Ep 192. Freebirth, Autonomy & Birth Outside the System (Pt 2)

Join us as we jump into the complexities of freebirth, discussing autonomy, safety, and the various reasons women choose this path. We'll touch on our perspectives and share about the importance of responsibility in the birthing journey. Part 2 of 2.

00:00 Introduction to At Home with Kelly and Tiffany
01:09 Continuing the Free Birth Conversation
01:54 Historical Perspectives on Birth
04:25 The Role of Midwives and Birth Attendants
11:04 Legalities and Regulations of Home Birth
18:15 Responsibilities and Considerations for Free Birth
21:36 Empowering Women in Birth Choices
25:20 Conclusion and Further Resources

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Transcript

0:00

Welcome to at Home with Kelly and Tiffany, where we share powerful tools, exciting education, and relatable views about holistic health, physiological birth, and thriving in the female body. We are home birth midwives in sunny San Diego. Passionate about the alternatives that give women control and confidence in health, in birth and in life. We've poured a lot of love into creating very in depth and high value offerings. A monthly membership, a physiological birth course, and holistic guides for the women who really want to dive all the way in. But this podcast. We want to bring zero cost information about health and natural birth and make these important topics accessible always. Your support of the show is also zero cost and means everything to us. When you leave a review, share an episode and join our newsletter. It really helps us keep this space open, ad free and full of honest, valuable conversations. Now let's dive into today's show. Welcome back to at Home with Kelly and Tiffany. We are on part two. We left you last week with a bit of a cliffhanger. I'm really enjoying this conversation.'cause I just love, it's not necessarily like full on education of take this when you feel this particular way, this supplement is good for this. The nuance and the emotion and all of that surrounding our free birth conversation is just I dunno. It's really encouraging to me. So if you are here and you're like, what are you talking about? You can jump back to last week. To hear us introduce, give some. Foundations to free birth, why women choose free birth the kind of different paradigms I guess in birth and how free birth can fits into some of those choices and some of kind of the safety concerns that come up with birthing outside of the system in general. So we're gonna jump right back into this discussion with a look at some of the historical traditions of birth. Okay, so we want to be left alone in birth, right? We talk about that all the time, but when it comes to free birth and like that extreme, that's that more extreme side of the spectrum, I have to ask the question. Are we, have we arrived as the most autonomous brothers? Once we hit the free birthplace? Are we like when we're appreciating that and loving that and wanting that, is that the, is that what's up on the pedestal? Is free birth up on the pedestal? Because are we really meant to birth alone? Are we really meant to completely discard. Assistance or attendance or things like that. For most of history, birth happened at home, right? Pre 19 hundreds. Then like beginning of the 19 hundreds. We shifted to doctors and hospitals by the mid 19 hundreds, which was only 75 years ago. Women were anesthetized excluded from decision making. We have all that twilight sleep situation. Then in the sixties, natural birth and the educational approach to birth brought women back to the center, and now we have started since then exploring the integrative models like hospital midwives and birth centers. But the technological advances have continued harming us and leading to poor outcomes. So today's birth culture lives in this spectrum. Okay. And it can cause a bit of tension between what is best, right? And that stigma of what we think is best for other women, but really having to evaluate that personally and what is best for you. Yeah, and thinking back on the history of birth. It really is interesting, like your question of are we meant to birth alone? And I think probably free Birthers would say it's not necessarily alone. Like it doesn't have to be alone. But it's just, it's interesting to pull apart some of the things that we need to learn and unlearn just because we've been exposed to so much about birth. In our culture and come in with probably many of you listening have and myself included, a hard idea of what birth can be and maybe on some level should be right. And so it's just interesting to pull some of those things apart. Yeah, birth is physical, but it's also deeply cultural. Deeply social. It's a communal rate of passage traditionally. And so before hospitals and obstetrics birth was supported in the home by other moms, maybe your own mom, your own sisters, your friends, but there were also local midwives, or there were. Really experienced mothers who had given birth before that you would ask to come attend you. And they weren't just there for safety. We've turned this attendant thing into this safety thing. We're so fixated on safety, but they were there for comfort. For reassurance, for connection and their presence reflected. Having them there was good, right? Like