Speaking the unspeakable; why I’m not celebrating homebirth.
If this post triggers you or brings up any strong feelings please reach out and speak to someone.
You could call Lifeline , PANDA or Beyondblue
Today I need to be very vulnerable with you. I started writing this post during homebirth awareness week. But I was not, and will not be celebrating. We have since seen some incredible speeches from some inspirational women about the crisis of birth, both in this country and around the world.
I need to get this off my chest and share something that has been bubbling within me.
My heart hurts. It aches. It aches for me, for my baby, for my family, for my fellow birth workers and for all the women and babies who have been affected by the current climate of homebirth. I want to say something controversial to you;
I am sick and tired of celebrating homebirth
Don’t get me wrong, homebirth is, and has always been, my only choice for how I want my babies to enter the world. To me it just feels like my complete natural instinct to support the physiological birthing process and birth where I feel most safe. For me that is at home with a Midwife. Homebirth is incredible and we know from countless stories and an abundance of evidence that homebirth is both safer in terms of physical safety as well as providing increased emotional safety and birth satisfaction (more info here). It is our biological norm. When you tell me homebirth and continuity of care are amazing and worthy of celebration you are preaching to the converted.
This is not to discount women who have had wonderful experiences in the hospital. It’s just that at this time we need to start getting more serious about the reality of birth. We know homebirth is safe and incredible and yes we need to continue reminding those who don’t know. We need to remind, and take more action against those who disempower or take away a woman’s control or experience because they are not evidence based or because they work from a place of fear. Yes, we need to continue to have this discussion. Yes, we need to celebrate the amazingness that is homebirth. BUT this CANNOT and MUST NOT be the ONLY discussion!
Don’t you think it’s crazy that we are celebrating something that once upon a time was just called birth?
We are at a crucial time where physiological birth, homebirth or not, is endangered. We are seeing huge increases in intervention birth, and a huge increase in perinatal PTSD (more info here and here and here ) (which actually still isn’t completely recognised, thus not statistically recorded because PTSD was only ever really acknolwedged as something experienced by War Veterans – Sheila Kitzinger, 2006).
Now is the time we need to stop celebrating and start acting!
We NEED to start being uncomfortable with politics and stories that tell of the truth of what is happening to women every single day!
To discuss even with those who know that homebirth is amazing and worthy of celebration. Because even within these circles many are conforming to policies that dis-empower women, whether they want to or not. We shy away from discomfort in our culture because who likes to feel uncomfortable? No one does. But if we don’t feel uncomfortable then we are IGNORING the truth! And things will continue to get worse.
We need to stop acting as if orgasmic, transformative and ecstatic birth is a type of unicorn birth. Yes, birth is hard. Yes, it takes us to the brink of our being. Yes, it’s painful. But if women and birth were respected, more women would be having these unicorn births where they feel ecstatic more than they feel the pain.
We know this because the WHO statistics, and a number of other studies around what number of women will need intervention is being completely blown.out.of.the.water! The problem is so multi layered and multi faceted it’s hard to see through the fog of where to even start. Well, I’m starting by not celebrating homebirth. I’m not celebrating. I’m getting angry and honest and I hope you are too.
We need to get uncomfortable
We need to change
When I was 30+ weeks pregnant, I sat in the theatre watching ‘Why Not Home’. What a beautifully wondrous documentary. But I left the theatre so angry. I cried. I cried such intense tears of heartache and sadness after watching that movie because it reminded me of what we no longer have access to here.
Whenever I want to remember the magic of birth and true women centred care I watch ‘Birth Story’ about Ina May and The Farm. This beautiful utopian commune with wise women holding space for women in their Matrescence, as they transition into mothers. Just as we as women have done for millennia.
Again, during my pregnancy this movie brought me to tears. Not happy tears. Deep resounding sadness. Guttural longing. Because for me these movies were reminding me of what I already know, what I was already striving for, but what I could not have. They reminded me about everything that I wanted for myself, for my baby and for the women I work with. To trust birth and to trust our bodies, but also to have someone to care for us, someone WE could trust. This was not obtainable no matter where I looked.
Gold Standard of Care was not available to me
I’m a birth worker and am fortunate to be pretty networked and connected, particularly in my local area of Adelaide. Yet I could not achieve the care talked about as ideal in these documentaries. So how do we expect women who don’t know anything about birth to find the care that will best support them? These movies honestly felt like, and still feel like, a completely different planet. Universe even. A utopian dream. The guilt I felt for not being able to find the care that would support my needs and the needs of my baby was intense. The frustration and rage continues to affect me daily.
It’s not safe for midwives
The beautiful Midwife that I still have a relationship with from my first birth moved away when I was early pregnant with my second (like most midwives who want to practice independently do) because it’s not safe to be an independent Midwife in Adelaide; or at least it hasn’t been. Their own colleague is on trial. Facing charges of manslaughter. Being used as an example for standing up against the system. But no one really wants to talk about that do they?
This Midwife is being used as an example, strewn through the media like an ‘evil’ character from a movie. Not like the human being she is. The mother. The wife. The friend.
