Why would anyone free-birth?

When it comes to giving birth, Mia Freedman is frustrated by women who treat the medical profession as the enemy. Shouldn't we be more concerned with having a healthy baby than with having our fantasy birth experience?

A few weeks ago, I watched a program about an amazing Australian woman called Dr Catherine Hamlin. She and her husband, both obstetricians and gynaecologists went to Ethiopia in 1958 on a three year contract to work in an Addis Ababa hospital.

They quickly became aware of the plight of thousands of Ethiopian "fistula women". This is a severe gynaecological condition caused by difficult, obstructed childbirth and it's extremely common in third world countries where most women give birth without medical support.

It often results in the baby being stillborn and if that wasn't tragic enough, it leaves the mother with a constant and permanent stream of urine and sometimes faeces running down her legs.

The women suffering from this condition quickly become social outcasts due to the associated smell and stigma. They're forced to live alone and destitute, driven from their villages and families.

The mother is merely an instrument the baby uses to be born.

In 1961, Dr Hamlin and her husband founded The Addis Ababa Fistula Hospital where they began treating the fistula women of Ethiopa with an operation they provided for free.

Today, Dr Hamlin has opened multiple fistula clinics all over Ethiopia and has cured many thousands of women while simultaneously training Ethiopian doctors to perform the operation.

Despite being well into her 80s, she still operates and passionately campaigns for a better understanding of the fistula condition and for more medical facilities to be made available to third world women giving birth.

It's an inspiring, humbling story and one that made me think about some western attitudes to childbirth.


A particular fact jumped out at me while I was watching this program: this fistula condition has not been seen in the western world since the 1920s because of the medical facilities available - medical facilities that can provide vital assistance if things go wrong.

And as virtually any woman who has given birth can tell you, things often don't go according to plan. You rarely have the exact birth experience you expected. To safeguard the health (and sometimes life) of baby and mother, sometimes we need help.

Which is why I've always been baffled by women who treat the medical profession as the enemy when it comes to giving birth. Why?

My personal belief is that for birth, the needs of the baby must come first. As Penelope Leach says, the mother is merely an instrument the baby uses to be born. Guess what? It's not all about us.

There's a particularly dangerous practice called 'free-birthing' which basically means giving birth at home without any proper medical supervision, something these women describe as 'intervention'. I become infuriated by women who talk about intervention as some awful concept when what it usually means is something that could help save their baby's life. Or their own.

And while I understand that free-birthing is an extreme version of home-birthing and not the same thing, I've never understood or agreed with the idea of giving birth outside a hospital or birth centre.

Now before you inundate me with statistics and personal stories of fabulous home-births, hold fire. If you had a home birth and it was all wonderful and your baby was born healthy and there were no complications? Then I congratulate you. A terrific outcome.

But it would be naïve to believe that a home birth doesn't involve taking a risk. A higher risk than if you were in a hospital. This idea tends to sit uncomfortably with the home-birthers because I'm sure they believe they are doing the best thing for their babies. But are they?

Anti-intervention advocates will always argue:  "Childbirth is a natural process! Women have being doing it for thousands of years all over the world without medication or hospitals or doctors!"
This is absolutely true. Also true? Babies and mothers have been dying in childbirth for thousands of years. Dying is also natural. So are the complications that necessitate emergency caesareans, episiotomies, forceps deliveries and other types of intervention.

During the most perilous, critical journey of a child's life - birth - why do some women insist on shunning doctors and nurses and midwives and hospitals?

When our babies and children become sick do we eschew "intervention" via doctor's visits and medical treatment? Viruses and infections and diseases are 'natural' too but  do we keep our children at home to let nature take its course?

Of course we don't.

So why apply that philosophy to birth? Is it because we have become such an indulgent society that we insist on having our fantasy birth experience regardless of the associated risks for our baby?

In my mind, the priority should be having a baby - a healthy baby - as opposed to having a birth experience

And frankly? I'm baffled by anyone who chooses to take ANY risk when it comes to giving birth. And you can't convince me that having a birth away from medical support is not taking a risk.

Ricky Lake was in Australia a few months ago to promote her home-birth documentary called The Business of being Born.  She is a passionate home-birth advocate and in one of her interviews, I heard her saying how her home-birth was great because it "made me feel more powerful than anything I've ever done".

Did I miss the part where giving birth was about you? About being powerful? Silly me, I thought it was about ensuring your baby's safe entry from your body into the world.

Celebrity and daughter of boxer Mohammed Ali is due to give birth shortly and recently announced her intentions to have a home-birth on her blog: "As soon as I watched Ricky Lake's DVD I knew home-birth was for me. I was so thankful that I learned that it was an option before it was too late. I want to be in full control of my body and give birth to my son the same way women have been doing for thousands of years. Our bodies where made to birth and I trust the process."

I wonder if women in third world countries 'trust the process'? Growing up, before giving birth themselves, they will have seen first-hand the very natural process of tragic outcomes as their mothers and sisters and cousins and friends gave birth without the benefit of medical assistance.

Do you think the women who walk hundreds of desperate miles to come to Dr Hamlin's clinics - or any women in history - would have rejected the option of "intervention' if it would have increased the odds of a successful outcome for themselves and their babies?

What do you think about free-birthing? Do you think some women place too much emphasis on the birth experience instead of on a safe outcome for their baby?

Discuss Mia's blog and the issue of free-birthing.

Please note this blog is an opinion piece and should not be construed as medical advice.