As doulas, we are increasingly being asked if we will support families who choose to free birth. I am writing this page for potential clients to read and also for fellow professionals, be they doulas, midwives or obstetricians.
I do not believe that this upturn in demand is because families are following a ‘trend’ or that they are being ‘irresponsible’. In fact, I believe the opposite to be true. I believe that they are bucking the current trend of medicalising birth and taking back responsibility for their own safety and the safety of their babies. For many people, choosing to free birth is less about wanting to reject all medial care and more about having experienced a system that repeatedly fails to protect their basic human rights. They are responding to negative experiences, fears, coercion, disrespect, trauma, racism, unnecessary interventions, lack of informed consent, or being ignored within the maternity care system.
For many people, the system has become untrustworthy – they no longer feel that they can trust the information that is routinely handed out – information that leads them to feel afraid and consequently persuades them onto pathways that are not of their choosing -with harmful consequence. I believe that they are all too aware of the harm that can be created by unnecessary interventions and that they are choosing to avoid this.
Birthing without medical attendants being present is not a route for all or indeed for many and it is not the right work for all doulas. As doulas, we have a responsibility to consider our own position with respect to these requests. This is not work for doulas to step into lightly. People deserve support that aligns with their values and doulas need to work within their own boundaries and comfort zone. It needs to be the right fit.
We all know that the physiology of birth is incredible and that it also cannot be perfect. Most of the time, when a woman is truly supported on her own terms in an environment that is physically and emotionally safe, birth works beautifully. And sometimes it doesn’t.
I have witnessed very necessary medical interventions both with home and hospital births and I have always held huge gratitude and respect when HCPs have intervened in ways that I cannot.
If I am approached by a family who has decided to free birth, I ask these crucial questions
- Can I attempt to advocate for you to ensure that you do get the care that you deserve from HCPs? Can we attempt to get a safe plan in place that meets with your needs and values?
- What is your ‘Bottom Line’? At what point do you decide that staying at home is no longer a safe option?
- At what point do you decide that medical intervention will be beneficial?
- Are there any specific considerations that you have been made aware of and how do you plan to monitor and manage these (These may have been described as ‘risks’ by your doctor or midwife)
- Have you considered the possibility of emergency situations emerging?
- Who will call emergency services if they are needed?
- Who will drive if you choose to transfer to hospital by car?
- Who will be making decisions about safety on the day?
- Are your healthcare providers aware of your choice to birth unassisted?
If a family is unwilling to discuss these issues, I’m not the right doula for them. If a family wants to refuse medical help at all costs, I’m not the right doula for them. These are of course their decisions to make, but I also get to decide what I’m willing to be a part of.
This doesn’t mean that I think something bad will happen. In fact, most likely everything will be completely fine. But I am not a “stay home at all costs” doula. I am not a doula who doesn’t want to engage with HCPs.
I believe in informed choice, and that includes having a plan for when things don’t go according to plan.
I believe that most people are willing to accept medical care when it’s truly needed.
I believe that the person who cares most about a baby’s wellbeing is the baby’s mother – the person who has carried them and taken full responsibility for them for 9-10 months!
If you would like to talk to me about free birth, please contact me. I am always ready to ask questions and to listen intently to your replies.