Other midwives have and are working underground around Australia (please be clear, Lisa is not one of them). They are being reported for attending women at home and are having their registration taken away – most, pretty quietly. But here in my own hometown of Adelaide, one is being publicly vilified as if she represents homebirth and independent midwives everywhere. The whole system has gone to shit and women are being forced into scenarios they don’t want to be in because they are not supported. Many of these options are not evidence based OR women centred (or baby centred for that matter). We know that when women are affected negatively by birth, so are their babies. So this is not about choosing one over the other.
I need to say this again… many of the practices and policies governing women’s birthing rights ARE NOT EVIDENCE BASED! Many are actually based around insurance. Ask any Obstetrician about their rights to support vaginal breech or vbac (vaginal birth after c-section) and ask them how much of an impact their insurance company has over how they are ‘allowed’ to support women.
The blame for this mess is not soley on the shoulders of a handful of vilified midwives in this country. No, they were the deviants who dared speak up. Who dared stand by women who chose to opt out of the system because they were backed into a corner. Women like me. Women reporting horrendous things that you do not hear about. Situations where the people perpetrating these scenarios are not personally or publicly vilified and made to represent their entire profession. So many Doctors and other Midwives in the system go completely unnoticed. We cannot just be focusing on those who attend homebirths. We continue to regulate women, rather than change and look at the actual issues leading to women needing to go against these harsh regulations in the first place. Why would women choose to put themselves or their baby in danger? They wouldn’t.
Maryn Green on her IndieBirth Blog spoke the truest words in a recent post about this issue when she said:
I will no longer be silenced. I choose to not erase who I am and what my Truth is. I will be first and loudest; no Midwife should be in JAIL for attending a birth, no matter what the outcome. If we allow criminalization of Midwifery, we allow criminalization of a woman’s choice to birth where, or with whom she feels safest. When we watch Lisa walk through the fire, we acknowledge that we also get burned. I know, as well as I know anything, that she represents all of us. She is all of us, and her persecution brings harm to EVERY woman.
No Test, No Homebirth. The use of coercion for women choosing homebirth to comply.
I was considered ‘low risk’ throughout both of my pregnancies. Something that only a minority get the ‘honour’ to be ‘labelled’. Given that there were almost no Independent Midwives available, and my husband was very unwell at the time so money was definitely a factor, I went with what I thought would give me the same or at least a similar experience as my Independent Midwife. I went through the Midwifery Group Practice at my local hospital.
In reality, after experiencing care from around 10 weeks with my first, this time I spent the first 20 weeks with no support. Apparently your baby isn’t ‘viable’ before then if something were to happen so you don’t ‘need’ a Midwife. Those were the first hand words from a Midwife at my booking appointment. Despite having a slight bleed at 7 weeks (luckily I could call my previous Midwife for support) and a history of birth trauma and PND, my experience as a pregnant woman doesn’t count until after my baby is ‘viable’. Interesting.
Not more than a couple of weeks into the relationship I was told that I would be required to have both the GBS (Group B Streptococcus) and Gestational Diabetes testing. Neither of which I had risk factors of or symptoms for. And both of which I had intended to decline because I do not believe that there is sufficient evidence to support their use. Additionally, testing positive to either would then also force more testing and intervention. For example antibiotics in labour are compulsory (if you want to keep your care) should you test positive for GBS despite the evidence on antibiotics for GBS not being sufficient. GBS is a bacteria that lives in the vagina and can change from positive to negative on a daily basis. The test is done around 36 weeks. So knowing the accurate status of it at birth is completely impossible. You can read more about GBS testing here and here.
Furthermore, according to the Perinatal Practice Guidelines (PPGs), macrosomia (or a large baby) is the reason hospitals give for testing for gestational diabetes (a supposed extra risk for birthing at home). Using the sugar drink (while the evidence is insufficient in determining its efficacy as a test in it’s own right) is not diagnostic for macrosomia. Taking the sugar drink does NOT tell you if you’re having a big baby. And that’s because having gestational diabetes does not mean you will definitely have a large baby. You can have a large baby without GD. And you can birth vaginally with a large baby. Our bodies are a bit amazing like that. You can read more about GD testing here.
The PPGs say that antibiotics are required if a woman tests positive for GBS and that uncontrolled GD and macrosomia are risks for homebirth (rendering you unable to birth at home) but it does NOT say anywhere that you are unable to decline the testing. The insurance companies were overriding the Perinatal Practice Guidelines and had decided that these tests would now be tied up with my eligibility to remain in the homebirth program. By this stage I had been allocated a Midwife who fairly bluntly said that while she herself is not supportive of the tests, should I decline, she would no longer be able to be my care provider and I would not be able to birth at home.
This was a human rights issue, it goes completely against the Australian Medical Association’s statement on Maternal Decision making. I was NOT going to be forced to have unnecessary tests (that cost taxpayers a lot of money mind you) just because an insurance company said so. In fact, it was proof that it was again an attack on those choosing homebirth because my friend who was due a month earlier birthing on the ward was not even asked to have one of the tests. She was highly annoyed because she had actually wanted it! I would not be coerced to have tests against my will. Where do we draw the line? I looked for a conscientious objection for this instance but no one had ever heard of being coerced into medical tests that would remove care in this way. Why wasn’t anyone else outraged about this? When you look for things that aren’t there you are eventually going to find something.
