The way we frame “Unassisted Childbirth” matters

I birthed unassisted and am painfully aware of the prevailing attitudes out there surrounding it.  This post is an exploration of how Unassisted Childbirth (UC)¹ is generally perceived and how (mis)perceptions of UC have a negative impact on women.

(UC) has been an elephant in the room for a while but I think it’s multiplied into the whole herd. We need to talk about it and frame UC as it deserves to be–as one valid option for women. Earlier this week, an article was written on UC using the canary in the coal mine analogy.² I found the article patronizing in the suggestion that UC somehow needs fixing and also in the implication that someone other than the woman is the authority in birth. To my eyes, the article serves to reinforce the idea that our culture is in a position to judge what women have a right to (in this case, UC). Raising the “question of safety” paints UC as dangerous and misses the mark. The tone of the article is one I’m familiar with: fix the system and that will take care of women desiring UC. In essence, the article failed to recognize and understand the motivation for many women choosing UC.

I have a different way of looking at the canary in the coal mine analogy. To me, the canaries don’t represent the fact women are choosing UC. Rather, I see the canaries as representative of the stories, experiences, and rights of any woman whose choices have ever been invalidated. I argue that though a minority, UCers make up an important part of this category and worthy of noting. The fear and condemnation they face is real and the unwillingness to recognize the judgment they face as harmful is akin to the miner ignoring a canary taking a dive because he thinks the atmosphere doesn’t affect him.

The alarm isn’t that women birth unassisted. The alarm is that someone other than the mother thinks they have a say in what’s valid, legitimate, justified or safe for women.

I acknowledge that some women feel pushed into UC for lack of options and that is not okay–but this alone does not define UC. I acknowledge that a shift is needed in the system for the sake of all women. I also recognize it takes all kinds to make changes.

I’m thinking here of the new Facebook page by a nurse called: Hospital Birth Exposed – I Can’t Stay Quiet Any Longer. I feel she is brave in speaking out against what she sees and I respect her for doing so. But she also feels the need to single out UC: “while I support women’s birth choices, including not to birth at all, I do not feel comfortable with unassisted or unattended home birth, and am not promoting it here. It would be my desire that each woman have a trained attendant who can support her in exactly the way she wants and needs.”

Again, there is a failing to understand the motivation for many women choosing UC and a larger failing to recognize that humanizing birth includes doing so for all women (regardless of where or how a birth takes place). Aside from it being their right, many women want and need to be alone. Don’t be comfortable with it, that’s ok. I get it–it’s not what you would choose. But know that discomfort or lack of agreement for it does not prevent the right of another to pursue it. And let’s dig a little deeper into this common statement of not being “comfortable” with the choice to UC and where that leads.

I sense that behind the guise of “comfort” there too often lurks something more sinister–a judgement that says: “that’s just plain dangerous and women shouldn’t be allowed to do it.”

The FB page and article I mention are only two examples among many where a line is drawn in the sand on what women have a right to and UC comes up on the wrong side. Naturally, we all have our own opinions and are free to share them. But when the context is that of supporting women’s birth choices “except when” or supporting human rights “except for” I feel it’s vital to speak out.

The real issue is that human rights seem to be up for debate based on what’s popular or considered acceptable and “safe.”

Stop doing it because there is a price to pay down the line and one day it might be you or your children that’s paying. I have run into this before where an organization balked at including UCers because they were concerned they would lose respect from the medical community. I guess they were less concerned with losing respect from women who had been supporting their organization. They also didn’t want to be seen as “promoting” UC.

Validation in itself does not suggest promotion of a thing.  One can recognize a woman’s human right to choose the circumstances of her birth without promoting any particular choice.

What happens when we do not talk about UC as a valid option? Why do I care so much?  Well, as I stated, I birthed unassisted. I have heard many negative comments for my choices stemming from ignorance or fear–some of which were merely annoying. But other situations where far more harmful. I wrote about my postpartum hospital experience on the Humanize Birth site. I feel I was punished for doing what I felt best for both myself and my baby–for birthing exactly how I wanted and how I needed to.

The way I was treated as a woman who chose to birth unassisted impacted my life forever. I feel my rights were violated and yet few heard my plea. I was met with a lot of silence. This is why the way we talk about UC matters.

Excluding others for their choices is harmful. The significance of regarding UC as dangerous and irresponsible is that it lays down the foundation for someone other than the woman to be the authority. When that happens it’s the woman who pays. When I shared my own experience of abuse even “sympathetic” listeners asked me “well, what did you expect?” I wasn’t asking anyone to agree with me or even feel comfortable with my decision to UC. Was I wrong to think I’d be treated with respect? The lack of consequences for the person I feel violated my rights tells me that I was.

