Rise of the 'freebirthers': the mothers defying their doctors

For most pregnant women it would be a nightmare scenario: you're in the final stages of labour at home, there's no midwife or other medical help on the way. It's just you, in agony, on the bathroom floor, with your baby about to arrive – and your partner making frantic phone calls for help.

But some women, incredibly, are actually choosing to give birth at home without any medical professionals present, no drugs and having what is known as an unassisted or "free" childbirth.

Clio Howie from Pembrokeshire is one of these women. She felt that the NHS had nothing to offer her in terms of what she wanted for the birth of her second child. After a few antenatal check-ups and a 22-week scan to check that all was going well, she decided to "go it alone" and have the baby at home with only her partner there to witness the event.

"I believed emphatically in the ability of my body to be able to do this without any problems," she says. "I wanted to feel more involved with this birth, in a way I didn't with my first."

So emphatically did she believe in the power of her body that she allowed her unassisted birth to be filmed for a Channel Five documentary, Extraordinary People: Outlaw Births. It is an incredible event to witness. Howie calmly sits in the birthing pool, smiling and talking while her baby boy emerges and is lifted out of the water. At no point does she cry out in pain or scream – if ever there was an advert for an "ideal" intervention-free birth, this is it.

"It was a spiritual experience," she says. "I wanted my son to enter this world as a pure being and without fear. The best way to do that was by having an unassisted birth."

Clair MacVean, from south London, is another who had a planned, unassisted birth for her son, Rory, five months ago.

"I just didn't want anyone touching me or my baby throughout the labour," says MacVean. "I know it's not for everyone, but it felt right for me."

Having had a bad experience from her first birth in an NHS hospital, MacVean decided upon an unassisted birth at home. "I felt my birth in hospital was over-medicalised, over-managed and that the midwives had lost sight of the caring and empathetic aspect of their jobs," she says.

"I felt a loss of control in any decision-making and a complete loss of trust with the midwives. It felt like they were more interested in their machinery than they were in me or my baby. They took my baby away from me immediately after the birth when there was no need to. They left me there screaming, 'Give me my baby, give me my baby!' – it was only a few minutes, but it felt like a lifetime."

Although Howie and MacVean both had complication-free births and healthy babies, theirs is a controversial decision. The risks that they took in deciding to give birth without medical assistance are high, and the potential outcomes disastrous should anything have gone wrong. Unsurprisingly, it is not condoned by those in the medical profession.

Howie describes visiting her GP after the birth: "I had never met him before, but when he found out I had had an unassisted birth he actually shouted at me, he was so angry. I couldn't believe he was reacting like this. I have had to change to a different GP."

Maggie Blott, a consultant obstetrician at UCLH, is concerned that women are putting themselves and their babies in potentially life-threatening situations. "These women are choosing to take the kind of risk on behalf of their baby during labour that they wouldn't dream of doing after the baby was born."

Howie doesn't see what she did as risky, believing that "every woman knows by instinct when something is going wrong, and that is when she should call for help". When pressed about what might have happened to make her call for help, she is reluctant to hypothesise: "I didn't allow myself to think of any event that could go wrong, as this would have entered the element of fear into my mind about the birth."

Although there are no official numbers of women having an unassisted birth in the UK, there are countless examples of women who are unhappy with the standard of care they received during labour and after the birth.

The Healthcare Commission's review of maternity services, carried out last year, reported that 26 per cent of women had been left alone during labour at a time when it worried them, and 30 per cent did not feel involved in decisions about their care and the procedures performed.

It also showed a huge North-South divide: 70 per cent of maternity services in London fell into the lowest category of "least well performing", while in the North of England 75 per cent were rated as performing at the highest two levels.

Many women who do not wish to return to a hospital are opting for home births under the supervision of a midwife. But many independent midwives available for home births are prohibitively expensive (around £3,000 on average), so instead they can opt for an NHS midwife. But with an already overstretched NHS system and a chronic shortage of midwives, this brings with it its own set of problems.

Jo Lewitt, NCT chairwoman for Bath and Bristol, wanted a home birth for her second child. But when her contractions started and she called for an NHS midwife, she learnt that they were so understaffed that day there were no midwives available. "One midwife told me she was too tired to come – she said she had been working through the night and was too tired to drive. I couldn't believe what I was hearing."

Finally, a midwife did arrive, just in time – and less than an hour later, her baby was born.

"Even when there was no midwife on the horizon, I knew I didn't want to go into hospital again," says Lewitt. Her first birth experience had been terrible – on arrival at the hospital, she was told that her husband could not be with her in the labour ward because it was late at night. When she protested that she did not want to be without him, they left her to labour with her husband for 12 hours on a bed in the hospital corridor.

With the memory of this experience still in her mind, she says: "I would rather have had an unassisted birth at home if it came to that, than return to an NHS hospital."

Of course, there are thousands of women who give birth in NHS hospitals every year and are happy with the treatment they receive and speak of the wonderful midwives that ensured the safe arrival of their babies. But, as the system is faced with a shrinking workforce, tightening budgets and closures of midwife-led birthing centres, the concern is that more women will turn away from the NHS and hospital births after feeling that the level of care they received was substandard.

This is something that also concerns Louise Silverton, of the Royal College of Midwives. "Maternity services are still being ignored and midwives are being stretched to breaking point," she says. "I receive letters from midwives who say they actually dread coming to work and often work 12 hour days or longer. Many are often close to tears and leave the profession simply because it is not possible for them to do the job that they were trained for."

According to the Royal College of Midwives, a further 5,000 midwives is needed after birth rates have increased by 13 per cent in the last five years. The number of practising midwives, however, has dropped by 16 per cent since 2006. "This is impacting on the quality of care. Women expect a lot more from their midwives but this isn't happening and the lack of postnatal care is a disgrace," she adds.

Similarly, the funds allocated to NHS maternity services have also dwindled. In the Royal College of Midwives Parliamentary briefing in February, it was revealed that they have actually witnessed a cut of £55m.

Only last week Lord Darzi, Chair of Surgery at London's Imperial College and government minister advising on modernising the NHS, stated in his Next Stage Review report that more hospitals should be offering homebirths to mothers. However, Beverly Beech, chairwoman of the Association for Improvements in the Maternity Services says that, for this wish to become a workable reality, more funds will be required to ensure that there is the appropriate homebirth training for midwives.

"Midwives are losing the necessary skills for a 'natural' birth – too often they are trained for an obstetric delivery, focusing on procedures and intervention," she says. "Midwives need to be trained in how to attend a homebirth and to have the confidence to let labour progress naturally."

Although she does not condone unassisted births in any way, she is concerned that an increasingly interventionist approach is causing more problems than necessary, leaving women traumatised after a birth that should have been straightforward. The danger is that if NHS maternity services are not improved, more women may decide to opt out of NHS care altogether and perhaps go to the extremes of an unassisted birth.

If the trend towards unassisted birthing does increase, it would be a sad indictment of a failing NHS maternity system. As Maggie Blott of UCLH fears, "It would only be a matter of time until something goes wrong."

'Outlaw Births', by Clio David, is on Channel 5 at 9pm, 9 July

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