What If Something Goes Wrong in an Unassisted Birth?

If you have tried to explain to your friends and family that you are planning an unassisted childbirth or if someone you know has told you that they are planning a freebirth, you know that the first question to come up in nearly every reply is "what if something goes wrong?" For someone who has always been taught that birth is dangerous and that it is common for babies and mothers to die in childbirth, this is a logical first response.

The answer, however, is far too multifaceted to answer in just one or two sentences. There are a number of situations that can occur before, during, and even after birth that can be addressed in that question. Not every situation will receive the same response. This is why the question is often met with an incomplete or even a condescending answer.

To begin, it is important to understand and dispel the myths surrounding unassisted birth. Television is designed to gain ratings by over-dramatizing situations, so a lot of misinformation can circulate on the topic of freebirth, started by those who know nothing of the freebirthing culture and therefore assume the worst.

One of the most common myths about unassisted birth is that women choose to freebirth because they are "crunchy" or "granola" and want to have a natural birth experience which allows them to find their "inner goddess" despite possible risks to the baby. While overwhelming feelings of power, love, and self-control are certainly a result of a natural birth experience, they are by no means the main reason why a woman would choose unassisted birth.

Another myth surrounding unassisted birth is that women who choose to freebirth do so because they are against hospitals or generally disestablishmentarian and will not go to a hospital no matter the danger. While a rare individual may actually be anti-hospital, it certainly does not describe freebirthers as a whole. On the contrary, freebirthers do seek medical care when necessary and are always open to the possibility of needing emergency medical care at a moment's notice.

The third and likely most common myth about freebirthers is that women who choose to birth unassisted put their babies and themselves in danger because they refuse to seek medical care from a qualified person for their pregnancies or their births. In reality, women who freebirth seek a higher level of care than a hospital alone can provide. Freebirthers do not just get pregnant and then go about life as usual until the baby falls out onto the floor. These mothers do seek a high level of prenatal and postnatal care, whether from a hospital, or a midwife, or their own care.

Most people today do not take the initiative to study the birth process in all of its forms to a high degree unless they plan to make a career of it either as a midwife or as an obstetrician. Most modern women rely entirely on their doctors to understand the birth process and how it works. The vast majority of women simply go to their prenatal appointments, let the doctors perform various tests, instruct them on what to do, and then return for labor and let the doctor handle the birth process by administering the drugs, coaching, and essentially removing the baby from the mother's body. Because it is most common today for most people to know very little about the birth process, it is understandable that they might assume that everyone else is the same way.

Freebirthers, however, choose to do their own care which means that they have taken on the responsibility to educate themselves about the birth process. Unassisted birthers study intensively on every aspect of birth and how to handle every situation. Many unassisted birthers put themselves through rigorous study and even attend professional training for things such as infant and maternal resuscitation. Freebirthers are very highly educated about birth and are just as knowledgeable about most situations as any midwife or doctor. They essentially become their own care providers - their own midwives. Deciding to birth unassisted means taking on responsibility for oneself including all knowledge required to be equipped to do so. Unnasisted birthers are as capable of doing their own care as a doctor would be of treating themselves.

Freebirthers are able to either perform their own prenatal care or they seek outside help from a healthcare provider to perform any necessary testing. A woman who chooses to do her own prenatal care may purchase medical supplies such as a fetoscope, Doppler, urine tests, and blood pressure monitor from a medical supply company and will seek training in how to perform the required testing. For any further testing, they may go to a local clinic and request that certain tests be done. Some mothers choose not to do their own prenatal care and may choose to see either a midwife or a doctor for their pregnancy, then birth unassisted.

The fourth most common myth about freebirthers is that they will not seek medical care if something goes wrong. On the contrary, women who choose unassisted birth do so because they are most interested in the safety and welfare of their babies. They believe that a normal healthy birth is most safely performed in a home setting and that a birth which involves complications is most safely performed in a hospital.

A freebirther will not choose unassisted birth to the exclusion of hospital birth despite any problems that may arise. Freebirth is not a religion. It is a healthy practice that results from a healthy pregnancy and labor. If at any time a pregnancy or labor develops a complication, the mother will transfer to a hospital immediately. Even if a woman is unsure of a situation, she will not hesitate to call an ambulance or, if she lives close to the hospital, have a family member or friend transfer her to the emergency room.

Unassisted birthers do not practice unassisted birth because it is all that they believe in. They practice birthing unassisted for safety reasons. Therefore, if anything occurs that compromises the safety of their baby, they will seek emergency care from a hospital. Home birth in general is the safest course for a healthy pregnancy and labor. Hospital birth is the safest course for a pregnancy or labor which develops complications.

The main reason why women choose to birth at home is because of the possible dangers of hospital birth. Most people will take for granted that a hospital is the safest place to give birth simply because the hospitals say so or because that belief has been so strongly ingrained in our culture for so long that it is now seen as basic common knowledge.