you wanted someone else there to remind you. Birth is normal. It's a sacred part of life. You're doing it. It's hard, but it's right. And so cultures had these traditions to mark and protect this transition. So when a midwife was present, her role was as much emotional and spiritual as it was at physical and practical. And I can totally see how culture would look at that and feel like we lost it. Like we we've lost this communal, traditional approach to birth and we're getting like, carried away with some other. Ways of being midwives, but the midwife carried the community's wisdom. She knew birth. She was trained by somebody who had been, involved in birth for maybe decades. It was one of those things that was like passed down the lines and she was there to hold space for the mother to lay labor and trust and just be someone who could just quietly be the presence of this is normal. You're doing fine. So midwives are meant to be the guide, the friend the keeper, the safeguard and birth belonged to the community in that way because you recognized that you didn't want to do it alone. You didn't want to be by yourself. You didn't want to not have somebody there to remind you of all of those things. And so I think it's important that we, like when we talk about birth and where it came from and what it used to be and how we've been doing it for. Thousands and thousands of years, and it's the only reason that we're all here. We have to look at the community and cultural aspects of how that worked well in society when home birth was the norm. Yeah, I've read a couple like historical fiction books about midwives in different communities. I'm like, oh, this is so fascinating. One. It's in some ways I'm like, oh man, I like long for that. That sounds so sweet and good and rich. Especially their training where it's like just community based and not as insane as it is now for midwives coming up. But yes, even the fact that like we have doulas, that is their profession, that you have to, that you have to pay for a doula and not they are worth it. I'm not saying that's nothing against. Doula work. It's just that used to not necessarily probably be a thing'cause your sister had seen so many births and gone through it herself, or your best friend or your neighbor across the street kind of thing, and everybody would come. It's just interesting how things have changed. Yeah. And there's still, there's I see this shift happening and how. Women who attend births are identifying with their role. And so you see a lot of people saying I'm a birth keeper, or I'm a wise woman, and it might not be somebody who's necessarily medically trained. Like they're not even calling themselves doulas really, because they wanna be so separate from this really modern piece that we've put on those roles. I, I totally get that. Like they wanna, they want the roots of being with women in a cultural way and not a clinical way. Yeah. Which is it's just, it's, it is just interesting. And I guess social media just illuminates it more of, I had no idea there was an entire kind of I don't wanna call it a subculture, but just like a different. Like view on that. Because even coming up in birth work, I was like, Ooh, the, I I just maybe put midwives on like a pedestal, like home birth midwives, this, when a wonderful yada, which got torn down pretty quickly. But but seeing it from a different perspective of seeing it's not that it's wrong or bad, but just we've lost something and we're trying to regain it. I completely respect that like viewpoint. Yeah. I just struggle with. The actuality of it, because even just in like our, I can see it working. I can see this idea and I love it. And when we talk about it, even right now, I'm like, yeah, that is what it should be. That is what it should be. We should be going back to that. And maybe there's some, there's plenty of scenarios and relationships in which that would work, but even as I just look back at the very limited population of women that we have worked with over the years, and we're quite picky and selective. So I think our clients are the best. But even looking at that, them as a whole, they don't. They're not asking for that. They don't want that. But then also it's then they're not, but they're not coming to they're, if you're in this place where you're like, I don't wanna, I don't want a clinically trained person, I just want a birth keeper and a sister. You're not gonna come interview home birth midwives and get, like you're not gonna get tangled up with us. But it's a very small population of women. Even when I think about our own clients. And taking this more sisterly, laid back approach. That's not what most women actually want. Yes. Yeah, I would agree with that. I'm thinking about someone that we know who utilized our services, who then decided to go the route of not having anybody with her. Yes. And that was really fascinating to me. But also ILI i'm sure there's a lot of, maybe there's a lot of birth workers listening who are like, free birth is, unsafe or whatever. When she walked into that decision, I was like, yes, this makes complete sense. And I was like, I don't feel an ache of oh or why it was like, look at you. And it was an enc. It was an encouragement to me. But again, that's somebody that like we knew very