Why do some women choose to freebirth in the UK? An interpretative phenomenological study

Abstract

BackgroundFreebirthing or unassisted birth is the active choice made by a woman to birth without a trained professional present, even where there is access to maternity provision. This is a radical childbirth choice, which has potential morbidity and mortality risks for mother and baby. While a number of studies have explored women’s freebirth experiences, there has been no research undertaken in the UK. The aim of this study was to explore and identify what influenced women’s decision to freebirth in a UK context.MethodsAn interpretive phenomenological approach was adopted. Advertisements were posted on freebirth websites, and ten women participated in the study by completing a narrative (n = 9) and/or taking part in an in-depth interview (n = 10). Data analysis was carried out using interpretative methods informed by Heidegger and Gadamer’s hermeneutic-phenomenological concepts.ResultsThree main themes emerged from the data. Contextualising herstory describes how the participants’ backgrounds (personal and/or childbirth related) influenced their decision making. Diverging paths of decision making provides more detailed insights into how and why women’s different backgrounds and experiences of childbirth and maternity care influenced their decision to freebirth. Converging path of decision making, outlines the commonalities in women’s narratives in terms of how they sought to validate their decision to freebirth, such as through self-directed research, enlisting the support of others and conceptualising risk.ConclusionThe UK based midwifery philosophy of woman-centred care that tailors care to individual needs is not always carried out, leaving women to feel disillusioned, unsafe and opting out of any form of professionalised care for their births. Maternity services need to provide support for women who have experienced a previous traumatic birth. Midwives also need to help restore relationships with women, and co-create birth plans that enable women to be active agents in their birthing decisions even if they challenge normative practices. The fact that women choose to freebirth in order to create a calm, quiet birthing space that is free from clinical interruptions and that enhances the physiology of labour, should be a key consideration.

Connecting Status and Professional Learning: An Analysis of Midwives Career Using the Place© Model

“…Research by Jackson et al [47] reports that women who free birth, do not view hospitals as safe places within which to birth. This view is further supported by other women who chose free birth in order to have choice, control and autonomy during birth [48] with some women relating the absence of the woman-centered care in maternity services, leaving them feeling vulnerable and unsafe [49]. It is important to note that safety relates not only to the physical sense of safety but also the emotional, psychological, and social aspects of care.…”

Challenging the status quo: Women's experiences of opting for a home birth in Andalucia, Spain

“…In our study the rejection of the biomedical model was a common theme that emerged as women's motivation to birth out of the hospital setting. Dahlen, Barclay and Homer (2010) as well as Feeley and Thomson (2016) reported that a medicalised care approach with routine interventions contributed to women's lack of satisfaction with previous births and to the drive to seek alternative birth places for subsequent pregnancies. Women who had a home birth felt that they were not bound to a biomedical model of care, which was the norm at the hospital (Laws et al, 2011).…”

I-POEMS Listening to the voices of women with a traumatic birth experience

“…A few women in our study had an unassisted birth after the birth they had experienced as traumatic. Although this might not be a course of action for all women with a traumatic birth experience, we know that this response is strongly associated with ascertaining human dignity, often a result of poor experiences with maternity care, a lack of faith in, and feeling unsafe with the care provided -due to the sense of loss of autonomy and the negative and disrespectful interactions with healthcare professionals [56]. These aspects seem to resonate with the experiences of the women in our study.…”