Freebirth. Fallen out with my friend. *title edited by MNHQ*

[whateveryouneed]

Friend is 3 months pregnant. We've been friends for around 5 years. Saw her today for the first time in 8 or so weeks. She was asking me about my pregnancy and son's birth. I was honest with her and told her how it went (she already knew a fair bit but not finer details). She said it scared her a bit hearing about my son being born blue and floppy, completely flatlined. He had to be intubated and resuscitated (he's 100% fine and healthy now).

The reason it scared her is because she's planning a freebirth. She wants to give birth in her bathtub at home (rural, about 18 miles from the nearest town, further from nearest hospital). She wants no medical assistance. Just her and her husband.

I told her (fairly firmly) that I think she needs to rethink that idea and that it could be really dangerous. She thinks that because she's not high risk (at the moment), that the chances of something going wrong are minimal. She thinks that if baby is head down that she will be fine.

AIBU to be really scared for her if she goes through with this? She's just told me she can't be friends with me throughout her pregnancy if I can't support her choice.

Not sure what to say or think...

@Merryoldgoat

My son was head down at 36 weeks. Breech at 38. Head down at 38+3 when I had to go for assessment. Breech 38 + 6 when I went in for section.

Her scan could mean fuck all.

My DS turned during labour...head down at the start, then went breech. Result was EMCS

@oblada I don’t understand that type of thinking. I had my preference for births but ultimately my birth plan was whatever is safest for my baby. I struggle to understand those who put their needs and feels above the safety of their unborn babies.

oblada
I agree with a lot of what you're saying in your posts.
I don't think birth centres are necessarily a magic solution. There is a birth centre attached to my maternity hospital and it's amazing but unfortunately there are very few births there, because a huge number of women get whisked to the delivery unit (happened to me, and the stats confirm that it's common). Of course in some cases it's necessary but in other cases it could possibly be avoided.
I think that the way in which maternity care is delivered is a bigger factor. There are very established ways of doing things, which involve low thresholds for intervention, and these are presumably designed to minimise risk and protect the mother and baby, but if we look at how it actually works in practice, I agree with you that it's not always ideal. I also think the attitude of the midwife is absolutely critical - I would hope that most midwives are respectful and supportive, and give women information and options, but unfortunately some aren't (I was unlucky). I think that's more important than the actual setting in which you give birth.
I had an interesting discussion with my doula about the big difference in power dynamics between a home birth - which is your territory so you're in charge - and any kind of setting, whether birth centre or hospital ward, because the HCPs are in charge, they literally decide whether to let you in or not (and, at the moment, who to allow in), they can send you home or keep you in a waiting room or whatever. And that power dynamic can affect the whole experience.

Andwoooshtheyweregone - I'm sure it is also in the OP's friend's mind but her assessment is different and not necessarily invalid. I never really considered a free birth (until briefly during lockdown but thankfully I never needed to conclude on this as I got my homebirth back on the card) but I can understand why some women may consider it. It is their right and if it is an informed decision then why not. It's definitely not black and white ie hospitals are safe and everywhere else isn't. It's a lot of shades of grey.

NameChange30 - that's a good point re power dynamic. Probably another reason why I don't want to go to hospital. Once you're there you lose an awful lot of control.
I think we need to rebalance how births are viewed. Yes the medical profession has removed or mitigated some serious risks to women during labour/birth. But I think that balance has gone too far towards medicalising the whole experience, creating other risks.

So frustrating for you OP, I would feel the same. I was also low risk and had amazing pregnancy (still running towards end of pregnant and felt amazing and strong, did all the hypno birth / yoga etc) but ended up having to have emergency c-section. Turns out even though I was petite I had an absolutely massive baby which would never come naturally - physically impossible.,

People who have successful home births with no complications are going to think hospital births are too clinical ( like my dm)

People who have unexpected significant birth issues are going to think that the risks of birthing are underplayed by the reduce medical supervision group.