I ended up writing letters to politicians and policy makers who had enforced this ruling of pure and utter coercion pertaining to the fact that if I declined the prescribed tests (not required in Queensland mind you because they’re not evidence based and Queensland just seems a bit more with the times) I would be ousted from the homebirth program. No test, no homebirth. While I still believe that I should have been within my rights to just outright decline, like all women had been able to a month earlier, I negotiated some monitoring that still was considered within the Perinatal Practice Guidelines. I clung to the option of a homebirth with a Midwife by a thread. But my gut, my heart and my head all knew this was not how it should have been.
What does good care actually look like? How should we feel when we birth?
“…parturition is an involuntary process and an involuntary process cannot be helped. The point is not to disturb it.” (Odent, 1987, p. 105)
The physiology of birth is such that whether we as ‘sophisticated’ modern human beings like it or not, birth is a completely primal experience. And really, while our society has changed over the last millennia, birth has not. In order for all of the physiology and for all of the interconnected ‘cogs’ in the body to interlock as they are meant to, we actually need to be able to allow ourselves and our brain to become primal again. Michel Odent is like the father of undisturbed birth writing. He and Sarah Buckley talk a lot about how vital undisturbed birth is, not just for the birthing process, but also to the woman and her outcomes, for the baby and their long term outcomes AND how these outcomes then affect future generations.
When birth is disturbed we get all sorts of out-of-whack consequences. For example, if a woman has been traumatised by her birth (say she was frightened, or she had lots of unnecessary intervention and she felt like a failure), aside from the possible physical effects that could be long lasting for her and her child, bonding and attachment, there can also be long term emotional effects. Breastfeeding could be disturbed which has it’s own detrimental effects. She may develop PTSD, PND, PNA which could last months or years. You see the pattern. Hence the saying ‘peace on earth begins with birth’.
Undisturbed, ideal circumstances for physiological, primal and optimal birth includes:
- The woman feels safe and trusting of her environment and care providers
- The room is dark, warm and safe
- The woman is not bombarded with loud noise, talking, smells, lights or other heightened sensory disturbances
- The woman is able to move, make noise, eat and talk freely, and do what she needs to do to get the baby out
- The woman and her baby are skin to skin for at least the first hour (the golden hour) and never separated. All checks are done while they are together. Delayed cord clamping is also respected.
- The woman and the birthing process are respected and trusted
(You can read more about the vital need for undisturbed birth and third stage/golden hour here, here, here, here, here and in the books referenced below)
Additionally, when ‘safety’ is mentioned in relation to homebirth, or birth, what is actually being discussed is solely based on the research which focuses on the physical – morbidity and mortality. However, safety is a completely subjective experience. The research and discussions about homebirth (or birth) ‘safety’ do NOT acknowledge or take into consideration emotional and psychological safety, which we know (from the research on maternal satisfaction and rising rates of birth related PTSD) is greatly impacting women and birth outcomes.
My story. Grateful to be here, to tell you the truth.
Homebirth with a Midwife was taken away from me because I was ‘out of time’. When you reach 42 weeks you are automatically considered high risk . Forget the fact that some women have longer cycles. Forget the fact that I had NO other risk factors or any indication that anything was wrong. Forget the fact that we cannot ascertain the true statistics around being ‘overdue’ because women are booked in routinely for their induction at 40+10. And forget the fact that while there is only 0.0015% (Norwitz et. al., 2010) higher chance of fetal demise between 42-43 weeks, the fear from the hospital was intense, and I was now seen as a ‘deviant’ by not complying with routine induction.
I was given an extra day and a bit to go into active labour… but if you know anything about the physiology of birth, you’ll know that stress, pressure and increased adrenaline and cortisol are the opposite of labour inducers. So of course I did not go into labour within my required time. And I was scared! Scared to be alone. Scared to go into hospital knowing that I would be handed over to the ‘high risk’ team. Scared because my Midwife who was supposed to be supporting me and understanding that I needed support told me outright that I may not have any Midwife available, let alone her.
I was a mess. But what could I do? No other Midwife would attend me, and I was afraid to birth unassisted (I hadn’t looked into it as a option, and was out of time to feel confident in doing so). I did not trust that I would be supported at hospital. In fact, I kept being told I would be given things I specifically didn’t want because of my deviance of going over 42 weeks. Interventions that are not justified by evidence. Interventions that were unwanted, unnecessary and precautionary. Interventions that I was told with certainty had ZERO side effects but that I had researched and knew came with with risks (however minor you might like to think) I was not willing to take. My fears were never ever validated, they were, in fact, heightened. I had to negotiate tests I didn’t want. I was denied a continuity agreement that I would know the Midwife on call if my Midwife was away (even after a letter from my psychologist). I was being coerced to comply with hospital policy that went against my individual needs, and against all of my instincts.