Freebirth is not for everyone, but can be safer than hospital birth for a woman who is properly trained and who feels more comfortable alone in a home setting. Freebirthers, determine for themselves after extensive study that for them, unassisted birth is safer than hospital birth. Hospital birth involves a complicated series of interventions which disturb and often completely halt the process of a normal healthy labor. The practice of intervening at every step of labor in hospitals today is the reason why the United States has one of the highest cesarean section rates in the world. One in three babies born in this country is born via surgery - a dangerous number which only increases year after year. The US loses more mothers and babies to childbirth than countries which still have a high rate of home deliveries.

Add to that the fact that hospitals contain a high concentration of many types of infectious disease. Sterility must be rigidly maintained in order for mothers and babies to be protected from disease spread throughout the hospital, yet many mothers and babies do fall prey to staph infections and pneumonia along with a host of other infections. These mothers and babies would otherwise have remained healthy in a home setting where hospital staff's constant internal checks would not introduce infection inside the mother's body and where the mother and infant would already be accustomed to the germs in their own home. Hospital birth can, in essence, be a death sentence for a healthy mother and child.

Hospitals, however, are not useless. They are extremely important for saving the lives of mothers and babies who do develop complications. Women who choose to attempt home birth are, essentially, increasing the odds of a safe birth for their babies and decreasing the likelihood of a dangerous situation. By staying out of the hospital for a healthy birth where a situation might become dangerous and transferring to a hospital in case of emergency where a home birth might become dangerous, freebirthers are aiming to remove the danger from both situations. It is not one or the other: hospital birth or home birth. Freebirthers are choosing the safest situation of both scenarios and utilizing the lifesaving qualities of both locations to produce a better and safer outcome than can be achieved by choosing only one option to all exclusion of the other.

Another very common misconception is that women should give birth in hospitals because birth emergencies happen very suddenly and a mother or her baby might die within moments without emergency help. This is also another false assumption perpetuated by the media who use dramatic situations to increase viewer ratings.

Childbirth emergencies can, for the most part, be fit into one of three categories. The first is true emergencies that cannot be handled at home. Childbirth emergencies that cannot be handled by the mother are detected long before they become a danger to either the mother or the baby and a woman who develops a real emergency has time to transfer to a hospital before even going into labor if necessary. True complications may include placenta previa, transverse lie, prenatal hemorrhage, eclampsia or preeclampsia, prenatal death of the infant, and cord prolapse.

Some complications do develop during labor, though they are extremely rare, and do allow time for a mother to be transferred to the hospital for an emergency cesarean. It is important to understand that if there is time enough during a complication for the hospital to transfer the mother to surgery and to perform all procedures in preparation of and leading up to an actual surgery and save the infant, then the mother also has time to transfer to the hospital. These complications are carefully watched for. If the child simply cannot be saved, being in a hospital will not help the outcome.

The second category of complications is derived of pseudo-complications: complications which can be handled at home by either the mother or her partner. These things include resuscitation of the infant, breech birth, postpartum hemorrhage, shoulder dystocia (stuck shoulders), cervical swelling, perineal tears, and posterior arrest.

The third category of complications are actually not complications at all. These may be comprised of old wives tales and situations which have long been believed to be complications either because of complete lack of knowledge by most or because of the lack of training doctors receive in dealing with said complications.

One example of a so-called complication is certain forms of breech birth. Breech birth is not necessarily dangerous when performed in a home setting where the mother is free to move into a safer position (such as squatting) which allows the pelvis to open enough to deliver a stuck head. Doctors, however, are receiving increasingly less training in how to deal with breech births and some have had no training at all - choosing instead to deliver a baby via cesarean rather than allow a vaginal birth in which the head may become stuck due to a woman remaining in the lithotomy position (lying on her back).

Another very common "complication" which actually is no complication at all and is in fact quite normal and healthy, is a baby born with the cord around its neck. Approximately one in four babies are born with a nuchal cord. In some cases, a nuchal cord can be beneficial as it prevents a truly dangerous situation - cord prolapse - from occurring. An extremely tight cord can cut off blood circulation to a baby's brain, but not only is this rare, a baby can survive for several minutes with no oxygen before sustaining brain damage. There is more than enough time to safely deliver a baby as it can be extracted within seconds once the cord is seen to pull tight. Also, in some instances, a nuchal cord can prevent further descent of the baby from the birth canal, but this is remedied by either performing an easy somersault maneuver of the baby or by simply clamping and cutting the cord and thus allowing the rest of the baby to exit the birth canal.

In conclusion, it is important to understand that simply having an unassisted birth does not exclude a woman from being able to seek medical care when necessary. Freebirthers are highly educated in natural childbirth and are well aware of any dangers that may arise. Just as a normal woman will seek medical care if she develops a problem in pregnancy, a freebirthing mother will also seek medical care when it is necessary. The number one reason that freebirthing mothers choose unassisted birth is the safety factor. They will, therefore, always seek the safest way to give birth available, whether that be a home birth or a hospital birth depending on the woman's individual situation. Unassisted birth is about seeking safety, not about seeking martyrdom.

For more information on what to do when something goes wrong at an unassisted birth, see Heather B.'s article here:
http://www.associatedcontent.com/article/223018/unassisted_childbirth_what_if_something.html?cat=52