intimately. Also. Yeah. And like we've been we've taken care of women before that. Were like, why do you have us here? You don't really want a midwife at your birth. You don't want anyone, is it your husband? Is he afraid? Everything you're asking us to do, sounds like you just really didn't wanna have someone here. Which is acceptable. So no, I think it's, I think it's helpful to recognize where we've come from, because of course that puts this perspective into our heads of what exactly is, what exactly birth should be, what it can be, what it could be, all of the things. So I think an interesting I don't know, comment, question, whatever, that we get often. From people on Instagram or that come up that we see, on like free birth Instagram accounts or whatever is about like legality. People will even message us this about home birth. Is it legal to have a home birth? Oh, I thought that was illegal. I didn't realize. So free birth and home birth, they're legal. They're legal in all the states, right? You're allowed to have your baby where you would like to have your baby, but who may actually attend your birth. Is going to vary state to state. And so that gets put right on the providers. The type of midwife that desire may be actually restricted where you are. So that also potentially motivates women towards unattended birth too, depending on ooh, all that's around me are just CN msms, or I can't find this underground, space of somebody else who is, going rogue and attending births or whatever. Like illegally or illegally that sometimes is a motivator to say I don't like these, options. I don't like what's going on in my state. And so CPMs, which certified professional midwives, they're unregulated in multiple states. Connecticut, Georgia, Massachusetts, Mississippi, Nebraska, Nevada, New York, North Carolina, North Dakota, Ohio, Pennsylvania, West Virginia. All of those places have unregulated. CPMs. So in some of those states, it's actually illegal for a CPM to attend a home birth, and they, there are many who still are. I will say that. So it's not saying that you don't have any options. There are many who are still are doing the thing because they believe in it so much, even though they're going against, legality, I suppose there CNS though, they generally have more options state to state, right? But they're trained in a medical model, so they may, be offering a bit of a different philosophy too than those women who are looking for greater autonomy. So again, women in certain states in particular are like let me look at my options here. And I understand completely where they're like, yeah, maybe there's a lot of options, but none of them feel good. None of them feel right for me. So many believe out in the world that unregulated midwives are actually a good thing, right? Having don't, not having the state say, here's what midwifery should, do how they should practice, they see that as a good thing, right? Less oversight, less restrictions on how to practice. And then on the other side, we also see poorer outcomes, unfortunately, in those areas too. So it's, it's helpful to. Toe both lines, right? And understand with eyes wide open what exactly is going on. And I'm not saying that those states are, bad to have babies in or whatever, or that these midwives are. Unregulated midwives are not performing their, duties. What, whatever. It's just that's just the information that I'm putting out there. That's what the stats say. But it's like brings to the question of do midwives actually does that need to be modernized? Who's going to set the standard? Oftentimes it's medical standards and physicians who have a say in what actually makes midwifery safe, which is a little crazy making because they don't understand it. And they have no grid whatsoever for what birthing at home actually looks like. So it, it makes a, makes me a little ticking about that. But that like in California we are regulated as licensed midwives. In California, our supervising board for our licensed is the Medical Board of California that regulates physicians and they are getting better about having midwifery representation. And stuff like that, but like it goes back, it reinforces that whole idea that the doctor knows best. And that his way is better and that midwives are like a subset of medical care providers. Who. Should ultimately answer to medicine. Yes. And I, so I completely see, like in a lot of states, people are like, women are fighting against midwifery regulations because they're like, we don't want what Cal, like what we see in California or whatever. Yeah, we have to be restricted. You could drive over state lines and have your twins at home. With your, home birth midwife, and that's totally fine, but here in California you couldn't. And not saying there are ways around that, whatever, that's a different conversation anyway. But so this, it's helpful to recognize that the law always it's just, it's a political thing. It's a legal thing, birth unfortunately, but there are a couple if you are like considering free birth or it's just something that you're like, huh, how does that work? There are a couple things to consider legality wise. Birth registration, right? Like how are you going to go about in your state getting your baby's birth certificate, any newborn services that you are