When I sought other options confidentiality was breached. The Midwife from the other hospital I telephoned in turn called my Midwife to tell her I had enquired to change care. Not only that but she was completely disrespectful with how she spoke about me and my ‘situation’ (being that I was just on 42 weeks and despite recent studies showing that the risk goes up only very minimally until 43 weeks, ‘no one wants a dead baby’). Every turn I made I was faced with brick walls. (more info about post dates here and here and here)
No matter who I spoke to, I was constantly told to just freebirth. Despite this, given my previous experience and knowing what it’s like to really have the gold standard of continuity of care, I really didn’t want to give birth without a Midwife.
The care that I received was not the care that I wanted or deserved. Or that any woman deserves. I did not trust my Midwife at all. She let me down every single chance she had. Trust was never built as it should have been. Had I trusted my care provider and felt that I was being supported and that my own individual needs were being taken into account (not just blanket rules) I would have absolutely considered things she may have deemed necessary.
The only time in our whole relationship that she was ever on time was the moment that the clock ticked over past my allocated time to be able to birth at home. Right as the clock ticked over, she messaged immediately to remind me that my time was up. That no one would come to me at home. I had been such a naughty girl for going over my time.… cos I wasn’t already staring at the clock hoping I would suddenly go into active labour that second. No of course not.
I was not able to fully let go and have the mind-blowing ecstatic experience that I feel like I might have had, had I felt safe. The type of ecstatic birth that Michel Odent talks about as what should be more ‘normal’ when respected and left undisturbed. My experience was still incredible and I do feel grateful and empowered that I did birth my baby on my terms. That I trusted and listened to my insticts. The fact that I birthed my baby on my own despite the shitty care and support that I had makes me feel so happy! I was able to heal in many ways. I am so grateful that we were able to bond and connect. I got the oxytocin rush (albeit brief) that I missed with my first and I did not develop PTSD. I am also certain that my baby got the best possible birth he could have, and he is far better off for it. For that I am grateful.
But this experience did nearly (and I really hate to say it) cost me my life. NOT because homebirth or freebirth is innately dangerous, but because I did not feel safe or supported. I was scared. I didn’t want to freebirth. I know how corrupt this state’s culture is around supporting homebirth. I didn’t want to be on my own. I wanted a Midwife. My Midwife. Who was supposed to be modelling continuity of care. Who was supposed to have fostered a trusting relationship with me throughout my pregnancy. To be with me; with woman.
Reluctantly, my husband and I agreed to labour at home as long as possible as instructed by the Midwife, and then transfer in. But I wasn’t confident when to transfer after labouring for 3 days last time.
My baby came quickly and unexpectedly. I laboured (early labour) at home for a few hours. Contractions were steady but I didn’t know when/if it was time to go in. I decided to get into the pool (that we had set up because a few hours earlier I was still ‘allowed’ to have a homebirth remember) to get more comfortable and ease my discomfort and nausea. It was like heaven. I finally felt a sense of safety, comfort and warmth.
We decided to call an ambulance when I started involuntarily pushing. I was overwhelmed. I thought I still had ages to go, like last time. My husband and friend kept saying we should go to the hospital. They even packed the car. But I couldn’t move. My baby was coming. Every time I tried to move I vomited. I couldn’t get in the car. I couldn’t even get out of the pool. I refused.
I had not planned to freebirth. I had not planned to go to 42 weeks. I had not planned to not be able to get out of the pool and not go to the hospital. I had not planned to be without a care provider present. I had not planned that my labour would be quick after being many days last time. I had not planned to not know when to go in, to not have anyone to say it was time, and to feel that if I did go in I would be entering some sort of battle because of my ‘high risk’ label applied only hours earlier.
It just happened, and my Midwife told be that she had ensured no one would come to me because I was ‘outside of the guidelines’ by a few hours over 42 weeks. Not even for the labour.
And guess what happened… after birth, I was half a pint of blood loss from death. Half.a.pint. (237ml). I didn’t actually know this until last week when I had my iron checked and I had to have yet another iron infusion (after 2 blood transfusions already). I decided to google how much blood you can lose. I lost 2.6L, most of which was in an ambulance because despite having synto in my fridge, ambulance officers don’t give or carry synto (WTAF?!). Ambulance officers are trained by Midwives, often attend fast births, but still do not give synto? I still haven’t recovered. My body has struggled to build itself back up. I was on a high those first couple of days. I just hadn’t realised quite how dire it could have been.
But I didn’t die. Nope. I was probably burnt at the stake in another life, but not this time. I will not stay silent. I am angry. This was so easily preventable. If only the message from ‘Why Not Home’ was actually listened to instead of watched in awe as something unattainable. Something we should all swoon over about how ‘they’ over ‘there’ in some other place are getting it so right.
My Midwife tried to deflect any responsibility by saying that my uterus didn’t work. Which makes no sense since I have birthed 2 babies vaginally – my first was just malpositioned in an asynclitic position. It was my first birth and it took a LONG time. I was in labour at home for 3 days. I could not keep food down from vomiting so transferred in. And my second, well he came perfectly, just quicker than expected! She tried to say it’s because I have red hair. Yup, red hair. She asked why I would call the ambulance? They would of course disturb my third stage. The blame was placed on me, my body and nothing to do with the fact that she wasn’t there. That the policies are fucked and not evidence based. That I should not have been high risk because I clicked over to 42 weeks.
