What do mumsnetters think of freebirthing?

[withorwithoutyou]

Just wondered what people on here think of freebirthing as I've never seen it discussed on here before.

My gut feeling is that it's dangerous and an unnecessary risk but I've never really heard the positives - does anyone know much about it, or have experience of it?

"The inference is that the hospital birth CAUSED the PPH! However it's more likely that women who are at a higher risk of PPH are strongly encouraged to deliver in hospital and take that advice seriously"

Actually - low risk mothers birthing in hospital are more likely to have: a c/s, forceps/ventouse, syntocinon augmentation and epidural (all associated with higher rates of PPH) than similar low risk mothers who have chosen to birth out of hospital.

"And by the time you get to hospital, with a serious PPH, it's game over. You've got a very small time frame to work in"

I agree. But look at the figures. In 2003 to 2004, 6 women in the UK died of a PPH. Out of approximately 716000 births. Of these 716000 births about 0.5% would be classified as 'BBA' (ie - born before arrival at hospital, or 'unplanned homebirth'). This means that several thousand women had their baby without a health professional present. A good proportion of these women would have been high risk. Many of these babies would have been preterm. And yet from that year only 6 deaths from PPH, of which probably all happened in hospital. (hard to tell from the research. Overall 2 women died at home out of 108 deaths in total - it's not clear whether the mothers who died at home had given birth at home).

"the single biggest killer of women associated with childbirth is PPH"

Actually major causes of maternal mortality in the UK 2006 were (in order):
-sepsis
-pre-eclampsia
-thromboembolism

Rising rates of obesity and increased numbers of c/s have recently pushed thromboembolism to the top of the list.

In some hospitals only a MINORITY of mothers will get through the birth without instruments, an episiotomy or a c/s.

I have had 3 DCs in 3 different hospitals and have done without any of the above. I haven't drawn up a birth plan, I have just been open minded and gone with the flow. It can work well. If you are going to be suspicious and anti from the start you will most likely get just what you expect. If you have the sort of problem free birth that means you could get away with 'freebirth' then you won't have a problem in hospital either-or at home with midwife.

Ok - so the major cause of c/s and interventions in birth is the mother having a bad attitude on the mothers part?

Aaargh grammar!

You know what I mean.

If you are going to be suspicious and anti from the start you will most likely get just what you expect.

So the women who have a CS, episiotomy or instrumental birth have one because they are suspicious and get what they expect?!? Words fail me....

Have you ever considered that at least part of why you have had three problem-free births is because you are lucky?

Of course I was lucky! I wasn't suggesting that CS etc are because you are suspicious and anti!!
I do however think that a lot of women get very precious over childbirth and write minute birth plans when they haven't experienced it and have no idea what to expect or how they will feel at the time. They want to be in control-even down to policing visitors afterwards-and nature is one thing that you can't control. Even if you have a history of easy births, there is nothing to say that you will carry on 'being lucky' therefore it is irresponsible to put 'having a wonderful experience' for you and DP over common sense and medical professionals.

I have a friend who had baby at home with a painkiller-free labour and midwife and doula. It took 7 hours and went well. Because of this, she remains absolutely convinced (she's a woo fiend in general, it's not just childbirth related) that every woman can do it if they avoid nasty male doctors and harried midwives, do yoga, and 'get in the zone'.

If they have failed (and a neighbour's home birth went sadly wrong, but she ignores this) it is down to the woman's lack of education, her sheep-like attitude to the male-dominated medical profession and her fear of her own body.

Of course, nothing to do with her luck, her physical attributes, the baby's position. And of course she ignores the unusually high attrition rate humans suffer in childbirth compared to other mammals owing to how we've evolved.

She has no idea how patronising she sounds.

I'm genuinely pleased it went well for her. But she fails to see she is guilty of unwitting confirmation bias (as most woo fans are) because it went well for her, she did it correctly, and others effectively 'failed' to get into the zone, 'listen to their own bodies'.

If you want scaring, check out the perinatal (not infant mortality, which is the usual metric) rates in Netherlands, which has half of births out of hospital. Just to put what childbirth can put us through (and we as a species are unique in how dangerous it is for us) into perspective.

She may get a shock next time-she might not like what her body is saying!

...so it's not where you jump out of a plane to induce labour?

oh. as you were.

But exotic given that consultants tend to see births only at a stage of emergency and MWs are rarely there for the whole event what's wrong with a woman trying to at least have a think about the whole thing?
If medicalised childbirth is so great, then why on earth is the CS and instrumental birth rate so high?!!! I don't believe for one second that every CS is unavoidable nor that forceps/ventouse need to be used. Something is not right and I'm willing to bet it's the environment in which these mothers are giving birth in.

I just wanted to add that I think I swerved into homebirthing vs hospital birthing and the OP specifically said not to! Sorry.

"consultants tend to see births only at a stage of emergency " This is a myth. My aunt is an obstetrician and has been present at many a straightforward birth.

The attrition rate for humans is something like 7 percent in a non medical environment. I would say the CS rate is maybe too high and perhaps the medical profession is overly cautious, and the set up of understaffed maternity units lead to events leading to CS and instruments, but ultimately I don't have an issue with overcaution in this area. Others will, I get that.

