Welcome to Birth and Earth, where I will be talking about birth, mothering, and all things Female.
Some of you may have heard of "UC" or Unassisted Birth - other wise known as Unattended Birth, DIY birth, and freebirth - all these are labels given to a planned homebirth, unattended by a medical professional.
I think that before you can ask, why would a woman choose to have a birth, without the assistance of any paid, knowledgeable person, you have to first clarify so many women choose assisted births... What is the appeal?
Women often choose assisted births because it alleviates some concern that they have - they are afraid that something will go wrong and believe and attendent can prevent or fix it, they are afraid they will not be properly supported as they need if they are alone or just with their partner/family/friends, they are afraid they will not be able to listen to their instincts and will need some knowledgeable guidance, they are afraid that the law will prosecute them and they will be accused of neglect/endangerment regardless of outcome. These are the common concerns I have heard; I am sure that there are many more as well. The underlying factor is fear of the unknown, and a lack of belief in a woman's ability to birth in health and safety.
Another possible reason is a feeling that birth is a moment to be shared in the company of other women, and there is a feeling of rightness, connection with women throughout history, and a sense of community.
Also , many women don't actually know that unassisted birth is even possible/viable/legal... a typical first response is "You can do that???" - lack of familiarity with the concept is prohibitive. In our society we are culturally conditioned to expect assistance at birth, it is the long standing ingrained norm. Women have assisted births because it is never questioned, we accept it as how things are done, and assume that they are done that way for a reason.
Why would anyone give birth without professional attendants? Reasons given are :total autonomy and freedom, no one checking you for anything to make sure it's all "going well" (the implication being: it might not be going well, regardless of what your body is saying, once again subtly undermining the woman's ability to trust her own birth)... no one making any suggestions for position, etc (which again undermines the woman's ability to totally trust in her own body and follow those cues without hindrance)... complete privacy, complete control, complete empowerment, with no interference from someone who -except in rare circumstances - is a virtual stranger that has only been in your life for a few months. The birth is a bonding experience for the family, the community the woman actually lives in - nothing more and nothing less. A midwife in the room changes the energy of the birth - and for a UCer this viewed as negative.
Does having a birth attendant automatically place one in the realm of birth management that brings with it possibly poor outcomes (whether so subtle as to be unnoticed or so obvious as to become yet another "birth horror story")? I think it depends on the birth attendant. It is obvious with any clear-headed study of birth that many illnesses and issues are due to how pregnancy/birth/postpartum are handled. I think it starts with the assumption that a woman's body is somehow incapable of birth, that she is not able to access her innate instincts and needs "someone with know-how" to guide her... these are such pervasive ideas, and so damaging. There are some attendants who very much believe that women can't birth without their help, and that puts them firmly in the birth management realm. There are others who believe earnestly that birth is safe and natural, and that their role is to provide support, encouragement and comfort while the woman gives birth - something she could physically do safely with no assistance, and I think that is a different kind of birth assistant.
Every single intervention is a layer that separates the woman from her own body/birth/baby... my perspective is slightly different than most in that I believe that a midwife in the home is an intervention in and of itself, but obviously the degree of that intervention (interference) varies from midwife to midwife.
However, the woman's level of power in her birth is a subjective thing. I think that if a woman has an unassisted homebirth and feels totally out of control, overwhelmed, lonely, unsupported, and insecure - that is obviously not empowering... likewise a woman could have a highly interventive hospital birth and come away from it feeling that she is more powerful than she realized and that there is nothing she can't do. So a great deal of it has to do with the woman's personality, the circumstances of the birth, her existing perception of her abilities/strength, and the support and respect that she is shown in making her own decisions. It is far too personal for someone to say: this is what will empower every woman, because each woman is starting from a different place in her perspective.
I think that it is a matter of what each woman needs, in each birth... something that can vary a lot! For instance, I think that unassisted birth is an extremely spiritual experience, and that having relative strangers there touching me, talking, etc, would only hinder that aspect of it. I don't have any contempt for assisted birth... however,. I do think that UC is a wonderful, beautiful, powerful, safe, and normal way to birth, and that in our society women are often discouraged from even thinking of it. I think its vital to encourage women to trust in their own body to do what it is supposed to, in their own ability to be and do everything that they need.
There is a huge difference between having a midwife attend your birth because you like the company of other women and crave that connection and society... and having a midwife there because of all the things that can "go wrong" or a feeling that you won't be able to "know what to do" and you need someone to tell you how to birth your baby. These are two completely different ways of looking at it. The woman who is a social birther should be completely encouraged and supported in that; the woman whose reasons involve doubts about her ability to birth, or her baby's ability to be born, has some fears that a midwife can alleviate and address - raising the woman's understanding of her own body and instincts to a higher level, working her through those concerns, and empowering her. This isn't to say that she couldn't work through her fears and become confident in he innate knowledge on her own, of course - every woman has inside her the capacity to be empowered, whether that empowerment comes from external sources or from within herself.
No matter what, on a fundamental level birth is essentially unassisted. It is a biological function that *happens*. No matter what, the birth is the sole responsibility of the mother, whether from her own choices or from allowing others to make those choices. And it is undeniable that the mother's body is the one doing all the work - on it's own, naturally. Anything done to assist that is an intervention that has it's own set of effects.
I would never say that midwives and other birth attendants don't have a place in birth - I think that they do... but it really is a sign that we deep down believe that birth is something more than a perfectly natural, normal, family occurrence. Whether this is due to the woman's beliefs, lack of adequate experience or support from her family, or outside circumstances, birth has been removed from this realm. That is valid and she should have all the options and support that she needs/wants to have what to her is going to be a satisfying and fulfilling birth, and I believe that midwives can provide that, as long as they are sensitive, intuitive, and fully trusting in birth.