This wouldn’t have happened if I had had the support that is celebrated and talked about as ‘gold standard’ as I birthed. If I had had a third stage that was quiet, safe, warm and supported – as it should be. As she knew it needed to be.
It is clear as fucking day, I bled because my third stage was filled with fear.
And you know what the real clincher for me here is? This blood loss, while I don’t plan to have any more children, does now make me officially ‘high risk’. I was informed as I lay in hospital being told I bled for all these reasons pertaining to my own doing:
I would never be ‘allowed’ to birth at home again. It would be too dangerous. That I would be considered high risk. Well, low risk did me no good anyway, but still, that label of high risk, that just topped it all right off.
I don’t blame my Midwife. I am angry at her. But it’s not all her fault. She was supporting a system that doesn’t support women, because otherwise she herself would be persecuted and burnt. She is scared just like so many other Midwives who want to support women’s choices. She didn’t understand the impact of birth trauma or have any way of supporting it, like so many Midwives. But again, why would she when it’s not acknowledged as important in the majority of circles. I triggered her because I wanted something from her she couldn’t give me. I wanted something she used to be able to provide, that she would like to provide, something she herself had wanted, and something that isn’t available without threat of persecution.
That persecution is very real here in Adelaide
It is reverberating out to everyone – birth workers, Midwives, women. The lack of choice around birthing options and the heightened fear of birth (especially homebirth and physiological birth, or birth outside of the very tight guidelines) can be felt far and wide.
Homebirth should be celebrated but not when women and Midwives are being persecuted in our own backyard. Midwives whom many called their friends and mentors are on trial and going to jail and the ripple of fear against homebirth is traveling world wide.
But you know what, I’ll be honest; I would have done anything to be able to access even an underground Midwife. I would have trusted an underground more than the options I had. And I’ll tell you with certainty… I wouldn’t have bled like I did because my third stage would have been respected. I would have been respected. Birth would have been respected. And if all else failed, I had synto in my fridge that the ambos, who are supposedly taught about birth, refused to give me.
The Midwives that hold the ancient wisdom of childbirth are the Midwives on trial and scared for their lives and families so stop practising; just like the witch burnings all over again. And because of that I bled. I bled and I bled not healing the red thread that I had hoped I would.
Is freebirthing illegal?
I started Midwifery before I became a doula and I chose not to continue because I knew how restricted and restrained I would be to actually support women and birth in the way that we celebrate. I had never seen firsthand such insidious bullying, fear of those higher up in the hierarchy, such vicarious trauma being thrown around in every direction, and complete lack of ethics (I’m a social worker first so I had a pretty good ethical foundation which made it all the more unbearable). This is not at all to discount the wonderful work of some of my beautiful hospital Midwife friends, and the Midwives I am so grateful for when I have transferred. To the Midwife who was there, who helped stop the bleeding and still ensured my baby and his placenta remained attached, I am so grateful. But what we talk about as an idea of the ‘ideal’ and what the reality of practice is, are two very different things.
As a doula, I and the majority of the doulas here in Adelaide are scared to attend homebirths because there are laws in place that could see us prosecuted. Yes, laws. Not policies. Official, black and white l.e.g.i.s.l.a.t.i.o.n (Restrictive birthing practices could see anyone who is not registered or in the presence of an unregistered person at a birth prosecuted). People think this is just a myth but you know how I know it’s not… because as I bled, three police officers filmed me in my house. Which just led to more blood.
As a doula I was told to call an ambulance if a baby was coming quickly. I knew I wanted someone there to support me and my baby if something did happen. But I had heard many horror stories of ambulance officers physically forcing women into their ambulances with their babies heads half way out and this thought filled me with fear. I could not move. They knocked on the door as my own baby’s head was starting to crown and I instinctively told my husband to ask them to wait just a few moments so I could push him out without being disturbed. At that moment we were completely fine. Great in fact. We just needed an undisturbed moment. He went to the door and calmly explained my request and they said they would wait. We were trying to be responsible.
Unbeknownst to us, during this time they quickly called the police then knocked on the door again and said that if they couldn’t come in right then and there they would leave. My confused husband came back to me and explained briefly (trying to keep the space calm and the interruption to me minimal) that the ambulance officers were going to leave if we didn’t let them in. This was not a conversation I needed to be having as my baby was crowning, which was obviously requiring every ounce of my concentration. I quickly stated that they could come in if they didn’t try and move me. I just wanted them to let me birth my baby. To just be present if they were needed. Isn’t that what you call an ambulance for? Is birth actually an emergency?
Birth is not an emergency, it is simply an emergence.
~Jeannine Parvati Baker~
The ambulance officers must have agreed and in they came, followed soon after by uniformed police officers who entered our house and my birthing space without invitation, with my husband asking what they were doing here. The ambulance officers called the police to report us to child services and ensure there was no ‘rogue’ Midwife hiding somewhere in our house. They did not trust that I could have possibly asked for an undisturbed moment to birth my baby before they came in wanting to take over and get me out of the pool.
