Labhsetwar, S | title = Maternal Mortality During Hospital Admission for Delivery: A Retrospective Analysis Using a State-Maintained Database | journal = Anesthesia & Analgesia | volume = 93| issue = 1| pages = 134–141| year = 2001| url = http://www.anesthesia-analgesia.org/cgi/content/full/93/1/134| doi = 10.1097/00000539-200107000-00028| access-date = 14 Apr 2009 | pmid=11429354|s2cid=30026609 | url-access = subscription}} A study of anesthesia-related maternal mortality in the United States between 1979 and 2002 found the share of maternal mortality deaths caused by anesthesia to be just 1.6%, and that the share had dropped 59% between the time periods examined.{{cite journal|vauthors=Hawkins JL, Chang J, Palmer SK, Gibbs CP, Callaghan WM |title=Anesthesia-related maternal mortality in the United States: 1979-2002|journal=Obstetrics & Gynecology|date=January 2011|volume=117|issue=1|pages=69–74|doi=10.1097/AOG.0b013e31820093a9|pmid=21173646|s2cid=31489519|doi-access=free}}

Other aspects of this response have also been called into question by scientific research. First, an analysis of historical data from Europe and the United States concluded that in developed countries, the main determinant of maternal mortality before 1937, and its decline since the 1930s, was not levels of poverty and associated malnutrition, but rather the overall standard of maternal care provided by birth attendants.{{cite journal| last = Loudon| first = Irvine| title = Maternal mortality in the past and its relevance to developing countries today| journal = American Journal of Clinical Nutrition| volume = 72| issue = 1| pages = 241–246| date = July 2000| url = http://www.ajcn.org/cgi/content/abstract/72/1/241S?ijkey=15188feef24c66546145d107dadf8a54b8c109e9&keytype2=tf_ipsecsha| doi = 10.1093/ajcn/72.1.241S| pmid = 10871589| access-date = 14 Apr 2009| doi-access = free}}

Second, with respect to UC proponents' claim that unassisted childbirth is a natural process, researchers in the field of paleoanthropology have asserted that assisted childbirth is, in fact, a central evolutionary aspect of humanity, and may date back as far as five million years to when humanity's ancestors first began walking upright.{{Cite news| title = Anthropologist's Studies Of Childbirth Bring New Focus On Women In Evolution| newspaper = Science Daily| date = 25 Feb 2009| url = https://www.sciencedaily.com/releases/2009/02/090217173043.htm}}

On 27 March 2009, Janet Fraser, a leading advocate of UC and national convener of the highly popular Joyous Birth website, lost her child{{cite news| last = Elder| first = John| title = Tragic sequel to home birth| publisher = The Age| date = 12 Apr 2009| url = http://www.theage.com.au/national/tragic-sequel-to-home-birth-20090411-a3hh.html| access-date = 14 Apr 2009}} during a birth assisted only by her partner and a female friend.{{cite news| last = Kara| first = Lawrence| title = Joyous Birth advocate's child birth death tragedy| publisher = The Daily Telegraph| date = 6 Apr 2009| url = http://www.news.com.au/dailytelegraph/story/0,22049,25294329-5001021,00.html| access-date = 28 Apr 2009}} In an interview five days earlier with The Sunday Age, Fraser, in the early stages of labor at the time, stated that she had at no point during her pregnancy consulted with a health professional, and that she intended to deliver the baby at her home without an attending midwife. The cause of death was reported to be cardiac arrest.{{cite news| last = Barry| first = Evonne| title = Fears on mid-wife impact with new birthing regulations| publisher = Herald Sun| date = 19 Apr 2009| url = http://www.news.com.au/heraldsun/story/0,21985,25351078-2862,00.html| access-date = 28 Apr 2009}} A coronial inquest concluded in 2012 that Roisin Fraser's death was the result of a complication resulting from cord entanglement, was almost certainly preventable if the birth had proceeded in a maternity unit, and was probably preventable if the birth at home had been attended by a registered midwife. It also found that Fraser's claim of "birthrape" during her first birth followed a planned homebirth attended by a midwife, where Fraser herself requested transfer to a hospital for epidural anaesthesia, and then subsequently requested a caesarean birth without medical indications and against medical advice.{{Cite report| author1=Magistrate Scott Mitchell| author2=Deputy State Cornoner| date=28 June 2012| title=Inquest into the death of Roisin Fraser| url=http://www.coroners.lawlink.nsw.gov.au/agdbasev7wr/_assets/coroners/m401601l4/roisin%20fraser%20finding.pdf| publisher=Coroner's Court| docket=0817/2009| access-date=28 Oct 2012| archive-url=https://web.archive.org/web/20130419222424/http://www.coroners.lawlink.nsw.gov.au/agdbasev7wr/_assets/coroners/m401601l4/roisin%20fraser%20finding.pdf| archive-date=2013-04-19| url-status=dead}}

{{reflist|30em}}

{{Pregnancy}}

• [http://au.lifestyle.yahoo.com/b/marie-claire/2379/i-gave-birth-completely-alone "I Gave Birth Completely Alone" - marie claire magazine Australia] {{Webarchive|url=https://web.archive.org/web/20090624015627/http://au.lifestyle.yahoo.com/b/marie-claire/2379/i-gave-birth-completely-alone |date=2009-06-24 }}

Category:Childbirth

Category:Natural childbirth