Why would birth professionals be more likely to choose unassisted birth?
Could it be… because birth is actually safer and better unassisted?
Or because fear is actually the main cause of interventions in birth? And knowledge defeats fear?
I’m asking these as questions, but really they’re my answers.
The title (“pipeline,” as in “school-to-prison pipeline”) is a misnomer both because the move from birthwork to freebirth is a choice, not compulsive; and because it’s a positive move rather than a tragic one. But it’s catchy.
It took me four years, a doula training, three months of midwifery intensives, and two years in the field to move from assuming that a “birth center” is the best possible place to give birth to recognizing that planning to stay home is the only way to have a chance at feeling safe and authentic in birth.
No wonder a lay person often never gets to that point.
I was talking with a friend about the circumstances under which I would go to the hospital for a birth of my own (if I started gushing blood; if I felt a cord come out before a body; if I instinctively felt I needed to), and I found myself adding the caveat that most people are too deeply trusting of hospitals to have this conviction.
For most of my birth work life, I intentionally avoided looking too much at the Free Birth Society instagram page that would pop up occasionally, because the idea of birth sans medically trained assistant seemed dangerous.
But as I witnessed births myself, mostly in hospitals, I saw so many layers of true danger show up that they started to outweigh the vague dangers I had in my head.
Determined to get to the bottom of this for myself—what IS the safest way to give birth?—I began midwifery study with Elizabeth Davis, a pioneer of American and global licensed midwifery.
Having researched the cost of licensed midwives (I would budget $9,000) and not having much savings outside of my retirement fund, I wanted to know: could I be my own midwife?
From the course description, ending in suturing practice, I gathered that suturing myself would probably be the hardest part. If I learned how to do that, could I then give birth myself (in the woods, say) with no paid midwife there?
But over the course of those beginning and advanced intensives, one message kept repeating: birth is best left alone.
Doctors and medical/industrial midwives say this, too: that they’ll “avoid unnecessary interventions” (and then they don’t).
The goal of licensed home birth midwifery, it turned out, was to provide interventions at home in order to avoid having to go to the hospital for them.
But the crux of the ability to administer those interventions wasn’t even that they were necessary (except in very rare cases): it was to calm the fear of the birthing parents.
As I contemplated my next steps in midwifery study, applying to the National Midwifery Institute and then deciding to take the Free Birth Society’s “authentic midwifery” program instead on a grant, the need for intervention consistently came back to fear.
Almost every person going through childbirth will reach a point of utter desperation. Maggie Nelson describes it so well in The Argonauts as facing death. Elizabeth Davis describes it as “realizing that birth is bigger than you.”
There is a surrender that has to happen, that paradoxically feels completely impossible. Even the most confident birther will reach that point and realize that they can’t do it after all. (And then they do.)
There are many points in labor when the birther will likely want to reach out for help—whether for the hand of their partner, or the knowing eyes of their midwife. In the hospital, they will submit to anesthesia. Desperation takes hold. They will take what is available.
What birth workers know is that it matters what is available, for this precise reason. On a much smaller scale, it matters whether I keep candy in the house when I reach a point of desperation via hunger, emotion, isolation, overwhelm, etc. So I don’t keep it in the house.
Similarly, someone who is familiar with birth knows that, if the birther can just make it through—just cope—they will eventually birth their baby and feel amazing. But if they are offered something to change it, to make it stop, to let them off the ride—they will take it.
Birth workers know that the only way out is through.
This brings us to freebirth, or unassisted birth: birth left totally alone, up to the birther, maybe a partner, maybe another lay person or two, to contend with.
The birther is free to go through the process, to go inward, not to answer any questions, not to be pulled out of the dreamy birth trance. There is no one to demonstrate the pain to, no one to look to for a way out, and no one to intervene out of fear or pity or boredom or impatience.
It is the essence of the continuum of sexuality: private, internal, bodily, metaphysical, intimate.
Many birth workers go into the field after giving birth. They see either what is terribly wrong with the system or impossibly wonderful about birth. They want to help others see.
Some birth workers, including me, go into the field out of fascination and a desire to “do it right.” I want to learn how to birth before it happens, so that I’m not one of the tragedies.