Three police officers stood by the pool as I pulled my baby out of the water. The moment my baby touched my chest the ambulance officers completely ignored the universal need for calm during the third stage.
It was rush rush rush. Rub Rub Touch Touch.
They wanted me out. They wanted my baby. I was safe, my baby was safe; chubby, pink and crying! But neither I nor my baby could be controlled while we were in our little warm bubble in the pool. I was not even given a minute to take in what had happened. What I had just done. They were reaching, touching and rubbing and not just letting us be for even a moment. The police officers stood watching as I got rushed out of the pool on my wobbly legs by the ambulance officers. As I had to defend my right (and luckily so given the outcome) to not cut the cord (why aren’t they taught about delayed cord clamping?). They wanted my baby and I to be separated immediately in the cold, while their fear of birth filled the room. While the fear of the police filled the air.
Wet and cold I was instructed to take my sports bra off and told to squat to ‘encourage my placenta to dispel’, which was not ready. The first gushes of blood began. With cameras on their lapels the police were asking what was happening and said they needed to ‘make sure everyone is ok’. I guess we were off the hook because everyone was ok?
The fear was palpable. The young ones you could see were terrified. One ambo in particular was completely triggered, freaked out and angry. All of this energy was the complete opposite from my needs at this vital time. It is pretty widely understood that the third stage can be a risky time. If a woman’s space is not warm and filled with oxytocin, her risk of bleeding is much higher. It is not just birth that needs to be undisturbed but also, and almost more importantly, the third stage. Placentas are shy organs. They take their own time and like a certain ambiance to emerge. It is no wonder my uterus refused to allow ours to make an appearance.
All this event did was reinforce to the officers why they think homebirth is dangerous. As I stood there naked and bleeding, holding my baby, I should have been warm and calmly waiting for my placenta to arrive on it’s own, riding an oxytocin wave. Instead I was thinking about how these officers will forever have this scary image etched into their mind. I want them to know that it wasn’t homebirth that did this. It wasn’t me being stupid or reckless. If only they could know how amazing, positive and backed by solid evidence homebirth is. That we (my husband and I) were informed about birth and I trusted my body, my baby and homebirth. I just didn’t want to be without a care provider for fear of, well; bleeding, death, or something being wrong for my baby.
I wasn’t bleeding because homebirth is dangerous. It was because of the lack of support and the lack of options. It was because they were interfering in the sacredness of birth. Because those who should know better, prefer to feel needed and interfere instead of being taught how to identify and trust normal birth. This was not my choice anymore than it was their choice to be there. And therein lies the cycle of fear.
Imagine if I had lost that extra half pint of blood. Think of the headlines you would be reading right now about ‘that horrible homebirth in Adelaide’. Imagine the policies that would have come in. Imagine how much more fear and restriction would have been put on women who gestate a bit longer. Well, I’m sure glad I’m here so I can tell you first hand exactly how it is and how it would have been completely misrepresented.
This shouldn’t have happened.
I watched a video recently that made me cry of some ambulance officers who attended a woman birthing at home whose baby was distressed. Despite the officer’s own personal experience with loss, and the woman’s own history of stillbirth (aka high risk) they treated her with so much respect and love. They wrapped her in support and empathy. They spoke to her gently and softly and reassured her that she was amazing. Why couldn’t I get that? Why can’t every birthing woman be treated with that much respect and non-judgment?
I didn’t plan to birth at home in that way but birthing my baby was FUCKING AMAZING (as it should be) and I was a FUCKING GODDESS! We did the ‘right’ thing and called for support, so why was the ambulance officer angry at me? Angry at everyone? She was huffing and grunting at every light we sped through saying ‘this shouldn’t have happened; this will be reported to child services!’ as I bled and winced in pain.
Why was I having to explain to the police what had happened,
as I bled, and bled
asking why they were there
and if we were in trouble?
Why was my friend who was there supporting me through my labour and who had tried to get me out of the pool earlier being questioned over and over by police? Being interrogated using different words in an attempt to catch her out as if she was some sort of underground Midwife? A rogue. One of those witches who supports a woman’s choice on where to birth. She was just my friend, supporting me as best she could, watching me bleed and scared for my life when she wasn’t allowed in to see me in the hospital. Scared for her own safety.
Why did the police follow us to the hospital and further interrogate my husband and my friend prohibiting them from getting to me to see if I was ok? Why was there a guard at my door in the hospital who wouldn’t let my husband in to be with me as I was bleeding? Why?! Why did I feel, in my foggy oxytocin high state that I needed to apologise to that angry ambo for feeling like I had traumatised her, or opened some wound for her. WHAT THE FUCK WAS HAPPENING? (Side note – and I want to say this because I appreciated her gentleness at a time when I needed it the most. The other ambo was beautiful and lovely, calm and kind to me, but her actions were overshadowed by the others).
Leave your shit at the door and support your patient without judgement! Compassion costs nothing, but the lasting effects will impact many.
