Freebirthing fad

Freebirthing — giving birth without help from a doctor or midwife — is small but growing trend, reports Denver’s Westword.

The birthing tub had already been inflated and inspected for leaks. Towels and a plastic bucket were laid out to sop up water and other fluids. A blanket was at the ready for swaddling. They even had string and clean scissors on hand to cut the umbilical cord.

Still, this birth would be remarkable not for what the parents had, but for what they lacked: experts. Elizabeth and her husband fully intended to deliver the baby themselves, without a doctor or midwife within twenty miles.

I’m not a fan of home births, even with medical assistance. My daughter would have died if she hadn’t been born across the hall from a first-class intensive care nursery. Most freebirthers will get away with it. But not all.

Although (Tracy) Ryan has tried to smooth the birth process at Mountain Midwifery, she’s still uncomfortable with the idea of unassisted birth. “It’s absolutely true that women have been giving birth throughout time unassisted. And babies have been dying, too,” she says. “If you want to get totally natural about it, death is natural, too. So a very small number of babies and mothers will die, and that’s totally natural. But in our especially litigious society, I’m always afraid of the extremes of both sides of the pendulum.”

Elizabeth was bleeding badly after her daughter was born. Her husband raced her to the hospital and saved her.

About Joanne


  1. Hunter McDaniel says:

    These people should visit an old cemetery sometime to appreciate how many young women used to die routinely during “free” childbirth. Or perhaps they should read a few 19th century novels where maternal death was a recurring plot device.

  2. Yep, there are a lot of things in nature that will kill you. One of the advantages of living in the time we do is that we have learned from our experience and the experience of our predecessors. Some people just don’t get that…

  3. Cardinal Fang says:

    Freebirthing sounds ridiculous to me, and some babies will die because of it.

    Home birth with a trained attendant is a completely different story. Check out the perinatal mortality stats for the Netherlands– best stats in the world, and 30-40% of babies there are born at home with trained midwives.

  4. BadaBing says:

    Most certainly the women that tout freebirthing are white and educated. Going against a prevailing wisdom or practice gives these women a feeling of transcendence and power. If the majority of women were freebirthing, however, you can bet they’d give birth to their child another way just to validate their narcissistic notion of being somehow superior to the non-thinking herd.

  5. SuperSub says:

    Freebirthing brings to mind the Darwin Awards…

  6. Are midwives allowed to deliver at home in every state now?

    Until recently they were not. In my state you could be delivered by a midwife who was under the direction of a physician, and only at a hospital. I have personally met people who have chosen to do give birth at home without any help but they only did so because at the time it was illegal for the midwife to work outside of a hospital. The midwives refused to attend births because it opened them up to criminal prosecution if anything went wrong.

    Freebirthing wouldn’t be my choice either. I think I would be too anxious about a mishap to benefit from the relaxing home environment.

  7. Hunter: For most of the 19th Century, the death rate was even higher when doctors were involved, and highest in hospitals – until medical personnel finally learned to wash their hands between patients, most of the childbirth deaths were due to infections doctors, nurses, and midwives carried from patient to patient. Probably doctors were the worst just because they saw more patients in a day, and because in that era almost all doctors were men and a man might run around covered in blood and slime, but a woman would want to wash up…

    OTOH, there are also conditions that show up during birth that can kill the mother or baby unless properly trained medical personnel and the right equipment is there to handle it. Once the medical personnel and the delivery area have been properly cleaned-up, it’s certainly safer to deliver in a hospital surrounded by experts than in your home with few ways of handling an emergency closer than an ambulance ride to the hospital. (Statistics might not properly reflect the difference, as many other conditions requiring special help are identified well ahead of time, obviously those mothers won’t be home-birthing, and sometimes their problems will be beyond medical help.) If an expectant mother has had the proper doctor visits and everything looks fine, home-birthing is not a huge risk, but those doing it should know that it is somewhat riskier than a good hospital delivery room.

  8. Cardinal Fang says:

    You might guess that hospital birth would be safer than planned home birth, but numerous studies show it isn’t.

    If the US went to a birth system similar to the Netherlands’, where midwives delivered the majority of prenatal and birthing care, we’d end up saving money. And the babies would be healthier too.

  9. Twill00 says:

    Birth statistics are not comparable across countries due to reporting differences. OUtside the US, many newborns that we count are simply disregarded if they die shortly after/during birth.

  10. I don’t believe it’s “absolutely true that women have been giving birth throughout time unassisted”. Even in the most traditional, primitive, or undeveloped societies, my impression is that women prefer to give birth surrounded by the older women of the tribe, including their female relatives, with the most experienced woman taking charge as midwife. Of course, snowstorms and such could force a woman to give birth alone or with only her husband’s help, but surely that has never been standard in any society.

