The Freebirth Study

This text is a useful overview of freebirth. It was written on behalf of AIMS for people who are contemplating freebirth and for health care practitioners who may encounter someone who has made this decision. In line with the goal of promoting human rights, it outlines the relevant law, ethics and issues that pregnant women and people may encounter when interacting with midwives and doctors. Although it does point readers to interesting academic publications, it is focussed primarily on practical considerations and ensuring that people understand their rights and remits.

The Conversation asked me to write an article on the risks associated with freebirth. Given that those risks are unknown (there’s no studies on them), I instead wrote an article on the risks women are trying to avoid when they freebirth. From my own research, I know there are all kinds of risks associated with birthing in the NHS maternity system, but in this article I focus largely on obstetric violence.

This document is the full PhD thesis which I wrote for The Freebirth Study. It contains the analysis of all the women’s freebirth accounts and material that is as yet not available in academic publications. It contextualises women’s testimony with exploration of obstetric violence, social condemnation and punishment for women who do not conform to expected standards of behaviour, and the laws/policies that underpin the right to freebirth. In addition, it provides a detailed approach to the Voice Centred Relational Method and the use of the ‘heroine’s journey’ as a method of presenting qualitative data.

A meta-narrative is a form of literature review. In this article my goal was to understand how different people in various academic disciplines had written about freebirth over time. The texts I found on the subject range from 1957 to 2018 and appear in publications in countries such as USA, Peru, Canada and The Netherlands. The topics discussed are wide ranging. They include consideration of birth trauma, the role of religion, the needs of indigenous women, stigma and the ethics of incarcerating pregnant women as a way to ensure they give birth with health carers present.

This article is a methodology paper. It focusses in detail on how I created I-poetry from freebirthing women’s accounts of their experiences. I-poetry is part of the Voice Centred Relational Method, which is a unique way of analysing qualitative data (non-numerical data such as interviews). In short, it consists of lifting sentences from women’s accounts that include the word ‘I’ or its equivalent such as me, myself or mine. Examples of my own I-poems are included which highlight the frequently complex relationship freebirthing women have had with midwives and doctors. The poems touch on subjects such as obstetric violence, consent and the importance of respectful maternity care.

This article was written with Dr. Elsa Montgomery, who is a midwife and academic. In this paper we wanted to explore how women give birth when they have no direction or guidance from health carers and can rely only on instinct. Women’s accounts of freebirthing provide a unique opportunity to explore this way of birthing, which we termed ‘undisturbed physiological birth.’ We compared women’s accounts to existing medical and midwifery literature. Surprisingly, we discovered that many of the phenomena that freebirthing women recalled – such as the fetus ejection reflex – had never been properly researched and did not form part of maternity texts. Our argument concluded that there needs to be more research on undisturbed physiological birth as this provides the benchmark of ‘normality.’ Without this, women could be subjected to medical interventions unnecessarily.

When women recounted their freebirthing narratives many would recall midwives and doctors acting unethically and sometimes even unlawfully. This article takes four examples from the interviews and uses them to explain the philosophical underpinnings of good, ethical and lawful maternity care. This is particularly relevant when midwives propose people undergo any form of medical intervention. The primary focus of the paper is on consent. It explores how midwives can ensure consent is freely given and not ‘extracted’ from pregnant women and people via coercive means such as threats, manipulation or force.

The article was originally published in The Practising Midwife, which is a subscription only journal and the link can be found here. A Word version of the article can be found here.

When researchers discuss and write about obstetric violence they typically refer to acts carried out on women in hospitals and other maternity units. However, in the Freebirth Study women provided examples of obstetric violence occurring in their own homes. This article explores what that means for the definition of obstetric violence, especially if the UK were to follow the example of other countries and legislate against it.

The article was published in the Journal of Gender Based Violence which is subscription only and the link can be found here. If you don’t have a subscription, you can read a word version by clicking the Read More button.