Why some Queensland women are choosing to give birth without medical help

When Ruby became pregnant for the third time, she decided to give birth freely, without the support of clinic staff.

“I didn’t want to be born to fight with anyone because I wasn’t very good at fighting. [the first] time,” he says.

“I felt like I would be most emotionally safe when I was born with my close friend, my partner, and my children, and that’s how it happened.”

Focus on free births

Free births refer to births that occur outside the hospital or medical system, usually at home, in an environment where a medical professional is not present.

While some women choose to give birth alone or with their partners, others are assisted by a doula, or “birth guardian,” who is not legally recognized and often not medically trained.

Although not a new practice, free birth has been the subject of renewed scrutiny following: The death of 30-year-old influencer Stacey Warnecke in September, A person who experiences serious bleeding during free birth.

Royal Australian and New Zealand College of Obstetricians and Gynecologists and Australian College of Midwives released a joint statement this month It called for tougher legislation to penalize doulas who undertake clinical duties during home birth, and for labor and birth management to be explicitly restricted to “appropriately trained, registered practitioners”.

Maternity advocates said such laws would restrict women’s choice and autonomy and alienate those who distrust birthing systems from medical support.

Queensland Health Minister Tim Nicholls said he was concerned about reports of damage and deaths in free births where doctors or midwives were not present, but did not publicly say whether stricter legislation would be considered.

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“We make it clear that here in Queensland we support specialist obstetricians, practicing obstetricians and midwives who are qualified and appropriately trained to manage labor and birth independently,” says Nicholls.

“When things go wrong outside the hospital, the first thing done is to call the Queensland Ambulance Service and the patient is taken to hospital. If birth goes wrong, the hospital remains the safest place for a woman.”

But other mothers and advocates, including Ruby, say discussion of changing laws overlooks why many women choose to give birth outside the system in the first place.

“These laws feel dangerous. It feels like they’re trying to control women instead of controlling them.” [addressing] other things that we know will improve outcomes,” says Ruby.

Why do women choose to give birth outside the system?

Dr Melanie Jackson did her PhD on why women turn their backs on the hospital system.

Private home birth midwife and host Great Birth Revolt The podcast found that many people give birth free due to inadequate birth care options or because they believe it is the safest route.

“Unpaid birth is a symptom of a maternity care system that is failing to meet women’s needs,” Jackson says.

“And so women took responsibility for their own care and their own needs by making this radical decision to free birth.”

Some of these needs arise from lack of choice, high intervention rates in hospitals, and previous birth trauma or obstetric violence.

Alecia Staines, founder of the Maternity Consumer Network, says statistics show one in three women experience birth trauma, often through the hospital system.

A recent survey of women in Queensland has revealed “disgusting” experiences, from birth mothers being subjected to vaginal examinations without their consent to being disrespected by healthcare workers.

“Everything is well and good [for peak medical groups] point finger [at unregulated workers and freebirthers]But if they had landscaped their own backyards this wouldn’t have happened,” says Staines.

Jackson says her research concluded that birth outside the system “is a medically motivated problem that would not exist if the birth system were truly meeting women’s needs.”

Staines agrees. “You don’t get radicalism when you put everything else in order.”

home birth

Like Ruby, Philippa Scott chose free birth after two traumatic medically assisted births.

“I had my first baby at a private hospital under the care of an obstetrician. It resulted in a C-section that I didn’t need,” says Scott. “I later went to a public hospital and had a vaginal birth after a cesarean section, but I was still subjected to violence and pressure related to birth.”

There was no midwife available to perform a home birth for baby number three, so Scott decided to have a free birth. The fourth was born at home, but with a male midwife present.

Jackson said many of the women she spoke with wanted to have a home birth with a midwife or take advantage of a publicly funded program but were unable to access services.

Private home birth midwives can cost up to $7,000. In the 10 years since her research was published, the number of publicly funded home birth programs across the country has increased from 16 to 20.

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There is only one in the whole of Queensland, based at the Sunshine Coast Hospital, which was introduced in July last year.

Scott, currently coordinator of Home Birth Australia, lives in the Noosa Hinterland, not far from the Sunshine Coast home birth programme.

She supports the initiative, which has helped more than 40 women give birth at home in its first year. But she says she has heard from women who were not accepted or removed during pregnancy due to strict eligibility criteria.

“Women are giving birth freely because they planned to have a home birth all along, and then suddenly they are told they are no longer suitable – and there are no evidence-based reasons for this,” says Scott.

Queensland’s Chief Midwife Officer Liz Wilkes says she has seen an increase in demand for home birth services, particularly due to Covid-19. While other hospital services have expressed interest in the home birth program, she says it will take time to expand to other areas.

“We can’t really increase access unless we have the workforce to do it,” Wilkes says.

“My biggest priority now is to find the right qualified people with the right skills, in the right place… so all Queensland women have access to quality maternity care.”

Choice, access and autonomy

Some women are philosophically aligned with free birth and ideologically opposed to medical intervention. But all mothers and practitioners who spoke to this imprint said respecting women’s birth choices and autonomy and improving mainstream birth care are priorities.

“The woman needs to be the one who has physical autonomy and can make choices about her own care,” says Wilkes.

Scott notes that these choices are based on access. “There’s definitely a ‘why’ [behind people birthing outside medical systems]If we focus the conversation around that instead of blaming, what is the solution and what do women want?”

Ruby isn’t sure if she’ll be able to give birth freely if she gets pregnant again, but she says despite recent tragedies, she hopes people can look at the choices women make with more compassion.

“Most women themselves have fears about this. [freebirth] It is the right decision to make. “This has definitely crossed my mind many times,” he says.

“I think almost every mother wants her baby to be born well and healthy and have all the medical care she needs… but you don’t get to decide what someone else wants to do.”

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