  11. Cardinal Fang says:

    But Twill, there are American studies, comparing American women who give birth at home to American women who give birth in the hospital.

    Like this one:

    After careful matching of all appropriate data, Schlenzka examines perinatal outcomes of nearly 816,000 births [in the US], comparing low risk births outside and inside the hospital and high-risk births outside and inside the hospital. His findings clearly show that the natural approach and obstetric approach produce the same perinatal mortality outcomes for both low-risk and high-risk births.

  12. Cardinal-

    Without delving into the study, on a visceral basis those numbers don’t make sense. If a woman was getting pre natal care, and knew the baby was at risk, why in the heck would she still choose to have the baby at home without a ob/gyn around?

    Maybe I need to check the definition of “high risk” used in the study…

  13. Cardinal Fang says:

    Because she had a breech baby and didn’t want a cesarean? Because she had diabetes but it was well controlled? Because she was a healthy 38-year-old with a healthy pregnancy who wanted to have her baby at home? Because the baby was big, but she had already birthed two 10 pounders vaginally? Who knows?

    A visceral disbelief isn’t very valuable in this discussion without backup facts.

  14. Fang, I think your first paragraph above is right, but it can be summarized as: “high risk” but not “really high risk”.

    It might be a perfectly good and accurate study, but there’s the principle that extraordinary claims require extraordinary proof – and in this layman’s opinion, that applies to a claim that high risk births are as safe at home, or that low risk births are safer. An experiment that would (with a large enough sample size) begin to meet the “extraordinay proof” requirement”: find low and moderately-high risk cases where the woman has selected home birth, have someone who did not know which way the women had chosen match each one as closely as possible to a woman who intends to give birth in a hospital, and wait and see what happened when they gave birth – and then the only two questions left would whether there was some sort of statistical fluke in action here (that is, if you work to a 95% confidence level, up to 1 in 20 studies will be wrong just by random chance), or the integrity and thoroughness of the person doing the matching and the data collection. That is why scientists have to see experiments replicated.

    If I read the abstract correctly, this is not what Schlenzka did. Instead he did a retrospective study where he tried to match up women who had already given birth at home with women in the hospital. Retrospective studies pose an additional risk of unconsciously biasing the sample selection when the researcher already knows how it came out. (It wouldn’t necessarily take a bias towards home birth to tilt it that way; If I was doing it, I might well bend over backwards to avoid falsely confirming my expectation that risky pregnancies are safer in a hospital…) I can think of ways around that, but an abstract isn’t going to have enough information to satisfy me on that point, nor would the full study (which I lack time and expertise to read) fully meet all the objections I could think of.

    Also, I very much doubt that you could find an adequate sample size of the “really high risk” cases going for home birth. So if Schlenzka’s study really is accurate and unbiased, he still overstates his conclusion: he really found that low and medium risk cases are as safe in a home birth, not low and high risk cases.

    Whatever, I’ll agree that if you’ve had your pre-natal checkups and haven’t found a compelling reason for an in-hospital delivery, there isn’t much additional risk in a at-home delivery – and there are plenty of things in life that outweigh a, say , 0.1% risk…

  15. Cardinal Fang says:

    Let’s be clear on the difference between what the medical establishment terms “high risk” and what we might think of as high risk. A medical study would use the medical definition of “high risk,” and that might not comport with our lay intuitions.

    Women who are overweight or over 35 are automatically classified “high risk.” So are women who have had a previous caesarean. Some of those women choose to deliver at home, and midwives wouldn’t automatically try to dissuade them if the pregnancy was healthy.

    I don’t think the study is talking about what we would think of as really high risk pregnancies. Probably very few women in that situation choose to deliver at home, and probably very few caregivers would agree to a home birth even if the mother wanted it. This is a strawman– no one is advocating home birth for an HIV+ woman delivering triplets.

  16. Bill Leonard says:

    Cardinal, you are welcome to your views, and clearly, you are clinging to the idea that home birthing is somehow at least as safe as a hospital birth. I have no doubt a great many counter-culture types agree.

    I just don’t buy it. One reason doctors virtually never make home visits anymore is, as a physician once told me, “there just isn’t really much you can do beyond taking vital signs, perhaps giving shots or dispensing medication samples, and practicing your bedside manner.

    Similarly, high risk or not, if something does go wrong, the chances of survival in a hospical v. at home are simply exponentially higher.

    FWIW, I was born at home, in a rural environment and during WWII. Everything went well, and we were lucky, all things considered.

    Lucky is fine, but it’s not the smart way to bet.