One point often argued as a reason for not including UC in the discussion is that they are “outside of the system.” It’s true that many UCers do not access medical care at any point (for reasons that vary) while others choose outside pre or post natal care. Others yet may transfer during or after the birthing process. It matters when we fail to understand UCers and their inherent rights because when they do access care they are at risk of being mistreated. It’s hard to get formal complaints of any kind recognized in the current climate but I argue it’s even more difficult for UCers to be taken seriously. How can we expect a system to respect a woman’s birth rights as human rights when it doesn’t even recognize that UCers have these rights?

It all starts with something like: “I believe every woman has the right to choose the circumstances of her birth…except you and you and you.” There fall the canaries.

UCers who do not access medical care may face other hurdles as a result of their choices such as in difficulty registering their births and obtaining certificates. Some women are harassed in pregnancy or even during the birthing process when it’s discovered they are UCing. Some of these problems aren’t unique to UCers but I do suggest the difficulties they face are compounded. Too often, the very people claiming to strive for humanized birth are the ones invalidating the choice to UC. And so, women who UC fall though the cracks because people aren’t “comfortable” with the choice.

I say that unassisted birth matters. How we frame it is of significance to us all.  Either women have the right to choose the circumstances of their births or they don’t. If you participate in discrediting UC, then also be prepared to ask: who’s next in line? ³

Don’t promote UC. No one is asking you to. But stop discrediting women’s choices. If you feel uncomfortable or fearful of even talking about it, please reconsider the implications of your silence. Stigmatizing UC hurts women, babies and families. Don’t ignore the canaries that are falling because they are smaller in numbers or because you think they fly funny. Their falling away is the alarm that you–what you would choose–could be next.

  1. I recognize the term “unassisted childbirth” is problematic in itself. There are other terms for birthing without the assistance of a medical professional including but not limited to free, undisturbed, unattended, DIY, unhindered, family birth, etc.
  2. Reference to the controversial article on Unassisted Birth: “A canary in the coal mine: the growing popularity of unassisted childbirth.”
  3. Read my earlier blog post on the topic and take special note of the poem quoted there called: “Why we must stand together.”

Why are birth issues human rights issues?

I’ve been asked this question several times lately by family, friends and the media. I’m surprised how many people are reluctant to think of birth rights as human rights.

“Human rights are women’s rights, and women’s rights are human rights.”  –Hillary Clinton

It’s quite simple: women are the owners of their bodies. They posses the sole authority with regard to their bodies and this fact is no less true during the birthing process. I believe this is the baseline we all need to work from.

Okay, so let’s say that seems reasonable, why is it such a big deal? It becomes a big deal when these rights are neither recognized or upheld.

Women around the globe are suffering violations in childbirth. At first glance, certain violations may seem more obvious than others so perhaps another approach would be to ask: “what do the violations look like?” Some examples of violations in childbirth include:

  • Lack of birthing options.  Yes, lack of birthing options is a violation of human rights. Each woman has the right to bodily autonomy and to choose the circumstances of her birth. When women are restricted in making those choices (indeed, sometimes punished) a violation occurs. This can range from lack of access to midwifery to the inability to find, for instance, a care provider who supports a vaginal birth after cesarean (vbac).
  • Lack of informed consent and refusal. Women are not always given all the information needed to make an informed decision. Women are often told what they are “allowed” to do with respect to maternity care without acknowledging they have options. To read women’s stories on this topic, visit the Humanize Birth campaign: Without My Consent: A Message from Birthing Women.

This list is by no means exhaustive, the point is to recognize what these violations look like so we can speak up and make the changes needed to protect birthing/human rights!

We all have a stake in this (regardless of age or gender) and I urge you to take action to ensure that a woman’s fundamental human right is upheld during pregnancy and birth.

“The freedom of a country can be measured by the freedom of birth.” –Dr. Agnes Gereb

Humanize Birth website posts women’s stories of how they were violated. Also their campaign on Facebook: Without My Consent: A Message from Birthing Women
Human Rights in Childbirth website lists the fundamental rights of birthing women and a page outlining what the violations look like. 
White ribbon Alliance website lists The Universal Rights of Childbearing Women and their Youtube video Break the Silence: Respectful Maternity Care
Your Birth Coach youtube video: End Violence Against Women.