Unassisted Birth Rights

[Nataliejayne85]

Hi!
I was wondering if anyone could direct me to what my rights are to have an unassisted birth in reality.
I met a nurse yesterday who very bluntly said it was illegal to which I informed her it wasn't!
I am not very far along and I am already being wound up by the medical profession, I don't mind being given the information but I feel that I am being bullied which is why I am relucent to have even midwife present (though may consider if funds allow an indepentant midwife but as I don't want to be checked, I don't want to be causing trouble for a midwife RE her legal responsibilties and requirements). Also having experienced bad medical practice in the past I know saying NO doesn't mean NO to everyone and I do not want to be worrying about people not listening to me.
Also can I have other people in the house at the time of the birth or will they be held responsible if something went wrong, even if I refused their help?
Also anyone know any good legal people to draw up paperwork re unassisted birth if applicable?

Thanks

Sorry but I will judge someone who does freebirthing especially because a midwife has pissed them off in some way. It is naive to think that because it is natural it is safe for mother and baby, it is stupid because you are risking your health abd that of your baby's, it is selfish because you are risking the physical and mental healtho of those around you for no good reason. Especially when there are perfectly acceptable alternatives available such as a home birth.

Sorry am not usually confrontational on mumsnet but I feel that some of you are acting as if giving birth alone is no big deal. It is.

Some of the opinions on this thread are a bit narrow minded.

1. to whoever suggested that freebirthing is like not breatfeeding your baby - here are 2 of my friends stories perhaps you'll think again: a) SIL breastfeed until 18 months. Her son was ill from severe iron and vit D deficiency despite her eating balanced diet b) another friend tried to breastfeed, it didn't work out, developed severe PND and became suidical. With her 2nd baby she bottle fed (took anti-depressants) and bonded really well.

Perhaps breastfeeeding is best (and I have bf both my children) but in the west (with proper sanitation) bottlefeeding is not dangerous.

2. To the op if she is still around - I felt the same in my first pregnancy re: I was wound up by the doctors I met. It just means you need to find alternative care givers. From what you have said an IM midwife would be best - one that you can meet and discuss your concerns with in advance. Would you be able to live with yourself if your baby suffered a birth injury as you did it yourself? Do you mind bleeding top death if it all goes wrong?

As others have pointed out, anyone else in the house (even in a different room) could be prosecuted if no doctor or midwife present.

Tittybangbang

"Can someone address the point I've made - which is that unassisted birth for women with full-term babies, who've had adequate antenatal care, doesn't appear to be that risky, if you look at actual outcomes, rather than speculating like mad about how dangerous it is? "

Don't know if anyone else has answered this yet but in my opinion a BBA baby is likely to be in very good condition as it will have been a short labour and therefore less chance for the baby to become hypoxic. This is becasue most mothers will ring for ambulance or m/w when they realise they're not going to make it to hospital and if the ambuklance or m/w don't make it then its been very quick. A very different situation from a homebirth where the mother doesn't ring anyone and labours by herself for days or hours.

There will be less birth trauma to the mother as well because the figures for hospital birth trauma will include those for forceps, ventouse, episiotomy for fetal distress or shoulder dystocia. Again these things aren't going to happen at a BBA.

Chellesgirl

"did you know cory that electrical fetal monitoring for over a certain amount of time can actually put a baby into distress??? It happened with dd.
"

Have you any research to back that up 'cos my first opinion is what a crock of shit! Sorry but it is.

How are they on homebirths in your area? I have had 2 and the midwife was amazing both times. I was pretty much left to get on with it and had no pain relief either time.

That said, I couldn't have done it without going on a hypnobirthing course and practicing the relaxations for weeks beforehand, using acupressure and having a very supportive husband in labour.

Even if everything goes well for you, which I hope it does, the midwives also do all sorts of things post-delivery.

I had 2 lovely labours but there was no way I was going anywhere straight after and 1st time I didn't have a clue what I was supposed to do, what should be happening to my body etc etc. The bleeding was a shock to me and apparently "it was nothing". Without a midwife there to tell me that I would have thought I was haemorraghing (sp?).

"Sorry but I will judge someone who does freebirthing especially because a midwife has pissed them off in some way." I think you need to rethink that sentence smallorange No one has said that they would freebirth cause a midwife pissed them off. The OP stated that she was thinking off free birthing because of a frinds experience and that of her expereince in hospital, and that of a professional nurse's opinion on freebirthing.