Actually otcha the perinatal rates may not be as simple as that - I've read somewhere that there is the risk of over reporting and a perinatal death in one country might not equal that in another (ie reported as something else). So I'd be careful about leaping to conclusions.

For example there was a similar issue with comparing rates of heart disease between the UK and France (something Cameron tried to use to criticise the NHS for) - they don't measure in the same way.

Has she been there for the whole thing? One persons experience doesn't mean that all consultants see normal births all the time. If they did then why did the ones I spoke to tell me I wouldn't be able to cope with childbirth as it was my first

The attitude of independent midwives who have been present for a lot more births than consultants and over worked NHS midwives is astounding - I can't see how being "over cautious" accounts for that.

"I do however think that a lot of women get very precious over childbirth and write minute birth plans when they haven't experienced it and have no idea what to expect or how they will feel at the time."

Actually what most people are concerned about is whether they'll be listened to. They're also worried about being pressurised into accepting medical treatment in labour that they might not need, and that they don't understand.

Is it unreasonable for them to feel like that, given the poor quality of maternity care that some women are receiving in the UK at the moment?

"it is irresponsible to put 'having a wonderful experience' for you and DP over common sense and medical professionals".

Most women know that birth isn't going to be 'fun'. They want it not to be horrible, or frightening. They want to know what's happening, be looked after well and be listened to. And usually if they get all these things, and they have a healthy baby at the end, they come away thinking it was wonderful.

I think it's really that you think it's irresponsible and selfish for women to have a strong desire for a reasonable birth experience and to believe that they might have some control over the outcome. And you're wrong in thinking that NOTHING an individual mum can do in labour will ever make a difference to the birth. At one end of the spectrum there are the babies that can't be born without intervention, and at the other end are the babies who will come safely no matter where the mother is and who's looking after her. But in between there are many thousands of mothers who encounter physiological difficulties in labour which might be overcome - with the right approach from both the mother and the midwife. Midwives know this. Some mothers know it.

"consultants tend to see births only at a stage of emergency " This is a myth. My aunt is an obstetrician and has been present at many a straightforward birth."

I'd bet my eye teeth that your auntie doesn't practice in the UK. Or if she does, she deals mostly with private cases.

Obstetricians in the NHS DO NOT GET INVOLVED WITH BIRTHS WHICH DON'T NEED MEDICAL INPUT.

"The attrition rate for humans is something like 7 percent in a non medical environment."

What - 7% of mothers or babies die during birth if doctors are not present?

Ina May's birth centre in the US reports a c/s rate of 1.4%. Not all her mothers are low risk. They deliver twins, breech babies, and women having their 5th or subsequent baby. And 44.7% are first time mums.

I am not against home births and women trying to have the sort of birth they want-just those who think they can do the whole thing alone because they (with limited experience) think that know better.

"just those who think they can do the whole thing alone because they (with limited experience) think that know better."

They don't think they have more medical knowledge than doctors or midwives.

They're not stupid.

They just feel, rightly, that they know themselves better, and are better able to birth their babies without interference.

And you know what? They're usually right!

I understand the desire for a free birth completely. I wouldnt do it though.

I dont think its necessary. You can have a wonderful homebirth with midwives who stand back and leave you too it until you need them IF you are lucky.

By the time I had DC 5 he was my second HB and I knew what I wanted. I was v. lucky to get a couple of MWs who had seen it all and been in the job for decades. They were happy to watch and wait.

Ideal for me.

Much as I fear medical interventions and hospitals I would never consider going as far as a freebirth.

Just to reinforce

Homebirth does NOT = Freebirth.

Ok?

That is why I think homebirth is a good thing-if you don't like hospitals. I am only against freebirth which is irresponsible and self indulgent IMO. Anyone who does it is also expecting the emergency services to rush to assistance when they get it wrong.

Freebirthing started (and is mostly practised) in the US, right?

Because I have lived there, and it is almost impossible to get a homebirth or a MLU birth there. This is the stance of the American College of Obs and Gynaes: "Based on the available data, The College believes that hospitals and birthing centers are the safest place for labor and delivery. Although The College does not support planned home births given the published medical data, it emphasizes that women who decide to deliver at home should be offered standard components of prenatal care, including Group B Strep screening and treatment, genetic screening, and HIV screening." So you can have antenatal care, but no homebirth. This was taken from their webpage. What about midwives? In 23 states it is illegal to hire a professional certified midwife (a qualified independent midwife) as an individual. So you are left with hospital care, or nothing. And hospital deliveries are very medicated. Not to mention very public - a friend of mine had her mother-in-law there (and her mother and sisters) and that is considered normal.

I think that if a homebirth with an independent midwife was available to a lot of these women then they would leap at the chance.

I suppose that I consider it the same kind of situation as someone who has been abused and doesn't want a smear test because it is so traumatic. I know that it's not a perfect comparison, because cervical cancer would only risk one life, not two, but in the same emotional ballpark.

spout

An article on the WHO website cites the biggest cause of maternal death in developed countries to be attributable to "other causes" which apparently "includes largely complications during interventions such as those related to caesarean section and anaesthesia". So walking into a hospital raises your chances of intervention... It's something that someone should be thinking about.

Death from PPH etc is an issue in developing countries.