unassisted birth: what is it, why i attend them, and why some people don’t want me to.
i’d like to express my deepest gratitude to the mamas who shared their photos with me for this blog. i loved looking at them and i am glad to be able to share them.
unassisted birth art by cameron of wyld magick
birth is political. there is no way around that truth and so having a conversation about unassisted birth really stirs up a lot of emotions. what i’m hoping for is as you read this, you’ll sit with the emotions that come up for you and you’ll do some reflection on how you got to the perspective you have.
though, i know that for some the concept of unassisted birth, or freebirth, is completely new and so, i’ll start there.
what is unassisted birth?
unassisted birth is birth that happens without a medical professional. usually unassisted birth, or freebirth, happens at home, but i’ve heard it done in hotels, airbnbs, and even in tents or yurts in the woods. it is legal in all fifty states and there has always been and there will always be birthing people who choose to birth their babies outside of the system and they choose their choice for a variety of reasons.
they don’t want a regulated professional in their space.
they have experienced obstetrical violence, or birth rape by a medical professional.
they may live in a state or country where it is illegal for a regulated professional to attend their homebirth.
they feel confident in their ability to birth their baby and don’t feel a need for a medicalized professional.
they’ve “risked out” of their home birth because of government regulations put on their midwife and don’t feel comfortable birthing in a hospital.
they don’t want to be bothered by beeps or hands or other peoples energies.
there are as many different reasons as there are people free birthing. but usually, it’s not because they don’t want support. i say usually because i know of people who really do want to birth alone. but for the most part, people who are birthing outside of the system still want the support of a wise woman/doula/birth keeper.
so, what’s the role of a doula in an unassisted birth?
it’s the same exact role of a doula in a birth where there is a medical provider. when i attend an unassisted birth, i’m applying counter pressure, gentle massage, using a heating pad, encouraging the parents, etc. i’m not making any medical decisions, or checking heart tones, or measuring dilation or catching babies. i have even chosen not to weigh baby at births, because parents can absolutely be taught how to do so.
during the pregnancy, if i have a client that wants to learn to do their own care prenatally, i might teach a client to do those things if they want the option. i have many resources i can share so that clients can learn these skills for themselves. it’s not difficult to use a doppler, or interpret a urine strip, or belly map to find baby’s position, and when clients want to do those things themselves, they can and should take responsibility for self monitoring, and decisions throughout their pregnancy and labor. it gives the wisdom and authority of pregnancy and birth back to the birthing person, where it belongs.
scope of practice and practicing midwifery without a license
Allysha fay, unassisted birth mama, and owner of virago birth and beyond
i just want to quickly address scope of practice because it is a huge topic in doula communities. doulas are not bound by licensure or government regulation. we are not medical providers, and so this idea that doulas could violate a scope of practice is a fallacy. i don’t have a scope of practice, because i don’t do anything that requires one.
the second argument against doulas attending unassisted birth is that we are practicing midwifery without a license. but, by only doing what i have always done prenatally and at births, regardless of the presence of a regulated provider, i completely avoid any chance of ‘practicing midwifery.’ i intentionally keep a very wide berth from midwifery and in fact, i would not attend an unassisted birth where the birthing person was not very clear on my role in their birth.
when would i choose not to attend an unassisted birth?
i truly believe that i need to honor my biases and acknowledge what i do and don’t feel comfortable attending. all birth professionals should do so. there is this long standing, and i believe unhealthy, mindset that doulas need to put their biases aside and support whoever comes their way. if i am uncomfortable with a client, or a client’s choices, what the hell am i doing in their space and to the energy there? answer: nothing good. (and for the record, i really mean this. if you support a person’s desire to have a freebirth, but don’t feel comfortable attending an unassisted birth, you shouldn’t be there. i’m in no way advocating for all doulas to be available for unassisted births.)
now, i want to clearly state that just because i wouldn’t feel comfortable attending a particular unassisted birth, that doesn’t mean that i believe that those clients shouldn’t have an unassisted birth. everyone gets to decide on the birth they want to have. they have the right to make the choices that are right for them and their families and i 100% support anyone’s right to birth unassisted and free from regulation.
with that said, i wouldn’t attend an unassisted birth where the client does not understand my role in their birth. i am not a midwife, nor do i want to be right now, and so if a client wants me at their freebirth ‘just in case,’ that is not the birth for me.
i wouldn’t attend an unassisted birth, or any birth for that matter, in a home that is unsafe due to domestic violence. that isn’t a safe place for me, or for the birthing person. in cases of domestic violence, i would support my client in getting the help they need to find a safe home, and resources for themselves and the child coming earthside.
if a client was planning an unassisted birth for financial reasons, they didn’t have insurance or couldn’t afford a midwife, i’d have to sit down with them and really check in with their intentions. because again, i would want to be clear on what my role is and if they’re thinking, oh, we can’t afford a midwife, so we’ll get a doula, i wouldn’t feel comfortable attending that freebirth. but if they are prepared to take ownership of their birthing experience, then i would.