  17. Cardinal Fang says:

    I don’t buy either of your claims, Bill. First of all, I don’t think it’s true that there’s not much a doctor could do at home. Almost every time I see my doctor, everything she does could have been done at my house if she’d brought the same small bag of equipment (and her large store of medical knowledge). Moreover, when I had a bad infection, after I was released from the hospital, I had nurses come to my house to check me out and take care of me. So there’s a lot a doctor could do in my home, if it were cost effective for her to come there. She doesn’t make house calls because it would be costly and inconvenient for her, not because she couldn’t examine, diagnose and prescribe at home.

    Now, as to your claim about the safety of home birth versus the safety of hospital birth. Let’s consider the kinds of catastrophes that could happen in a home birth but not a hospital birth. First, we have to realize that it’s only a catastrophe if it’s sudden, unforeseen and not amenable to home treatment. If it can be handled at home, then there’s no catastrophe: e.g. if a mom starts bleeding out, the midwife will give her a shot of Pitocin (same thing happens in a hospital); if the baby needs oxygen or resuscitation, the midwife will give it oxygen, suction it or give it resuscitation; and so forth. If the emergency is not sudden, the mother and baby can be transported: e.g, if a caesarean or Pitocin augmentation is called for, the mom can be whisked off to the hospital. If the condition is foreseen, the planned home birth will not happen and the mother will give birth in the hospital: e.g. if the baby is way late, as happened in my case, the planned home birth becomes a hospital birth. The incidence of true obstetric emergencies that require immediate action is tiny, but certainly not zero.

    Now, let’s look at the other case. What can go wrong at a hospital but not at home? Unfortunately, hospitals are full of sick people, some of whom are infected with drug-resistant bacteria, and these can infect the immature immune system of a newborn. Whereas the mother is already immune to the bacteria in her house, and she passes on that immunity to her baby, neither she nor the baby are immune to the hospital bacteria. So that’s one thing that can go wrong in a hospital. Moreover, a lot of women are more comfortable at home, and a comfortable mother is going to make for an easier (and therefore safer) birth.

    So there are some reasons why, in the usual case, a hospital birth might be more dangerous, and some reasons why a home birth might be more dangerous. In order to figure out how those risks balance out, we don’t consult our gut feeling. We look at the data. That is why I provided data.

  18. Sharon R. says:

    Statistics or no, I cringe whenever I read about home births. My first and I would not have survived a home birth. My pelvis turned out to be an odd shape where it mattered, which was only found *after* the baby’s head got stuck during labor. I doubt I’ll ever forget the sensation of having the baby’s head pried back out and up during the C-section. That’s leaving aside the preeclampsia that didn’t come on until right on my due-date, and might easily have been missed in a home-birth process. Whee! So much for the (in-hospital) midwife and our nice birthing plan! People are welcome to home birthing if they like, but….

    There’s a lot to be said for already being in the hospital when you find out that (surprise!) you need an emergency C-Section!

  19. Should I sit by the hospital in case I get sick?

    I don;t think pregnancy and birth is about being sick.

    I think Doctors generally practice “Hurry up I got more babies to deliver this hour” This is why I think caesers happen so readily along with epis and the use of forceps and vaacum etc.

    I am keen on an unassisted pregnancy and birth next time because I have had three in hospital and apart from cleaning up after me and feeding me I didn’t feel I needed to be there. BUT this means I must do much more research. I must feel prepared and I must get over my fears.

  20. Cardinal Fang says:

    Sharon, I don’t see why your first child wouldn’t have survived if you had planned a home birth, though most likely you would have ended up delivering in the hospital. For one thing, the midwife almost certainly would have diagnosed your preeclampsia (blood pressure checks and urine tests are basic prenatal midwifery care) and arranged a hospital birth. But even if you had been laboring at home, when the baby got stuck, either the midwife would have known some tricks to get it unstuck (midwives tend to know more such tricks) or you would have been transported to the hospital for a C-section.

    But I’m glad that everything worked out for you and your baby.

  21. Bill Leonard says:

    Fang, are you a medical professional at any level? If you are, say so, and be explicit about your qualifications; the audience will judge your comments accordingly. Similarly, be explicit if you are not.

    Regardless, I think your position can best be charactized as foolish and potentially dangerous. You have my best wishes if you give birth at home.


  22. Cardinal Fang says:

    No, I’m not a medical professional. But I provide data, and you provide insults. You must be a Republican.

  23. Bill Leonard says:


    Yes, I am a republican. But I am a rational man, not a fool.

    No, by your own admission, you have no medical credentials. But you are a true believer in home birthing.

    I will not comment further on this thread.

  24. Ragnarok says:

    Have you taken a look at markm’s post? Doesn’t seem to me that you’ve addressed his points.
    And your shot at Bill Leonard is pretty cheap.