There is no shade of grey about the need for immediate medical intervention when you need an emergency c section due to a breech cord prolapse and your dc ends up needing resuscitation before intensive care.

I thought my dc had died because the hospital staff thought that, DH ended up with clinical depression and needed trauma counseling. It was very difficult and everybody lived and was physically well in the long run. We were very lucky but it was still hard. It would only have been worse with less medical supervision because dc would have died and I might have as well.

Childbirth is a dangerous activity with a high mortality rate naturally.

I couldn't support anyone who would want to do this either. Having zero medical assistance is very dangerous!
I have birthed 6 children. One of them was blue and floppy due to meconium aspiration. Another had the cord wrapped around her neck so tight she could have died. And I have an angel who was stillborn after a completely uncomplicated text book pregnancy. Each of these went unnoticed, until during labour/birth. If I wasn't surrounded by medical professionals, I would have lost 3 babies instead of 1.
My opinion is you must never give birth knowingly without at least a trained midwife present.

I think we need to massively develop birthing centres - near hospitals but not within the hospitals.

I agree with this. We have an INCREDIBLE birthing centre in our city - I went there for a postnatal appt and felt so jealous of the women that had been able to give birth there (cds for me as type 1 diabetic).

I don't see why double beds, mood lighting, birthing pools and tea/coffee facilities are not standard for every delivery room. Well, obviously money, but it seems unfair that low risk pregnancies have such lovely surroundings whereas women that are high risk and already stressed have a small clinical room which feels like a dentists.

There are also fetal heartbeat monitors that are wireless and can be used in pools, however only a few trusts seem to have them.

I think a more peaceful and relaxing delivery environment would really help women relax and feel more satisfied with their experience.

endlessginandtonic - there are also many women and babies left injured and traumatised (and worse) by unnecessary medical interventions. Yes of course a home birth can have risks. And free births probably are higher risk compared to home birth (although I haven't researched it in details). But the evidence does show that hospital births have many significant risks too. It is definitely not black and white, not simply safer in hospital.

"Childbirth is a dangerous activity with a high mortality rate naturally".
You're confusing childbirth and the whole pregnancy. Yes without antenatal/natal/postnatal care at all throughout the risks are high. But it doesn't mean birthing should be medicalised/done in a hospital setting. There are various factors to consider.

Fwiw the thread has focused on birthing. It seems that the OP's friend has also decided to forego some of the antenatal care and that does seem reckless without any background as to why. If it was my friend I'd try to understand why and help her research the pros and cons.

"it seems unfair that low risk pregnancies have such lovely surroundings whereas women that are high risk and already stressed have a small clinical room which feels like a dentists."

Agree with this. But...

"I think a more peaceful and relaxing delivery environment would really help women relax and feel more satisfied with their experience."

As I said in my previous post, environment isn't everything - it depends on the midwife who is responsible for your care. You can be in the loveliest room ever and if your midwife is a bitch, it's going to be traumatic. Equally, the clinical hospital rooms aren't ideal, but if you have a respectful supportive midwife then it's going to help.

OP I think your friend is being an extremely selfish idiot. I say that as a now bereaved parent. My DD was stillborn last November at 41 weeks. We lost her during labour.

I had a very straightforward low risk first pregnancy. Went to all my appointments and scans showed all was fine. However even with going to all appointments no one picked up on the fact that my daughters growth declined at 38 weeks. This contributed to her struggling during labour, her heart rate decelerate and after over 48 hours of labour she was gone. I was in hospital too, had we been at home on our own, I'm not sure if still be here either.

We have been and still are totally devastated by our loss. Our lives will never be the same again. This may sound harsh but I cannot explain the agony of expecting to come home with a baby and coming home with nothing but empty arms. I wouldn't wish this pain on my worst enemy. In your position I would cut my friend off anyway, for her completely irresponsible attitude to her and her baby's life.