requiring, any insurance, like things that you may need to know, information or paperwork that you may need to have. It does get a little bit dicier trying to get those things if you don't have a medical care provider just because. They're usually the ones who are filling those things out for you and handing them over and making that part easy. So it's a bit of extra I don't know, research you need to do to be prepared for that kind of legal aspect of things. Yeah, and like just if you're considering free birth, like really think about how are you going to get what you need, because we have people reach out to us all the time. Asking for certain types of documentation and stuff that, because that's what they need in order to get their stuff done. And we're like, we really can't do that for you. I'm sorry. That's not gonna work. We just I actually can't do that. And that kind of, to me, goes along with. People reaching out to us all the time to ask for medical advice for things because they've chosen not to have a provider, which is very interesting to me. And I don't think that because you're not a client or a patient somewhere, it doesn't mean that you don't deserve to have information and have clinical care if you desire it. But I'm not I don't think I wanna get tangled up in that necessarily, especially somebody who I don't have a client relationship with that. Some of that protects me, right? Because I do have a license, so I do need to conduct myself in a certain way. Then now you're saying, I need this information, or I want help, or I want the expertise of someone. But you've chosen, you've made the decision not to, and I wish there I wish there was more in the middle for people where, and there's lots of workarounds too, right? There's a lot that we could totally take somebody on. I don't wanna say anything. There's lots of workarounds, right? There's lots of workarounds. But it really does come down to the responsibility. And so I wanna share some of those pieces as a home birth midwife, maybe I'm missing some stuff.'cause again, you guys, I'm not the, I'm not the free birth expert. Turns out people listening. If we, there's if there's like some die hard free birthers out there who are listening to this right now, they probably think that this entire episode is rubbish. It would be really fascinating, to have one of those reaction videos of somebody like, oh, I think we're representing it in the way that we in the way that we can represent it. We're home birth midwives. Yes. We're talking about free birth. Yes. Okay. We're not. The authority on free birth. That's the funny thing, is that nobody is right. Okay, so how are you gonna deal with pregnancy, right? Prenatal self-assessment. Some people do go get clinical care for their pregnancy, but it's also called a wild pregnancy if you don't, because you're gonna keep track of your own health status, your own screening, you're gonna learn your own warning signs. You're gonna get your own general health education and watch some of those things. Responsibility includes contingency planning, like knowing what can go wrong, having a transfer plan, even if you don't have a provider to initiate that, recognizing that can be needed bringing in other support, right? Like your partner probably needs to do more during your birth than he would if you had an attendant. A asking a doula to be there and finding someone who's comfortable with them, being the, probably the one who has the most knowledge and information about birth, but really they're not supposed to be providing any clinical anything clinical. They're just there for emotional and physical support, but you're actually asking them to be the birth expert, right? That's. Tricky. It's a whole thing. Have you ever been invited to a free birth as a doula? Like before you became, do I feel like it came up a couple times? Yeah. Yeah. And I just couldn't, I just couldn't wrestle. Maybe when I was a student midwife too, it came up and then I would've gotten in so much trouble. Oh yeah. I would not have been able to say yes to that. I think that's actually part of it could get you kicked out. That's what I mean. Yeah. Yeah. Yeah. And, and there's doulas who are reaching out to us all the time asking us, Hey, what should we do about this thing? Or trying to get our clinical advice because now they're managing the pregnancy situation for their doula client, essentially. Yeah. It's messy. It can be really messy. So everyone being on the same page about expectations and roles and stuff like that is pretty important. And the supplies that you need. The stuff that you're gonna need at your house, that's pretty easy. You can find a list online and just order it all on Amazon, to be honest. Postpartum knowledge about bleeding, infection, newborn breathing, feeding your baby, all of that. And then just emotional and mental responsibility, like being psychologically ready in charge, confronting the possible outcomes, and just being prepared for that. Yeah, and so much in birth is. In our culture is giving that responsibility away. And even if you were having a midwife attended, pregnancy and birth, I love it when women are like, and I got a fetoscope and I'm understanding how to listen to my baby. And I understand, I'm like, yes, because this is your body, this is your