Homebirth, freebirth and doulas: Casualty and consequences of a broken maternity system

Humanised care and a change in practice in a hospital in Benin

“…Such systematic care often does not adequately meet the needs of women and their families. This causes some women to prefer to give birth in midwifeled birthing homes in high-income countries (Coyle et al, 2001;Walsh, 2006;Jimenez et al, 2010;Dahlen et al, 2011). A review of evidence by Bowser and Hill (2010) on disrespect and abuse in facility-based childbirth in low-and middle-income countries suggested that disrespectful care may often serve as a more powerful deterrent to choosing skilled birth care than other more commonly recognised deterrents such as geographic or financial obstacles.…”

Birthing outside the system: Perceptions of risk amongst Australian women who have freebirths and high risk homebirths

“…The majority of the scientific evidence and health policy however consider intentional birth at home without the presence of a health professional (freebirth) (Newman, 2008, p. 451) or planned homebirth for higher risk pregnancies, as less safe (Bastian et al, 1998;Dahlen, 2009;Symon et al, 2009;Kennare et al, 2010;Wax et al, 2010). There is some evidence that both freebirth and high risk home birth are becoming more common in Australia than they once were (Newman, 2008;Dahlen et al, 2010;Dahlen et al, 2011). Out of 832 submissions made to the Commonwealth of Australia as part of a recent review of maternity services in Australia (Commonwealth of Australia, 2009) 26 women reported their choice to freebirth and many of the 470 women who wrote about their homebirths had had high risk pregnancies .…”

Risk in pregnancy and birth: are we talking to ourselves?

“…Is it even possible for women, families, social groups, professional cultures, organisations and governments to behave differently in the contexts of shared existing and preceding cultures and histories, or put another way, can any of us think beyond our cultural landscape? Current debates about 'freebirthing' (home birth without professionals in attendance; see Dahlen, Jackson, & Stevens, 2011) suggest that even privileged women do not have the right to elude surveillance and supervision, the irony being that the freebirth 'alternative' so closely resembles the only choice available to women in low-income countries who have no right of access to safe, high quality maternity care, and this brings us back to the starting point of this editorial. Perhaps risk theorists working in the field of pregnancy and birth, and in general health care, might together begin to unpick the human and organisational costs and benefits of regulation and governance in late modern 'risk societies', to consider the opportunities and burdens we might unthinkingly bestow on developing economies, and ask what reach of regulation societies are willing to concede, and what should be considered excessive.…”