Unassisted childbirth

Unassisted childbirth (UC) is birth without the assistance of a medical or professional birth attendant^[1]. Unassisted childbirth is also known as unassisted homebirth, freebirth, unhindered birth, and couples birth. The term "UC" is used to denote that these circumstances were chosen by the mother and were not merely the result of an emergency situation or ill timing. While most UCs do happen within the home, planned homebirths usually include the presence of a midwife or other birth attendant.

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History

The term unassisted childbirth was first coined by Laura K. Shanley in her book which bore the phrase as its title. Shanley had been inspired by the writings of Dick-Read and gave birth to her own children unassisted. UC has grown out of, and is an extension of the Natural Childbirth movement whose pioneers include Grantly Dick-Read, Robert A. Bradley, and Fernand Lamaze. The works of these doctors have received recognition from the medical community and raised the credibility of those who were disaffected with modern medicine's treatment of birth. Other voices that have influenced or reassured many who chose to give birth unassisted include Marilyn Moran and Jeannine Parvati Baker^[2].

Principles

The reasons for choosing to give birth unassisted range greatly from mother to mother but a few key factors are common to most.

• The conviction that birth is a normal function of the female body and therefore not a medical emergency.

• The belief that most interventions commonly used by the medical profession during birth cause more harm than good in a normal birth.

• The sense that the mother will be more apt to follow the natural flow of her individual birth in an undisturbed birth setting, thus enabling her to find the optimum positions or techniques to birth her child safely.

• The understanding that birth is an intimate, sexual, and potentially orgasmic experience ^[3], and that privacy is absolutely essential for the erotic dimension of birth.

• A noted increase in the feelings and ability to bond with and take responsibility for the welfare of her child.

Types

Unassisted with friends and/or family

While unassisted childbirth does not include the use of medical personnel or birth attendants in a professional capacity, the birthing woman may still wish to have other people present at her birth. This might include her partner, close friends of the mother, the grandparents-to-be, or other family members. These people may take on various roles such as minding the other children in the family, preparing food, making sure the mother remains undisturbed by phone calls, etc.

Couple unassisted

A husband and wife may wish to be alone together for the birth of their child. Some couples who choose unassisted childbirth consider the birth to be a consummation or extension of their married life^[4]. Others may simply consider birth to be an intimate bonding time between the spouses and their newborn child.

Solo unassisted

Some women choose to birth completely alone. They may retreat to a room alone at the time of the birth and then bring their partner in afterwards or they may be entirely alone in their home or another location. Women who choose a solo unassisted birth may see birthing as an intensely private process.

Birth preparation and prenatal care

Women who choose unassisted childbirth often educate themselves about birth preparation and prenatal care through online resources, books, and other mothers. Learning about sound pregnancy nutrition, pregnancy fitness options, and other positive practices for pregnant women is useful, whether seeking professional prenatal care or not. Women who plan for an unassisted birth will often explore a variety of birth preparation avenues, including medical prenatal care, personal focus on health, and spiritual introspection.

Assisted

Many women who are planning an unassisted birth choose to have professional prenatal care as part of their birth preparation. This may include regular prenatal visits with a doctor or monitoring by a midwife. Seeking the assistance of a doctor or midwife may allow for discovering risk factors that might make an unassisted birth unadvisable, such as placenta praevia. Professional prenatal care may also help identify risk factors that could be managed so that the unassisted birth can continue as planned. Rather than keep to a traditional prenatal care schedule, some women may also selectively choose prenatal care. For example, they may schedule an ultrasound around week 20 of their pregnancy but not any other prenatal visits.

Unassisted

Some women who choose planned unassisted childbirth also choose to have a medically unassisted pregnancy. Though they do not visit a doctor or other birth professional for prenatal care, they are keen practitioners of informed choice, self-care, and nutritional responsibility. They may view the entire pregnancy and birth as a private affair.

Prevalence

Australia

The prevalence of unassisted childbirth in Australia is rising owing to the policy of State and Territory governments closing smaller maternity units and attempting to centralize birth in large hospitals. Women, particularly from regional Australia, are refusing to travel the large distances required to give birth in a medical setting and are preferring to birth at home. Whilst most home births are attended by midwives, the lack of insurance available for midwives in Australia has reduced the number of midwives available and willing to offer a home birth service. This has prompted a rise in free births.

Controversy

Many critics say that UC is not safe as its proponents claim. In poor countries where there are conditions of malnutrition and taboos surrounding childbirth or there is a lack of qualified birth attendants, rates of maternal^[5] and infant mortality^[6] and complications such as fistula are definitely much higher. Critics also point out the high rates of complication and death arising from childbirth that existed before the development of modern medicine, between 1,000 and 1,500 deaths per 100,000 births.^[7]

However, proponents of the informed choice of Unassisted Childbirth emphasize that childbirth is not a disease, but rather an optimal physiological process that requires proper nutrition, hygiene, prenatal self-care, and psychological preparation. UC proponents point out that in conditions of poverty or nutritional ignorance, maternal mortality becomes an issue, throughout history, as well as modern third world/poverty regions (for example, the prevalence of rickets in daughter of malnourished women, which deforms the pelvis and increased chance of hemorrhage in scenarios of anemia) Proponents point out that modern maternal mortality rates in US hospitals are often obscured by being statistically tracked under Anesthesiology. They also assert that women who choose a planned Unassisted Childbirth (many of whom are giving birth to their second or third child, with a 'proven' pelvis), do so with a wealth of information and self-care, and are better prepared than most women who depend on care providers to deliver their child.

Some governments frown upon UC.^[8]

References

Sources

• Moran, Marilyn (1981). Birth and the Dialogue of Love. Terra Publishing. 0940128012. 
• Bradley, Robert A.; Ashley Montagu (1996). Husband-Coached Childbirth : The Bradley Method of Natural Childbirth, 4th Rev edition, Bantam. 0553375563. 
• Morgan, Laurie Annis (2003). The Power of Pleasurable Childbirth: Safety, Simplicity, and Satisfaction Are All Within Our Reach. Writers Club Press. 0595265464. 
• Parvati Baker, Jeannine (2001). Prenatal Yoga and Natural Childbirth, 3rd edition, North Atlantic Books-Consumer Hlth. 1556433824. 
• Wainer Cohen, Nancy; Lois J. Estner (1983). Silent Knife : Cesarean Prevention and Vaginal Birth after Cesarean (VBAC). Bergin & Garvey. 0897890272. 
• Kaplan Shanley, Laura (1994). Unassisted Childbirth. Bergin & Garvey. 0897893778. 
• Griesemer, Lynn M. (1998). Unassisted Homebirth: An Act of Love. Terra Publishing (VA). 0966106601. 
• La Leche League International (2004). The Womanly Art of Breastfeeding, 7th Rev, Plume. 0452285801. 

See also

• Jeannine Parvati Baker, a midwife, herbalist, author, homebirth, freebirth and anti-circumcision activist