Why I don’t attend unassisted births

It’s controversial. The act of free birthing. The arguments for and against. The discussions about freebirthing amongst doulas. Even writing this piece. It’s all just controversial. When an expectant parent reads over my contract, they may feel hesitant to ask for clarification on those controversial topics. My “no planned unassisted childbirth” clause is certainly in that category. So, why? Why do I proclaim all births equal in one breath, and disqualify free birthers in the next?

Let’s start with what isn’t my rationale. This is not a moral high ground. My belief that there is no wrong way to birth does not exclude free birth. It simply doesn’t matter what I think. I believe in your right to make your own choices, period. You are an adult and you are capable of making that call. Your birth is valid, and deserves just as much support as any other birth. If you chose to hire me for distance support, or prenatal visits, I would be there every step of the way. But I won’t attend your birth.

I am not the doula for everyone. I’m the first to admit it. Some may think I’m too young. Others might prefer a Christian doula, with scripture based affirmation cards in hand, or more of a traditionalist. Not everyone will mesh with me, and that’s okay. I recognize I am probably not the best choice for an unassisted birthing family. It wouldn’t be fair to you. Not because I’m incapable of providing the support, or because I’m judging you, but because I’d be keenly aware of the risks. Not the health risks, not the statistics some like to site when encouraging free birthers to reconsider. But the risks to my profession, my livelihood, my family.

Practicing as a doula comes with little regulation. Anyone can walk into a birth off the street and call themselves a doula. But for some of us, education and training are immensely valuable. Part of practicing as a certified doula means abiding by a scope of practice. For most of us, this means living and working by policies that strictly forbid the attendance of freebirths.

You might have noticed I haven’t referred to unassisted births in general. The act of planning an unassisted birth changes everything. The most highly trained professional in the room becomes liable when things go wrong. Hypothetically, if I arrived at a home birth before the midwife, I’d be ethically obligated to help. I would call 911, explain I’m a non medical birth professional, and follow their advice while delivering the baby. I would be protecting myself legally and ethically. Not standing by when I have the knowledge needed to help, while also seeking help from a more qualified professional.

In a freebirth, neither practice would be possible. If things don’t go according to plan (and of course, there’s no way to tell exactly how any one birth will play out) I would have two options. Stand aside, not involve myself, not call for help, and risk a lawsuit for doing so. On the flip side, if I see you encounter a shoulder dystocia and apply the gaskin maneuver by myself, suddenly I find myself practicing medicine without a license, and face both legal action and liability for any birth injuries to you and your baby. My certification would be revoked. My career would be over. My entire profession would take a hit when the media picked up another “home birth gone wrong” story.

I value birth. I value your birth, even when unassisted. I wish I could support every family, in every circumstance. But reality has forced my hand. I wish nothing but the best for families seeking unassisted birth. I even hope they find a doula who suits their needs. But it won’t be me. It can’t be me.


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