Unassisted versus Homebirth
What are the differences between these two birthing options?
Few mothers are choosing homebirth today. Even fewer mothers feel comfortable giving birth without a trained professional present.
Women today have many options for giving birth. They can use epidurals and give birth in a hospital. They can use a midwife to attend their birth. They can use a birth center setting instead of giving birth in a hospital. They can hire a birth doula to assist them no matter their chosen location of the birth. They can use a tub for laboring or giving birth in, known as waterbirth.
Homebirth as a Birthing Option
Another option is having your baby at home. Homebirths typically include having one or two skilled medical professionals (most commonly a midwife and nurse) attend your homebirth with you. Only a very small fraction of mothers choose to have a homebirth and in fact only about 1% of mothers in the United States are choosing this option. In other countries where midwives are more prevalent, homebirths are a more popular option. In the Netherlands, about 30% of mothers give birth at home. There is evidence that having a homebirth is considered to be a safe alternative to both hospital and birth center births for low risk mothers.
Unassisted Birth - A Description
An even more rare option is having what is called an "unassisted birth" in which the birth not only occurs at home, but the parents take complete responsibility for the birth, the health of the baby and the health of the mother. There is no assistance from medical professionals, hence the term "unassisted" birth truly fits the description.
There are no accurate statistics of unassisted births since many of these parents do not broadcast their choice. There is an aspect of unassisted birth that almost requires parents go "underground" in order to have this type of birth.
Reasons for an Unassisted Birth
Reasons to have an unassisted birth include a desire to avoid medical intervention, cost savings (free), lack of available midwifery care, privacy, and a sense of fulfillment all top the list. Mothers who plan an unassisted birth often feel that they want to escape the inherent problems with the medical mindset of today. Perhaps they have already experienced birth in a hospital setting and feel that the only way to avoid being poked and prodded throughout labor is to do it themselves. In fact, the slogan on a recognized site for unassisted births is "If you want the job done right, do it yourselves."
Unassisted Births - The Reality
While avoiding infection and interventions can be a benefit to all homebirths, it is important for parents to recognize the reality of unassisted births. It can be very inspiring to read birth stories of unassisted births on internet web sites, yet it is quite another to truly understand the level of preparedness parents must have in order to undertake an unassisted birth. Here is a list of questions that may be helpful when deciding whether or not to have an unassisted birth:
- Who will be the person(s) responsible for assisting the mother in the birth?
- What preparation/education is necessary for support people to handle emergencies with the baby? (For example, the need for neonatal resuscitation.)
- What preparation/education is necessary for support people to handle emergencies with the mother? (For example, a postpartum hemorrhage.)
- Who is qualified and responsible to make a decision to transfer to the hospital if necessary?
- Is there adequate equipment in the event of emergencies?
The reality is that few parents are equipped or qualified to make these potentially life and death decisions on their own. While most births are indeed uneventful, emergencies do happen. If parents do not have adequate skills to deal with emergencies, an unassisted birth can be overwhelmingly frightening.
Prior to 1920 when the majority of mothers still gave birth at home, there were family doctors, midwives and experienced female relatives present to offer another set of hands. As far back as biblical times, we have examples of Hebrew midwives who attended births. Women throughout history seldom gave birth without help unless they had no other choice or the birth happened too quickly.
Unassisted Births - A Trend or a Fad?
One disturbing reality is that if our culture today was doing only what needed to be done with regard to births, unassisted births would not be needed. Women could labor where and how they wanted. They could eat, rest and move about as they desired. They could have as many or as few support people with them for support and guidance. They would have authority to make decisions regarding when any intervention could be used, how often they should be examined and by whom. Not to mention they could labor as long as they needed to have a safe and satisfying birth. They would not have their babies taken from them after birth, but could hold and nurse their babies for as long as they wanted.
Until we all make the changes necessary to get closer to this model and we protect the remaining options we have left for women, such as giving birth in birth centers and using doulas, more mothers may begin to choose unassisted births. And unless parents are taking the time to completely educate and prepare themselves for taking the responsibility required to have an unassisted birth, the result could be a risky one.
