The first time mother who was criticised for giving birth at home without the support of a midwife has defended her decision saying she felt she had no other option.
Jessie Goetze gave birth to daughter Mahli late last year, but attracted attention and criticism this week when a video of the free birth went viral after being shared on the Australian Birth Stories Instagram account.
The 37-year old photographer said she birthed without the support of a midwife after an extensive search to find one to attend a home birth failed.
"(I have been portrayed) as irresponsible, reckless, following a fad, naive, uninformed and uneducated – all of which I intensely dispute," Ms Goetze told Essential Baby.
"Had we had access to a midwife who could attend a home birth, definitely we would have used one.
"I decided to prepare for birth at home for a number of reasons. An important factor was that our hospital is over an hour away and my mum gave birth to me in an hour and 20 minutes.
"We just kept thinking what if we don't make it. I feared Mahli would be born on the roadside and it turned out this would probably have been the case."
Baby Mahli ended up being born 23 minutes after Ms Goetze's waters broke and 25 minutes after active labour began. The nearest hospital with a birthing unit is in Cairns, an 80 kilometre drive down a windy range.
In addition to the time it would take to get to the birthing unit, Ms Goetze was also concerned she would not be able to labour the way she hoped to if she gave birth there.
"It was very important to me to have an intervention-free birth including no cervical checks, but due to policies and regulations this could not be promised. I am allergic to pain killers and studies show you need less pain management and have a shorter labour in a waterbirth," she said.
Without the option of a midwife and fearing an unsafe birth on the side of a road, Ms Goetze decided to free birth with the help of an experienced doula.
"I was low risk and the pregnancy was completely unremarkable. Baby was head down and she was born at 41 weeks. There were no issues," she said.
"(My doula) Shelly has attended bush births in Papua New Guinea and lots of births at home and in hospital so I had complete faith in her that she would recognise if things weren't progressing or taking a turn and we had plans in place for every scenario, including a transfer if necessary."
Since the video went viral this week Ms Goetze has been flooded with messages from women thanking her for showing them that birth doesn't have to be feared.
"It doesn't always have to be a traumatic event that you 'survive'. Women have told me the video has inspired them to trust their bodies and research their options," she said.
"Having Mahli at home was peaceful and the single most incredible experience of my life. It is a day I look back on with such love. It was both peaceful and powerful, humbling and empowering.
"My wish is for all women to do their research on pregnancy and birth and have a full understanding of all their choices, and for all Australian women to have access to a doula, as I did."
Professor of Midwifery at Western Sydney University, Hannah Dahlen said women needed to be provided a true choice and more midwifery models of care, including support for home birth, to prevent them being backed into a corner and left with no other option but to free birth.
"With highly medicalised maternity systems that do not provide women with access to water birth and active birth support from known midwives it is hardly surprising that women choose to do it themselves.
The safety of home births has been questioned by a number of studies that show a higher neonatal death rate, but the data reveals a significant confounding factor. Namely, that unplanned, emergency home births (that often result in poorer outcomes for mother and baby) are included in addition to planned home births where the mother and birthing team is adequately prepared.
When this is accounted for, the research is undoubtedly in favour of planned home births for low-risk pregnancies, which indicates no increase in neonatal morbidity or mortality rates. Additionally, home birth mums often have better health outcomes and report higher satisfaction levels with their overall experience.
Professor Dahlen said home birth for low risk women attended by competent midwives who are networked into responsive systems is as safe as a hospital birth.
"Doing it yourself with no health professional in attendance is free birth, not home birth and that is a less safe option, but many women are forced to make this choice because they have limited choices where they live or have been bullied and harassed by unsympathetic health care providers," she said.
"The WHO said years ago don't ask women why they don't accept the service you provide, ask why you don't provide a service women will accept. Sadly, this holds true today in Australia more than ever before."