@NameChange30 well obviously not, but it isnt either/or is it?

@shelfiesonherownwings “sorry for your loss” doesn’t even cut it here, that’s heartbreaking, sending so much love your way

Well no, but the point I was making is that environment isn't everything, and the quality of care from health professionals is more important IMO.

I think it's a tragic waste that my hospital has an amazing (and expensive) birth centre that's barely used.

Hi OP I have freebirthed a baby.

Not on purpose. I was left alone by hospital staff and he was born very fast, cord snapped and he was blue. I had to shout for staff and when they did come, they had forgotten cord clamps so couldn't fully clamp the umbilical cord.

It was very scary and I am so glad there was a paed on hand. The hospital obviously badly mismanaged but at least when they finally clicked into action, there was help.

Imagine that with no help available.

I would never choose to FB and I say that as someone who had a homebirth with DD1.

.....all that said, I couldn't cut off a friend for this. I would personally keep channels of communication open. She may get cut off and unable to talk to others if she is also not attending MW appts and may need a friend.

sheflies I am so so utterly sorry. Your poor baby, and you. There are just no words.

there are also many women and babies left injured and traumatised (and worse) by unnecessary medical interventions

The answer to that is not to withdraw from expert care though.

But the evidence does show that hospital births have many significant risks too. It is definitely not black and white, not simply safer in hospital.

There are instances where home births are as safe if not safer than hospital (low risk second births, following straightforward first deliveries).

However it’s ludicrous to suggest that a free birth could be anything other than more dangerous than a expert assisted birth. There are many things that can go ‘wrong’ in a birth that can’t be predicted.

I had one beautiful home birth and another that was meant to be a home birth and ended up being transferred to hospital despite everything being spot on throughout the pregnancy. DD died.
For DS I was induced three weeks early because I was litterally losing my mind from the fear and trauma of DD’s birth. Thank goodness I was in hospital as I lost too much blood. He was born and the first thing I said was “is he alive?” He let out a cry and I relaxed. As I did I saw DH (ex military) and the Midwife’s faces drop at the sight of the volume of blood. I thought I was dying but I was so at peace because DS lived and I thought i’d See DD again. Luckily I’m here to tell the tale but it could have been very different.

there are also many women and babies left injured and traumatised (and worse) by unnecessary medical interventions

How do you define unnecessary interventions?
On another forum I came across a lady traumatised by her EMCS with DC1.
She was advised to have a planned CS with DC2 but declined wanted a Natural Birth. She got her Natural Birth but went home empty handed.
By the time she had DC3 she saw the light and had a planned CS.

What caused the most trauma?

Blackbear19 - I cannot answer what causes the 'most' trauma as you are giving only one example and that example is of a woman not following medical guidance. What I am saying is that women and babies can also be left injured/traumatised and indeed die because of needless interventions. A basic example could be an epidural which wasn't needed/requested and wasn't administered properly/went wrong. One woman I met was left permanently disabled as a result. I appreciate this is probably much less likely now but it is something that stuck with me at the time. There are also instances of women being induced without any medical need and that can lead to a cascade of interventions which can also go wrong further down the line. When I was in hospital with my first they were trying to push using forceps and episiotomy without there being an actual medical need for either. Ultimately the medical profession isn't perfect and there are many cases of professional negligence as well as evidence to suggest that merely being in hospital
to give birth increases the risk of intervention and every intervention comes with risks of its own, some small and some much bigger.
Of course it is always difficult to determine where the 'fault' lies and the 'what if'. I am just saying that it is not black and white. As mentioned however I would not agree with withdrawing completely from antenatal/postnatal care and I haven't researched free birthing enough to say that this is something I'd really want to do. But I can understand that some women may make that choice and if it is an informed choice then it is absolutely their right.