There’s a very common narrative that the “tragedies” possible in birth include baby or maternal death or disfigurement. What I’ve learned is that the overwhelmingly common tragedies are trauma, disturbed bonding, and loss of personal power.
Sovereign birth brings another twist with it: the attitude toward death or disfigurement.
In both doula and midwifery training, we learn that birth work is, inevitably, also death work. Not just because the presence/possibility of death is felt by the birthing person in the midst of labor, but because sometimes babies die.
Mothers die, too, but much much much more rarely, almost unheardofly (unless you’re BIPOC in a hospital), than babies.
I learned so much about stillbirth (that most-feared, vague, unexplainable phenomenon) through the stories I heard during trainings. The greatest thing I learned is that, when babies die, it matters less why and matters much more what happens after.
In a hospital, what happens after varies as much as the staff from shift to shift. Maybe you’ll have a super compassionate team, and all the time you need with your baby. Maybe you’ll have a terse, defensive team and a limited time to hold your baby before they’re taken away forever.
At home, what happens after, much like any death at home, is that you have a choice. You can hold your baby as long as you want. You can decide what ceremonies to conduct, who to call, what you need.
And when you choose a sovereign birth, you choose to accept the possibility of death. Even though death is more likely in a hospital, we collectively hold the illusion that being at a hospital will prevent death. Therefore, those choosing a hospital birth allow themselves an avoidance of confrontation with the prospect of death—a big motivation in our culture.
And what of birth emergencies? Of hemorrhage, of stroke, of clinical exhaustion?
Sadly, the possibility of emergency in normal birth has been overplayed, and the causation of emergencies by hospitals themselves totally ignored. Pitocin is more likely to cause oxygen deprivation than is prolonged labor itself. “Failure to progress” is simply failure to wait.
Putting the birthing body in a bright, unfamiliar room where it is constantly prodded and invaded and observed by terse strangers is extremely discouraging to the animal need for relaxation and privacy in all things excretory.
No one is taught about the very few and rare birth emergencies—instead, we are told to be in the hospital “just in case.” In fact, just as with any other normal human function, the hospital is not necessary until there is an emergency—and time is of the same essence. You have time before you lose too much blood, before the cord is compressed for too long. There is first aid for these things. It is possible to be prepared.
“Intervention” is such a buzzword, but most people don’t realize that the first intervention in a non-home birth is leaving the home at all. And most of the time it is unnecessary.
It took me four years of study to come to this conclusion, due to the indoctrination of birth professionals across the board. Even “independent” midwives are beholden to the conservative drive of the hospitals to protect themselves—a midwife’s decisions leading up to a transfer will be questioned to her detriment, risking her livelihood, where a doctor’s will never be doubted.
So I choose to be prepared. And I’ve found that “being prepared” involves more than researching and being close enough to a nice-looking birth center. It certainly involves more than showing up to “prenatal care” visits to be deluded and violated.
Being prepared for birth involves nutrition, most of all. Nutrition is preventive self-care that lowers risks of emergencies like hemorrhage and premature labor.
Being prepared for birth involves confronting death, defectiveness and injury: what will I want if my baby is stillborn? If my baby has developmental abnormalities? If my tenderest tissues tear? (For me, the answer to all of these is to be home and let us heal, as a family.)
Being prepared for birth involves submitting to the rite of passage process and therefore to the unknown. A solo mushroom trip might be a good place to start. I credit psychedelics for some of my confidence in knowing that, even if I believe that things are truly not okay, they will be. Faith is another place people find this.
Being prepared for birth also involves preparing for postpartum and parenting. This is where community is crucial. I have to know that there are people who will feed us, clean for us, check on us, listen to us, and celebrate us.
Being prepared for birth means preparing to be totally changed on a brain-chemistry level. I will never be the same, and I don’t want to be. My partnership will never be the same, and we are committed to changing with it.
Taking responsibility for birth is fundamentally taking responsibility for life. This is not normal, but I believe it is worth it—just as birth workers know that going through birth, as it really is, is not common but is absolutely worth it.
Birth.DIY 