A few midwives have PISSED ME OFF in the last few years, that does not mean freebirthing would be an option for me in my mind...I personally respect the mothers wishes if she is fully clued up on the risks and chooses to birth alone...if it was soooo risky why has the law not made it illegal??? Because that would mean everone who gave birth in the back of a car on the way to hospital would be breaking the law. It is illegal to act as a midwife for the mother and baby in planned unassisted births...just like it s illegal to practice as a doctor without the qualifications because then the risks DO become viable. People Die when others who are not knowedgable of the situation start getting involved in procedures - its completely dangerous. But a mother to birth alone without any assistance (just like she would with a midwfe in the other room not having nothing to do with her labour or birth) has risks, but we do not know the risks...so no one can judge from this point of view...yes help is thier if needed and it could be very silly of a mom who say: is not well, is overweight, has past medical problems, has family history of illness or death related to maternity to birth on her own....there is likely to be problems, however big or small, still problems which most likely will need at least monitoring.
If a mother has had antenatal care that shows she has a low probability of having problems, shes healthy, baby is known to be healthy, then the natural birth process can only be of benefit to both mother and the baby whether being watched or not. at the end of the day, we have medicine like syntometrine to make the third stage of labor safer. Natural 3rd stages occur with no ill effects, some with hemorraging even death, syntometrine can raise blood pressure, which can also cause stroke and death... dont you think its up to the OP if she wants to risk this???? At the end of the day the onus will be on her, she will have to live with the life or death of her baby, any complications and any illness after giving birth if something does go wrong.

Do you judge people that 'cut' themselves while trying to commit suicude/do infact commit suicide??? This is the one most selfish act that I perosnally can think of...You could probably compare UC's to this right??? You either do die or you dont and it lies with you.

What if your baby dies, though? If you're going to draw clumsy comparisons that is akin to murder, not suicide.

chelle, i have to say, i actually have no idea now what you are talking about

and there is a huge difference between giving birth in the back of the car as you are on teh way to the hospital , and a BBA .. and then a free birth , where there is no intention to summon medical help or get to a hospital where help is waiting.

so interesting.. why is freebirthing legal? i suppose it is hard to legislate over this sort of thing, that is such a minority spehre

maybe the majority of freebirthers don't come to the attention of docs and mws as they avoid ante natal care?

i'd be interested to know the legal position exactly and the legal consueuqneces if a baby died due to the mother free birthing and not having antenatal care and tehe was a problem sych as plaenta previa or a difficult presentation that could have bene diagnosed before brith?

but even if it was, it would exclude legally those with the intention to get /reach medical help

so it's a bit of a daft argument

stripey
Gary Mires, senior lecturer a, Fiona Williams, lecturer b, Peter Howie, professor a.

a Department of Obstetrics and Gynaecology, Ninewells Hospital and Medical School, Dundee, Tayside DD1 9SY, b Department of Epidemiology and Public Health, Ninewells Hospital and Medical School

Subject: Randomised controlled trial of cardiotocography versus Doppler auscultation of fetal heart at admission in labour in low risk obstetric population

"There were no significant differences in the incidence of metabolic acidosis or any other measure of neonatal outcome among women who remained at low risk when they were admitted in labour. However, compared with women who received Doppler auscultation, women who had admission cardiotocography were significantly more likely to have continuous fetal heart rate monitoring in labour (odds ratio 1.49, 95% confidence interval 1.26 to 1.76), augmentation of labour (1.26, 1.02 to 1.56), epidural analgesia (1.33, 1.10 to 1.61), and operative delivery (1.36, 1.12 to 1.65).
Conclusions: Compared with Doppler auscultation of the fetal heart, admission cardiotocography does not benefit neonatal outcome in low risk women. Its use results in increased obstetric intervention, including operative delivery. "

"The main justification for admission cardiotocography is that the uterine contractions of labour put stress on the placental circulation; an abnormal tracing might indicate a deficiency and hence identify potential fetal compromise at an early enough stage to allow intervention. Furthermore, a normal admission cardiotocogram offers reassurance. However, the incidence of intrapartum fetal compromise is low in pregnancies that have been uncomplicated before the onset of labour. Thus, labour admission cardiotocography may represent unnecessary intervention. In such low risk cases, confirmation of a normal fetal heart rate by Doppler auscultation should be sufficient.2

Evidence from randomised trials shows that routine electronic fetal monitoring throughout labour results in increased, and probably unnecessary, intervention for apparent fetal distress.3-5 Admission cardiotocography in a low risk obstetric population may therefore result in increased obstetric intervention without fetal and neonatal benefit. We compared the effects of labour admission cardiotocography and Doppler auscultation of the fetal heart on neonatal outcome and levels of obstetric intervention in a low risk obstetric population. "

no, it does not show it causes distress, it shows it causes an increase in intervention for 'apparent' foetal disterss, with no difference in outcomes for those not having CFM

it shows that CFM will increase the risk of intervention , that is unecessary, not that it increases foetal distress

"However, because of being connected to the machine, the mother cannot walk around. This inactivity may prolong labor and reduce oxygen levels in the mother's blood, both of which can be detrimental to the unborn baby."

Kripke, Clarissa C. "Why Are We Using Electronic FetalMonitoring?" American Family Physician May 1,1999.
Sweha, Amir, et al. "Interpretation of the Electronic FetalHeart Rate During Labor" American Family Physician May 1,1999.