This should not be celebrated! This is what women and midwives/birth workers are facing as a reality. #enough! Too many birth workers vicariously traumatised. Too many women suffering from birth related PTSD when birth isn’t even recognised as a cause of PTSD. I’m not the first and certainly not the last to have an experience like this. (read more about that here)
Every.fucking.day. No one questions the women and babies injured, violated or traumatised in hospital. I don’t see cops on the doorsteps of hospital Midwives or Doctors or Obstetricians who hurt women and babies. Whose practices are so far from evidence based and more about their own needs. Or their faces splashed over the front page of the newspapers likening them to serial killers. No, because that would create fear. That wouldn’t be acceptable… so how is any of this ok? Why aren’t we standing up to this? It’s not about us vs them either. We are ALL affected. It’s about choice, options and respect for evidence based birth.
So what do we do in this mess?
Is it hopeless?
Please, I need to ask you one thing. Please do not feel sorry for me. Do not try to understand or pick apart all the layers of my story to find blame where it does not belong. The sympathy in the eyes of others is the hardest thing about my telling my story. Do not feel sad. I had a beautiful birth without the unnecessary intervention I would have had (remember, there was no indication anything was ever wrong or warranting intervention. It was purely a time thing). I birthed my baby into my space, on my terms. My baby had a beautiful entrance into the world despite the aftermath. We did it together, and he was 4 kg of healthy plump, pink goodness with an APGAR score of 10! (FYI APGAR is the score they give babies right after they are born to indicate their health based on their appearance)
It’s not how I would have wanted it, and it’s not how it should have been or had to be. But please just do me one thing. Take that sadness for me and turn it into something productive.
What you can do is get angry! Please, get real. Please listen to these stories that women are telling of births that didn’t have to end the way they did. STOP trying to blame the women. It’s not their fault their options are so limited and they are not being listened to. If you are triggered, good, dive deeper into what is making you uncomfortable. Sit with that discomfort. Unpack it. Tell someone about it. THIS is why more women are choosing (or being forced into) planned freebirth. I sure wish I had at least looked into it more. It is not a myth. This is a reality.
If you’re a Midwife in a hospital this is not a personal attack. Or an attack on Ambos for that matter. I know you do an amazing job. I know women have lovely births. I love Midwives! And Ambos are incredible. But you should be able to practice your craft without fear. This is not about you personally, this is about needing to do better as a WHOLE. Take that anger and discomfort and use it. For all women to have the choice to birth where SHE feels safest and with the option of having someone to care for her. For physiological birth to be understood and respected over what we are afraid of.
We need to be having real discussions
about the very real threats to homebirth.
We need to be getting to the nitty gritty of the seeming utopia that is normal physiological birth at home with continuity of care that we keep celebrating and putting on a pedestal, and why it is not accessible to all women who want it?
Wise words by Heather Hancock:
Women choosing to give birth at home are becoming increasingly marginalised, with fewer options for quality care than those who give birth in other settings. These restrictions only serve to further diminish their confidence in the health system, which they see as working against them.
We need to intelligently and safely accommodate women who want to give birth in their home into the mainstream maternity care system and provide them with safe and varied options. We can and must do better
I cannot sit here and celebrate something that only a very select few can access. We need to be honest and raw. We ALL need to get political. There is no point celebrating the last rhino and how amazing it is. No, we need to use that energy to SAVE ITS FREAKING BUTT!
Hannah Dahlen on our need for change:
One thing is clear: home birth is not going away and government denial won’t resolve this issue. Governments must act quickly to resolve this issue to ensure Australian women have access to safe and supported home births.
I know this experience had to happen for whatever reason. Maybe to give me the fire in my belly to push forward and speak out. I did everything I could to find other options. There weren’t any. I did plan to transfer earlier, but things happened too quickly. I did not expect to be alone at home (without access to a care provider). I did not prepare to be blamed for my bleeding when it was caused completely and utterly by the preventable circumstances of my third stage.
I also know that I am not alone. That increasingly, many women are actively choosing freebirth. Not because they want to, but because they don’t feel like they have any other option. And this is increasing as less women have access to Independent Midwives, and more women are being labelled ‘high risk’ (You can read another similar story here).
I’m not entirely sure where to from here, but we need to WAKE UP! We need to resist and stand up against another witch hunt; against the extinction of homebirth. Rally together, not just for homebirth, but for a woman’s choice to birth where and with whom she feels safe, for a Midwife to practice her craft and for women to reclaim their right to birth undisturbed in any location. We need to remember that homebirth is amazing, but we also need to ensure its survival, and the survival of woman centred care in any setting.
We are talking here about human rights. Read that again – our rights as human beings. To birth as our bodies require. To be respected as birthing women. To make decisions about where and with whom we birth. Do NOT let your fear or discomfort prevent you from standing up and speaking out. Do not let your fear enable its extinction.
This blog, and the discomfort I sit with in sharing my story publicly is my ode and promise to homebirth. To women. To the next generation. To those being persecuted. I will not celebrate until our human right to birth undisturbed, where and with whom we choose is accessible to all women, without fear of persecution.
Will you rise and speak up with me?
Thank you to everyone who supported me and helped/doula-ed me through this experience and this writing process. I am so very grateful.