ownership and autonomy
and really, that needs to be what is driving someone to freebirth for me to feel comfortable being in attendance. birthing without someone regulated by the state allows parents to take back the responsibility, wisdom, autonomy, and ownership of their experience. the birthing person gets to decide what they feel comfortable with, and how they would address a situation that might come up. when a birthing person or their partner looks at me and says, “is that okay,” i want to be able to turn it back to them and ask, “what does your intuition say,” or “how do you feel,” or “how does baby look?” that reminds them that they have all of the knowledge and power to answer that question within themselves.
they’ve done the research. they’ve read the books. they’ve practiced listening to their body. they’ve done the work to educate themselves on their fears and then released them. they’ve put down the centuries old societal pressures to look to someone else to answer questions about their body and have begun growing and trusting their intuition and the wisdom that’s inside of them.
but what about liability?
desirae miller, the penssylvania birthkeeper, and coowner of holistically empowered rebel birthkeepers academy of learning, listening to her baby using a fetascope.
there is a fear in doula communities that attending unassisted births opens us up to liability if something goes wrong. so, here’s the thing, sometimes birth outcomes are not what we want. babies and their parents sometimes die. it’s devastating, but it does happen. i have never experienced a bad outcome, but we know they happen and when they do, especially in a homebirth setting, anyone there could be held responsible. regardless of whether or not there is a regulated birth professional there. just ask the many midwives, regulated or not, who are in jail because there was a bad outcome and someone within the medical model decided that it was that midwife’s fault.
the established medical model does not trust birth, or birthing people. so, when you as a doula (or midwife) dare to say, “i trust the physiology of birth. i trust this birthing person to make the right choices for their body,” you stir a decades old pot that does not want to be stirred. when you take the power away from regulated professionals and give it back to birthing people, and then they say, “i don’t need you for my birth to be ‘safe’” you anger a lot of people who like their power. so, yes, when a baby dies, or a pregnant person dies, or something scary or sad happens in the birthing space outside of a hospital, you open yourself up to somebody wanting to blame you for what happened.
Allysha fay, unassisted birth mama, and owner of virago birth and beyond
a couple of things of importance to note. first, babies and birthing people have bad outcomes or die in hospitals at a far higher statistical rate then they do at home, but because we have been taught to believe that doctors are the final authority on birth, they are almost never prosecuted for their bad outcomes. we are seeing a rise in providers getting called out for obstetrical abuse, thank goodness, but very often in cases of fetal or maternal demise, even if they are at fault for what happened, obstetricians are not questioned or held responsible. that’s because they hold a ridiculous amount of power and they don’t want to let that go.
second, in almost every case where a doula or midwife is prosecuted because of a bad outcome, it is not the birthing person or their family that brings charges. (unless of course that person acted dangerously, which isn’t what we’re talking about now and also refer back to what i said about obstetricians.) it is almost always someone in the community around them that believes that birth should never happen outside of a medical providers care. whether or not a baby would have died with or without a medical provider present is not the point, the point is that someone dared to birth outside of the medical system and a doula (or midwife) to be in support of that plan.
why do i attend unassisted births?
so, knowing there’s so much backlash for doulas who attend unassisted birth, knowing there is a risk that someone might not like what i’m doing and report me for “practicing midwifery without a license” even though we’ve already established that i don’t do that, why the heck do i openly attend unassisted births?
because those birthing people deserve the support they want. they deserve continuity of care. they deserve a calm, caring, and reassuring energy in the room with them. and because i trust birth. i trust birthing people. i don’t believe that birth is an emergency or a medical event. i don’t believe that birthing people are sick or broken in some way.
and because i humbly understand my role in birth as a student and a witness. i don’t have any authority over how a birth might go or over birthing people. i don’t believe that there is anything inherently special or magical or powerful about me as a person. but when a laboring person feels supported and comforted and loved and cared for, birth outcomes are better.
so now what?
if you wanna read more about what my birth beliefs are click here.
if you’re uncomfortable with the thought of a person having a freebirth, particularly if you’re a birth professional, i’d love to challenge you to really ask yourself what you believe about birth, and your role in it. consider what pushes you to believe that medicalized birth is safer or better. do the work to remove generations worth of propaganda against midwifery from your mind. ask yourself what you believe about birthing people and their abilities. these are foundational issues that need to be seen and heard within ourselves especially if we work in birth and with birthing people.
if you’re considering having an unassisted birth, please know that you are supported and i encourage you to do the work in preparing your heart and mind for the experience. please consider reaching out to me, i have a resource list i’d love to share with you. if you live in or around central florida and are looking for a doula to attend your unassisted birth (or any out of hospital birth) id love to see if i’m the right fit for you. if you live outside of central florida, i’d love to help you find someone in your community who might be able to support you.
grace and peace to you.