@WhiteCliffsBeside

Induction of labour (often done unnecessarily) ie starting labour before baby is in an optimal position and causing a very long drawn out labour, artificially rupturing membranes, hours and hours of an oyxtocin infusion, leading to a greater likelihood of requiring an epidural, meaning the woman is exhausted and on her back - all major risk factors for all the complications that you describe

Why would healthcare professionals unnecessarily induce babies? Pretty sure there will be evidence-based criteria for doing so, or is it just for shits and giggles?

I don't know what you mean by shits and giggles, sorry! But to explain - the UK has pretty much double the induction rate of the Netherlands, were maternal and neonatal outcomes are considered to the amongst the best in the world. They have a very high homebirth rate too.

An arbitrary time limit is put on pregnancy here, evidence shows that a pregnancy can safely continue beyond 42 weeks with regular monitoring, though this should of course be maternal choice and dependant on many factors. NICE guidelines state induction is not necessary based just on estimated fetal weight, yet everyday labours are induced due to 'big baby' (which often they aren't anyway). In my trust, every woman with GDM is induced at 39 weeks yet current guidelines now state if it is diet controlled, the pregnancy should be allowed to continue. In my trust, some of the consultants offer private antenatal care then come into the NHS for intranatal care, but that consultant oversees the birth. They therefore schedule those births to days they are on duty so they encourage induction. There are also many inductions for pelvic pain, but are these women counselled about the risks of induction, compared with waiting a week or so for spontaneous labour? They have managed 9 months, can they manage another week or two?

Many many many inductions are unnecessary. Often social inductions, when women have major childcare issues for example or a DH who has a very short period of leave from the army etc. I am very sympathetic, but again, are these women fully counselled on the risks?

An induction rate of 40% is absolutely unjustifiable. Is it for 'shits and giggles'? I don't know because I don't know what that phrase means. But I can tell you that a lot is defensive practice, no one wants to refuse an induction in case something then goes wrong with the pregnancy. Some is well meaning, eg the 'large baby' and the connection with shoulder dystocia. However the reality is that induction leads to increased instrumental deliveries, which is a big risk factor for shoulder dystocia. Only half of babies that suffer it are macrosomic. If there is genuine concern that a baby is so big that shoulder dystocia is a big concern, wouldn't it be safer to offer a caesarian? But this doesn't happen, induction is offered instead, which if anything may well increase the risk of SD.

Induction absolutely increases many risks so should be reserved for cases were the benefits of getting baby born outweigh the risks of induction.

Hopefully this answers your question.....

I’m very sorry to hear that @Shefliesonherownwings

@IHateCoronavirus

I had one beautiful home birth and another that was meant to be a home birth and ended up being transferred to hospital despite everything being spot on throughout the pregnancy. DD died. For DS I was induced three weeks early because I was litterally losing my mind from the fear and trauma of DD’s birth. Thank goodness I was in hospital as I lost too much blood. He was born and the first thing I said was “is he alive?” He let out a cry and I relaxed. As I did I saw DH (ex military) and the Midwife’s faces drop at the sight of the volume of blood. I thought I was dying but I was so at peace because DS lived and I thought i’d See DD again. Luckily I’m here to tell the tale but it could have been very different.

I am so sorry that happened to you I hope you don't carry any guilt. You were only doing what you believed to be best for you and your baby and statistically that absolutely is true. But sadly you and your precious baby were that small minority, the reality of which brings home that 1:1000 or whatever is irrelevant when you are the '1'. I don't know the circumstances obviously, so I don't know if your baby would have had a better chance of survival if born in a hospital, but regardless of that, you absolutely must not blame yourself for doing what was believed to be the right thing at the time.

@Spidey66

I thought it was illegal to give birth without a midwife or doctor available (emergencies excepted, of course).

I think it's illegal for an unqualified person to act as a midwife or doctor but not to give birth alone or with someone else there (doing nothing).

Tell her to be very sure of ambulance response times in her area and remind her that Paramedics are not experts in managing difficult deliveries.