TRANSCRIPT
A "freebirth" - sometimes called a "wild birth" - is when a woman plans to gives birth outside of a hospital, without the supervision and presence of a registered health professional in childbirth, such as a midwife or doctor.
The idea has its roots in the natural childbirth movement, which gained popularity in the 1960's and 70's, in response to concern over the level of medical intervention in childbirth.
The chief midwife at the Australian College of Midwives, Alison Weatherstone, says it is important to understand the level of risk when parents forgo the supervision of a registered health professional like a midwife or doctor.
"Freebirth is where a woman births her baby in the absence of an appropriately qualified health care provider, whether that be a midwife or a doctor, and so home birth on the other hand is you can still have a home birth without support, and I guess that equates to free birth because free birth can be anywhere and you can technically, the definition of home birth is anywhere outside of a hospital. But the key to that from ACM's perspective is that home birth for certain women is a safe option, providing they've got the support of our suitably qualified healthcare professional."
Data is not collected on freebirths in Australia, but the Australian Institute of Health and Welfare does note the majority (97 per cent) of births occur in hospitals, 1.8 per cent of women give birth in birth centres, and 0.3 per cent at home.
The recent death of premature twins in Byron Bay, New South Wales (11 February) - in an apparent free birth - is raising fresh concerns about the practice.
It follows another case in January in regional Victoria where a baby was born in a critical condition.
Hannah Dahlen is a Professor of Midwifery at Western Sydney University.
She told SBS, research shows good outcomes for planned home births attended by competent midwives linked to a responsive maternity system - for mothers with low risk pregnancies.
"The evidence for planned home birth for low risk women attended by competent midwives who are well networked into the system is that the outcomes are better than hospital for intervention rates, as good for the baby, and better for the mother."
Ms Weatherstone says freebirths carry increased risk, particularly when unrecognised complications arise.
"Part of that is actually having a backup plan when things don't go to plan. And that would include emergency services retrieval and I guess with free birth often, the woman isn't known to the hospital system so when they're turning up requiring assistance, if they require assistance and they're unknown to the hospital or care provider, it can cause delays in treatment and management."
Since 2022, 10 catastrophic incidents linked to "freebirths" in south east Queensland and northern New South Wales have been confirmed, according to an ABC investigation.
Professor Dahlen says anecdotal reports suggest the practice of freebirthing is on the rise.
She has done research on the considerations of women in choosing a planned homebirth with a registered midwife; and those who selected or were thinking about "freebirthing".
"It is being driven primarily by women's traumatic experiences in the system, or their inability to find choices that suit what they want, for example, unable to find a home birth supported midwife, unable to ind a birth center, or just feeling so bullied and coerced in the system that they feel there'll be no choice and so they choose to go outside the system. So that seems to be the one of the major drivers past trauma, and lack of options."
Professor Dahlen says it is important to look at the experience of women giving birth in mainstream care - and consider how it could be a factor in women choosing freebirthing.
"It's very easy to demonise these women and just call them irresponsible and ignorant. In fact, we have interviewed thousands, thousands of women, done surveys across the nation, published an international book on this. These are some of the most prepared and informed women you will ever come across. What they are often though is traumatised, and between a rock and a hard place with no other option. So if we want to fix freebirth, we have to actually stop looking at freebirth as the problem and start looking at mainstream care as the problem."
Professor Dahlen was an expert witness at the NSW birth trauma inquiry, which received a record 4,000 submissions; and heard graphic testimonies from women who had experienced trauma during birth in NSW hospitals.
Among the testimonies given, many women spoke of weight-shaming, inadequate pain relief and a lack of informed consent about birth intervention.
Ms Weatherstone says while there will always be some women who choose freebirth, others simply need the system to better meet their needs.
"It all points to maternity service reform to me we're not quite getting it right, women for whatever reason. Some women are choosing not to birth in the hospital system because of a real reason others, there will always be a cohort of women that actively and always will choose free birth and there's no way to really influence that because that will always exist. But it is the women that hospital avoiding or they can't access a continuity model of care where they have the same midwife throughout all of their pregnancy, labor, birth and postnatal period. They're the women that we really need to be supporting, to engage so that you know we can change the system to meet their needs."
