The Conversation Spain
Free childbirth is on the rise: why do some women choose it?
Shutterstock / Ink DropThe demand by women for free birth, understood as unassisted delivery by professionals legally accredited for it, is increasingly frequent. Although in our country it is still a minority option, in countries such as the United States, Canada, Finland, the United Kingdom and Sweden it is a recurring choice and cause of concern for maternal and child health professionals. The dissemination of these experiences through specific forums and social networks suggests that it may be an emerging phenomenon. Why is it booming? This demand is given in response to the empowerment of women and the perception of the excessive medicalization of the process of pregnancy, childbirth and the puerperium. The widely described episodes of obstetric violence also contribute to the choice of this form of birth. Childbirth, until a few decades ago, was identified as an inevitable and painful trance. However, it is increasingly seen by more women as a physiological and empowering life experience, which must be fully lived. Free delivery and home delivery Home delivery should not be confused with free delivery. The first, although it also takes place outside the hospital setting, has the means to develop safely and is supervised by a professional obstetrician. In this case, if necessary, I would go with the woman in labor to a hospital. Scientific evidence shows that home birth, with healthcare assistance, in low-risk women offers satisfactory results, both obstetric and neonatal. This is an option contemplated by the public health services of countries such as the Netherlands or England. Any health professional, even without specific training in obstetrics, is aware of the complications that can be triggered in a delivery that, a priori, is considered low risk. Obstetric professionals who attend home births study women who may be candidates for home birth. In the case of free delivery, there is no health professional who supports this decision or can act quickly if a complication is triggered. Free births are often assisted by doulas. The role of the doula is to accompany the delivery. In Spain, there is no formal education for their training, so there is no competent authority that certifies the suitability of these people to attend deliveries. However, logically, their services are paid. Risks of free birth We should not forget that the mortality related to childbirth worldwide continues to reach alarming figures. The World Health Organization estimates that about 830 women die every day from complications related to pregnancy and childbirth and about 7,000 newborns. Most of these deaths are preventable and occur in low-income countries. Complications such as bleeding or infections are very common causes of maternal mortality. These are easily preventable and treatable with the appropriate technical and human means. Without proper care, complications during childbirth can mean death or serious illness in the mother or newborn. In addition, from a legal point of view, the parents assume a risk if a harmful result for the child occurs, as a result of the lack of professional assistance. Why doesn’t a woman want to give birth in the hospital? Beyond the reasonable concern that this situation may entail, the following reflection is pressing: What leads a woman, with available means, to give birth at home without healthcare? Most of the studies carried out agree that women who use this option consider childbirth to be a physiological situation. They argue that they want to enjoy a unique life experience in privacy and intimacy and asserting their individuality and cultural preferences. Given these statements, it is urgent to reformulate the nature of obstetrics services. The Delivery and Birth Plan does not seem to be sufficient to meet the needs of families who opt for alternative formulas such as free delivery. Poor obstetric services Encouraging freedom of movement and the adoption of different postures during childbirth, facilitating early skin-to-skin contact, ensuring privacy and intimacy are some of the factors that would help women decide to carry out an assisted delivery by health personnel. In addition, it is recommended to facilitate the continuous monitoring of a person of your choice, allow the intake of clear liquids or include the use of materials and techniques that favor comfort, such as the use of spherodynamics, massages, hydrotherapy, etc. These activities, among others, are easily implemented in obstetric services and, although they seem essential, they are still utopian in many maternity hospitals. Despite the rejection that the choice of free birth may entail for health professionals for scientific, professional and ethical reasons, it should not be forgotten that it is an option that many women access after negative experiences in the hospital setting. In conclusion, it seems sensible to warn of the need to respect the preferences of pregnant women, assist in making informed decisions, individualize care care and promote a positive experience of labor and delivery. This article was originally published in The Conversation. Read the original. Eloísa Fernández Ordóñez does not receive a salary, nor does she work as a consultant, nor does she own shares, nor does she receive financing from any company or organization that can benefit from this article, and she has declared that she lacks relevant links beyond the academic position mentioned.