Unassisted childbirth (UC) quite simply refers to the practice of giving birth without the attendance of medical professionals such as midwives or obstetricians. The term was coined by Laura Shanley , the author of a book with the same title. Shanley is known by many in UC circles as the “mother” of the unassisted childbirth movement. On her site, she proclaims that “if you want the job done right, do it yourself”. UC is also known as freebirth, and some people who choose it prefer to call it unhindered or undisturbed birth, or even pure birth.
The word “unassisted” may not be accurate for every woman who opts to give birth without medical assistance because many receive support and assistance from partners or friends. Others opt to deliver their baby completely solo, either while they are physically alone or with only onlookers who do not touch the mother or play any role in the process of labor and birth.
It is probably not necessary to mention that UC is a controversial subject. Even midwife-attended homebirths are uncommon in most of the developed world, and opponents of freebirth see it as unsafe. Judging by internet message boards – like the unassisted childbirth forum at Mothering – and recent articles in the media, UC is on the rise.
Some women who choose to have an unassisted birth receive prenatal care from a midwife or OB/GYN, while others provide their own prenatal care. It is possible to monitor one’s own blood pressure, do urine tests, track weight, and palpate the uterus for fetal position, for instance. Yet others focus instead on the spiritual aspects of pregnancy and birth, and decide to give birth in an intimate environment for religious reasons.
Why choose unassisted childbirth?
Since I first became interested in unassisted homebirth , when I was pregnant with my first child, I got to know many women who had given birth without medical professionals in attendance or were contemplating it. There is one thing that is clear – women decide to give birth unassisted for many different reasons, and it is impossible to make generalizations.
Some people choose to give birth at home alone or with their partner after a traumatic hospital birth. Others would prefer a midwife-attended homebirth but decide to go it alone after they are unable to find the right provider, because midwives are illegal in their place of residence, or because they are not able to attend to women who want a vaginal birth after a c-section (VBAC), or have a breech baby. Some women decide they cannot afford a midwife but still want a homebirth.
Then there are those who believe giving birth is an intimate and sexual act, much like conceiving a child. Some trust God to take care of them during birth, while others place their trust squarely in their own bodies and their ability to give birth normally.
There are those who believe the maternity system has become medicalized to the extent that a natural and healthy birth cannot take place in a hospital, and those who simply prefer to do their own thing. When observers, interventions, and fear enter the equation, the progress of labor and the ability to deliver a baby safely become compromised, according to some who choose UC.
I spent several years living in the Netherlands, and met many women who gave birth safely and normally at home over there. I am sure that living in the country that normalizes birth more than any other contributed to my views about birth. Fast forward to my pregnancy, and I knew I wanted a homebirth – especially in the developing country I was then living in, with a maternity system so bad that anyone with a choice would run away from it fast. I did not want to have to bribe doctors to give me care, have no patient rights, and have my baby separated from me for days following her birth. Neither did I like the thought of compulsory medical labor augmentation, pubic shaving, episiotomy, and breaking the bag of waters.
Finding a homebirth midwife was tough. There is only one in my country of residence, and I did locate her when I was 36 weeks pregnant. The birth went fine, and I was happy to finally hold my baby girl in arms. But when I was pregnant again, I knew that I did not want the midwife, whose approach was too medicalized for my taste. She shouted at me during birth and attempted to cut an episiotomy, before removing the placenta manually after my daughter was born.
Throughout my son’s pregnancy, I provided my own prenatal care and saw an OB a few times for ultrasounds. After gathering information about the physiology of birth, potential complications and how to handle them, I was comfortable giving birth alone. My son was born after a short, relatively painless labor into my own two hands (while squatting on the bathroom floor!). During labor, I felt peaceful and aware of the processes going on within my body. The experience was powerful and uneventful all at once, and while unassisted birth is clearly not for everybody, it is a decision I would make again in if the circumstances were right.