Laura Roser's first birth was full of intervention, so when she became pregnant with her second child she was determined to avoid any unnecessary procedures.
The 32-year-old from Mudgee in NSW said being in a rural location she was unable to access a homebirth midwife and her preferred option was to birth at home with a friend for support, rather than go to a hospital.
"I birthed my own baby before and believed my body was powerful enough to do what it needed to do again safely on my own," she explained.
However, due to COVID-19 the family had to move prior to the birth 50 minutes away from the nearest hospital. After labouring at home for four hours, Laura decided she felt safer transferring to the hospital.
Despite the change of plans Laura said it was the best experience of her life and felt empowered. She believes women should be able to readily access a homebirth midwife, rather than freebirth.
Photo: Laura and her doula after the birth of her second child. Supplied
Laura is indicative of women surveyed in Australia's largest study into why women choose to homebirth.
Half the women surveyed said if there was no access to a publicly-funded homebirth or a registered homebirth midwife was not available they would freebirth without medical support.
The Why do Women Choose Homebirth in Australia study, conducted by Western Sydney University found 61 per cent of the 1681 women surveyed said giving birth at home with a registered midwife was their preferred choice.
Professor of midwifery at Western Sydney University, Hannah Dahlen, oversaw the research, and found most concerning was the high number of women who said they would birth alone in a freebirth.
"The majority of women would like to have a midwife attend, but if it was choosing between going to hospital and not getting their homebirth, nearly half would consider a freebirth," Professor Dahlen said.
Women gave several reasons for avoiding a hospital birth including avoiding interventions, inductions, forceps, CTG machines, dissatisfaction with the care they were receiving and pressure to repeat caesareans.
Other factors associated with hospitals such as time pressures being put on labouring women and having been coerced in the past were also cited.
Thirty-two per cent of women described their prior hospital birth as traumatic with six per cent of those leading to PTSD. This was compared to only five per cent of women who reported their homebirth as traumatic with only one per cent leading to PTSD.
Professor Dahlen said the majority of those reporting a traumatic homebirth were due to how they were treated when they transferred to hospital.
"This was all done pre-COVID and it is quite ironic we are now seeing this really exposing the weaknesses in homebirth."
The Australian College of Midwives survey around COVID-19 found 26 per cent of women were reconsidering their choice of birth and 60 per cent were not able to find a private midwife. Three per cent said they had chosen to freebirth.
The Western Sydney University study found one in 10 women who had planned a homebirth experienced a freebirth.
"All this points to an ongoing issue of lack of government support, lack of funding and insurance and continued medical opposition, despite the evidence of benefit and safety to the contrary.
There are only a couple of hundred homebirth midwives in the country. Most of them are in metropolitan areas, so rural and remote women have very little choice and the number is declining.
It is a mounting problem that is not being addressed," Professor Dahlen stated.
"We have got to stop this head in the sand attitude around homebirth. It is time the government listened to the demands of women. There needs to better support around making this a valid option."
She describes women choosing to freebirth, despite having complicated pregnancies as canaries in a coal mine.
"These women are warning us that our health system is often emotionally unsafe. Rather than blaming them for wanting to birth outside mainstream hospitals, we need to recognise and address the issues that are driving them to do so."