experience. Like I, we always say women really are the expert. Now, of course we're providing this like scaffolding space to provide support and help and impact on the places where they are not necessarily the expert or in the moment. Like when I was pregnant with my third, I had be, I was a midwife at the time or got licensed while I was pregnant, and everyone was like, ha, are you gonna be your own midwife? No, because in that moment I wanted to be a mom, right? Like I wanted to be able to be taken care of in that way, but that a piece of that was like, yes, of course I'm giving some of that responsibility to somebody else, because that's what felt right to me. And I recognize also not everybody wants to give that to somebody else no matter what the situation is, but. Again, thinking about like the ties that bind us all right. We all I think thinking about free birth is really important because I think it illuminates the things that we all need, right? As women, we all need informed choice. We need to understand our options. We need to have understand risks and benefits, make decisions that align with our values, right? And so we need the freedom to be able to do that. We need respect, right? That's a huge piece of right. It's our bodies that things are happening to, it's our instincts that we need to be respected and trusted. Women have a right to birth however they would like. So whether it's not at, they're not birthing at you, right? They are making the decision and deserve that kind of respect to be able to make the decisions that they are making. Recognizing too, like the ethics piece of it too, even with complete autonomy we have to balance some of that personal freedom space with responsibility too, right? For you, for your baby. In preparation. Good planning. It's a part of respecting the autonomy and the responsibility. Absolutely. That's a piece that like really we can learn from, glean from think about we all, no matter what, right? No matter where you are in the spectrum, we need good providers out there, right? We need people who are supporting autonomy. Consent low interventions, seeing birth as really normal, rejecting a system that drives really the opposite narrative. And no matter where you're at on this spectrum, recognizing that's a huge part of what women truly need out there. And if you are on the fence of becoming, a midwife or some kind of provider the world needs. More midwives who can have even a conversation like this. Not saying not patting ourselves on the back necessarily, but just saying to be able to be open and respectful and recognize like women are at the center of these conversations and. Needs support, right? Autonomy doesn't mean that you have no support or no help whatsoever. And so it means that like the woman themselves is at the central, is in the center of it all. They're respected and have access to information and resources as she needs. And I think yes, of course somebody choosing free birth is all of that. Yes, I'm like enveloping all of that, but I think. All of us can do exactly the same in the way that makes sense for where you're at and your vision and your kind of motives and a worldview too. Yeah, and so free birth is a valid choice, right? Do the work for free birth, if you're going to choose it, just like you would do the work for planning a hospital birth that you would do the work for planning a midwifery supported home birth. Take an honest. Honest risk evaluation plan for the backup needs. Build your support, know what's going on in your body and what to do about it. And so as you are considering this information, ladies especially if you are making a decision about what type of setting or place. Of birth or provider or all of those pieces, looking at your own values, being comfortable with the people that you choose to bring in, having a backup plan knowing how to detect if something is off, research your local resources and what's available around you. And a respectful and empowered birth journey is possible under many models. So we're not at all. Of course we love home birth. You guys know that We love midwifery, attended home birth. We think it's great. That's our official stance on it. But awareness and preparation are keys in every single birth space. So if education from that philosophy is important to you, then of course you guys know you belong. With us here on this podcast, but we also wanna invite you again into our online holistic birth course because it is so much more than just preparing you for birth, but walking alongside every detail and trimester of pregnancy, preventing complications, staying low risk, taking full ownership of your experience, and enjoying a connected postpartum so you can find more information in the show notes or by visiting beautiful one midwifery.com. Thanks so much, ladies, for taking this little journey with us. That's wonderful. Yeah, I honestly could have made it three or four parts I think I could have kept talking about a lot of these pieces. There's a lot of nuance there. And so we invite you all listen to both and feel free to reach out to us too of thoughts and questions and feedback and stuff like that because again, important conversation to continue having. We will catch you next week. Bye. 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