Undisturbed Birth/The Golden Hour:
An actively managed placenta may be the best option for most women
Odent M. The fetus ejection reflex. Birth. 1987;14(2):104–105. [PubMed]
Odent M. 1992. The nature of birth and breastfeeding. Westport, CT: Greenwood Publishing.
Odent M. 1994. Birth Reborn. London, UK. Souvenir Press LTD
A woman’s right to choose: Maternal decision making policy
Group Streb B- testing and the use of antibiotics:
SA Perinatal Practice Guidelines: Planned Birth at Home
SA Restrictive Birthing Practices:
Homebirth ‘safety’ in terms of physical safety:
https://www.ncbi.nlm.nih.gov/pubmed/22972043 (Olsen & Clausen 2012)
Maternal Satisfaction/Rising PND/PTSD
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4399594/ (maternal satisfaction)
Cotzias CS, Paterson-Brown S, Fisk NM (1999) Prospective risk of unexplained stillbirth in singleton pregnancies at term: population based
analysis. BMJ 1999;319:287. doi: dx.doi.org/10.1136/bmj.319.7205.2
Norwitz, E R,Belfort, M A, Saade, GR, Miller, H, (2010) Obstetric Clinical Algorithms: Management and Evidence: Chapter 49. Post Term Pregnancy. Published Online: 6 MAY 2010 Accessed Oct 2017
(only a 0.0015% chance of fetal demise at 42 to 43 weeks)
Intervention rates and risks:
Decline in Women’s Options and Rising Freebirth Rates:
What we can do?
Sarah Buckley (2009) Gentle Birth Gentle Mothering. Celestial Arts, Berkley USA.
Sheila Kitzinger (2006) Birth Crisis. Taylor & Francis Ltd London, UK.
If this post triggers you or brings up any strong feelings please reach out and speak to someone. You could call Lifeline , PANDA or Beyondblue
You are amazing. Thank you so much for sharing your story and knowledge, and your passion for birth. I’m so sorry this experience was so intense for you, but hopefully the equal and opposite of such a shitty ride will be opening up all sorts of honest conversations about how we can all do better by our future generations….
Oh Hellena, thank you so so much! It means so much to hear these words of support from you. I know you get it. And I really really hope so to! So much love to you <3
Everything you have spoke about here resonates with me Katherine.
I had a traumatic first birth in hospital at age 31 followed by PTSD. The first lie I was told by mainstream midwives was that I would never get a midwife to attend me for a homebirth in a large regional city in NSW and the lies continued from there.
When that 2nd line unexpectedly turned pick some 10 years later, I knew one thing for sure – my second baby would not be birthed inside any sort of medical facility.
Despite being ‘high risk’ due to being 40 (41 when bub number 2 arrived) and being diagnosed with an autoimmune thyroid disease at 7 weeks pregnant (which responded well to meds and was well managed by the end of the pregnancy) , I jumped online and found myself the most amazing Independent Midwife. She still remembers the desperate tone of my first email to her almost 6 years ago and quickly understood why hospital wasn’t for me.
I went on to birth my daughter just over 5 years ago in my spa on my back veranda in only 6 hrs with no damage to either of us. It was the most amazing, healing and empowering experience of my life and I want that option for all women.
This bogus rubbish of being ‘risked out’ of Midwifery Group Practice Homebirth programs for ridiculous non-evidence based reasons has to stop.
I want all women to experience the gold standard of ante-natal, birth and post-natal care which is with one trusted midwife in the private of your own home.
I am disturbed by what is going on in SA in relation to Lisa and other birth workers – it is most definitely a violation of human rights.
We politically need to come together to be heard. When you speak to an ob/gyn who lied to her work colleagues about her own homebirth, you know our maternity care system is very, very broken. And given that suicide remains one of the leading causes of maternal morbidity in our country in the 12 months following birth, our mothers and their babies deserve much better.
Thank you so so much for your comment. I just felt myself nodding along to everything youve stated. Yes yes so much yes! Things do need to change. Our stories need to be heard! Evidence needs to be adhered to. Im so glad to hear that you found a midwife to support you despite the risks for herself. I hope more midwives will be able to support women like us into the future despite what is happening. Thank you so much again for your support and for speaking out!
Katherine, so much cudos for bravely publishing these words, and telling your story. here.
I’ve slipped out of the birthing mama scene of late but
A friend shared your story – and I looked for my wonderful home birth midwife to find she too has left for interstate. I’m so devestated for women birthing without choice in this state. Is birth itself endangered here?
But your story is so pertinent as I had recommended a wonderful neighbour of mine to the midwifery group practice, thinking they might be her best potential support for a vbac.
She’s found our system so dehumanising- being Dutch, compared to the truly woman c entered care she received with her last birth. She’s both appalled and extremely grateful for the information you have shared.
I truly hope your courage will create actual policy change within the program- as iof course my friend has been told to “stay home as long as you can” which is what every woman who is wanting to have a natural birth is told.
Wow, thank you so much for your reply. I deeply appreciate you reading and taking the time to comment. I’m so sorry your friend is not feeling that she is getting the care she (and all women) deserve. I hope she has a wonderful and empowering birth on her own terms- despite the lack of adequate support. and I hope in time things will change for the better!