Now I agree that some women can move around while having this monitoring done, but the majority of women are laid on a bed on thier back, sometimes on the side depending whether heart trace can be found.
Another problem is the incorrect poistioning of the monitor. Sometimes the Maternal uterine activity is noted and recorded when the pressure of a contraction pushes on a sensor, which is on the underside of a tocodynanometer. Once again, incorrect placement may not completely detect contractions. The sensor on the tocodynanometer must be placed on that part of the uterus that can be palpated easily. If it is too high or too low, the contractions may not be detected.

When a mother is thought not to be contracting efficiently, Syntocinin may be used...therefore putting artificial hormones into the mother that are not needed...the fact that the mother may have already been lying on the bed for numerous amounts of hours and may have reduced oxygen amounts.. If too much oxytocin is given, the contractions may occur so frequently that there is too little time for utero-placental resupply of oxygen and removal of carbon dioxide.

did you not see my post? the research you posted does not support the point you made.
you are so carried away in your own enthusiasm, you are shooting yourself in teh foot!

also, it is possible for a mother to walk around, use a birth ball, remain upright, lean on the bed etc even with CFM.

yes lulu like I said she can move around, but some hospitals (like mine) literally tell you, you cant get off the bed because 'they cant trace the heartbeat' or because the midwives arent capable of attaching the electrodes while the mother is in her 'own' position. I did see your post, I just backed up my post witht he next one...it has been proven that fetal monitoring can interfere with a healthy labour and cause interventions that are not needed...this surely 'ruining the natural birth process' has affects on baby???? As stated this is the risk im associating with EFM ...

a prolonged labour can lead to intervention....a prolonged labour increased by lying flat/staying still with a EFM attached...lack of oxygen leads to fetal destress....how do you not get the correlation im trying to make here????

becasue you said that CFM can cause foetal distress.

the post you made first said it increased intervention due to 'apparent' or i would say perceived distress

this is absolutely not hte same thing as causing distress

a prolonged labour can create issues, but it is not the same as a causal link with foetal distress that is real not apparent.

it is very subjective according to who interprets the CTG

so it does not mean CFM causes foetal distress

the unecessary intervention and possible prolonging of labour due to immobility etc can create more intervention due to possible foetal distress

the distinction is quite clear

we were not discussing ruining the natural birth procves, taht is a different thing entirely causing foetal distress

different thing entirely to causing foetal distress, i meant to say

Chellesgirl - babies can get distressed for all sorts of reasons.

My DD was born blue and not breathing and it was lucky we were in hospital and the crash team could resuciate her (after the midwifes who were there when she was born couldn't manage to (with oxygen)).

a) I was upright / mobile, moving around - standing squatting, on all fours, leaning over beanbag, sitting on birth stool.

b) I was not attached to any monitoring. They held the handheld doppler on my stomach every so often. They knew she was getting distressed because of the doppler - how would you know in an unassisted homebirth? I am guessing that if it was an NHS homebirth I would have been rushed to hospital when she started getting distressed.

c) The only medication I had was gas and air but didn't have any for around 2 hours before delivery.

d) It was not an especially long labour either - arrived in hospital at 7am she was born at 1pm. However it wasn't a very quick labour where I might not have got to hospital in time - I agree that these babies are much less likely to be distressed.

Chellesgirl - totally agree with what Lulumama has said - the statement that "CFM causes fetal distress" is very different to the reasearch that says CFM can lead to intervention. It is also very different to saying that spending your labout flat on your back on a bed causes fetal distress.

Believe me there are plenty of women who don't have CFM who choose to lie on a bed throughout labour and as a m/w spend a lot of time encouraging women to be up and mobile.

The research you link to talks about "admission ctgs" ie; a monitoring on a low risk woman where there is no need to do one. I don't know of any hospitals that still do routine ctgS.

NatalieJayne,

just in case you check back, I DON'T want to encourage you with this at all, I don't even know how it can be done without some help. I was just thinking back and after I gave birth for about 20 mins my body went into complete spasm, artic freezing, and shaking, I had people to put duvet, blankets, socks on etc. Who will for you? Who will wrap up and hold your baby while your body recovers?

Natral birth is a big experience, but success is in the details. I had read Ina May's book a few weeks before and all the birth accounts there helped stay calm during this precipitious birth experience.

I can't help by feel that when you have to ask in the first place about legalities then you know you're doing something dodgy.

It's only a matter of time before some tragic happenings out there tie it all up as far as that's concerned.

The first time having a baby is very abstract, until you hold that baby, it's impossible to know what you risk losing.

But I know where you're coming from and I wish you well and good luck.

Lulumaam Freebirthing isn't illegal because generally one has the right to refuse medical intervention.

The law states "A person other than a registered midwife or a registered medical practitioner shall not attend a woman in childbirth" and there is a specific get-out for "sudden or urgent necessity".

The difficulty is the word "attend" but it is used in the sense of assume responsiblity for the care of. The mischief the law is meant to address is people masquerading as midwives or registered medical practitioners; not freebirth.

right, i knew there would be a good reason why. thank you. i wonder if the OP is ever going to come back !

I was thinking the same thing!!!! sometimes I really feel like not bothering to reply...shes not a troll is she??? does anyone know of her???