The Importance of Excluding Onlookers From Freebirths

13 12 2013

If you’re going to be of service to women and want to be taken seriously, having a well-rounded education is important. There are many things you’ll want to know before you can safely feel adequate to provide “care”. One important thing to know on laboring women is, when it comes to witnessing their homebirth, UC (unassisted childbirth) is not a spectator sport.

ImageEven if you allege to be hands off, the problem of the observer is one hopefully known to all UCers and would-be UCers. It is one of the reasons (maybe even a main reason) why many women decide on freebirth at all. One of my favorite writers on natural birth, Michel Odent, talks frequently of the mammalian needs in birth. Of our four basic needs, privacy is one of them. Without it, the mother senses danger and this complicates the labor.

‘To give birth to her baby, the mother needs privacy. She needs to feel unobserved.” –Birth and Breastfeeding, Michel Odent. Any doula, midwife, or doctor should read this book. 

You can read more here: Do Not Disturb: The Importance of Privacy in Labor, Judith A. Lothian, RN, PhD, LCCE, FACCE, The Journal of Perinatal Education- Advancing Normal Birth, from the US National Library of Medicine- National Institutes of Health (PubMed Central). Sidenote: This link also discusses the fetal ejection reflex, for the interested.

Now some may argue that it is possible to give a woman a feeling (or an illusion) of privacy and still have onlookers or caregivers. I will not debate that at this time, but I will state that if one is trying to observe a birth to determine their own readiness to venture into the fields of midwifery and the like, this learning experience is a detriment to the mother.

“There is no privacy without a feeling of security.” –Birth and Breastfeeding, Odent.

Anything you bring into the birthing space, the mother can sense. Any fears, hesitations, reservations, doubts, lack of confidence, lack of understanding of anything, lack of skill, lack of intuition, she spots like a dog smells fear. She taps into her primal state and the neocortex (rational, human, intellectual thought) attempts to disengage. If she has the awareness in any aspect of her consciousness that you are here to test yourself, this can generate feelings of insecurity in the mother. This is particularly true if you are not in an intimate relationship with her. Feelings of insecurity and lack of privacy will, again, complicate labor.

“Most women who understand what is going on are keen observers not only of their own actions, but of the reactions of those about them to every fresh event or incident. I have laid stress upon the sensitiveness of the mind of a parturient woman; if you wish to deceive them, you will fail.”

Confidence rests upon the knowledge of perfect preparation.”

“During labor, women spot doubt in a doctor’s mind as quickly as a kestrel sees a rat in the stubble… However good an actor or however suave a humbug, confidence has no counterfeit.” – these quotes from Childbirth Without Fear, Grantly Dick-Read.

The woman in labor, sensing any lack or fear on the part of anyone present, is hormonally receptive to those suggestions. This initiates the Fear-Tension-Pain cycle. Labor becomes hard or even dangerous for woman and child.

It is more important that we honor and respect the birthing space of the laboring woman and her most basic, primal needs as a mammal than to use her as a test subject for our own reassurance and education.

There are other ways we will be able to give ourselves a proper education on birth and physiology in order to ascertain in what capacity we may be of assistance to birthing women. Like the saying goes, “reading is fundamental”. I urge people to read, read, read, and learn everything they possibly can about true physiological, natural birth and the actual needs of a birthing woman in labor.

Privacy is one very basic and simple method of providing safety in the birth space of a well-prepared woman. We live in a culture, though, where the most basic methods of prevention are overlooked in favor of the most technical hands-on repairs we can put our logical minds to. But, what if we could avoid those dilemmas?

For example– Instead of relying on knowledge of which massage, drug, or herb will treat a post partum hemorrhage, what about understanding the seemingly invisible causes? The brain-body connection has a lot to do with our most commonly feared childbirth complications, and yet our culture does precious little to recognize and avoid creating the issues to begin with. We must look to the interconnectedness of our systems, hormonal responses to environment and stimuli, etc. If we were to know the birth process from an unhindered, natural, physiological perspective, know the stages of labor through all non-intrusive signs, and respect the mother’s primal birth space needs, our shopping lists and interference levels would dramatically decrease. Healthy, normal births would be the result.

I have noticed that there are many UCers or those researching UC are preoccupied with the fix-it methods, though. They read almost exclusively midwifery and obstetrics texts (if they read at all), they focus on which tools or drugs or herbs can be used in a pinch to solve a dilemma or crisis. In the process, we are neglecting the very root of why freebirth is so important– the undisturbed aspect of birth only it can provide. When we more fully grasp what is primal and physiological, our tools and medicines become more and more useless and unnecessary. This is  such a worthy goal! To lose sight of that and to attempt to mimic health care professionals in all regards in many ways defeats the purpose. We aren’t trying to take over their work, we are trying to transcend their methods.

In other words… If I wanted a medical approach to my care, I would hire a medical professional. But, I digress. Because I associate onlooking with interference, I have touched upon the issue of hands-on as relating to eyes-on. Getting back on track–

For anyone questioning if they could handle the pressure of attending births for a living, I would strongly advise they find their confidence elsewhere than at a woman’s freebirth. I would suggest educating oneself to the utmost of one’s abilities, reading books like the ones quoted here (as opposed to a lot of the more mainstream, feel-good, interference-happy “natural birth” literature). I would recommend reading things which are very pro-unassisted childbirth, where lack of attendants is understood and encouraged on a scientific level, because this will provide technical and biological knowledge and a foundation for what makes this birth safe. That is knowledge that would become confidence-instilling for anyone of the right composition to attend women.

Even starting as a trusted doula for attended births of people you are personally close with (at home or in hospital) can give one an idea of their own abilities. Anything… anything to avoid adding hindrance to what could otherwise be an undisturbed birth. This would be one of the gravest insults to natural birth and the natural birthing woman. The needs of a woman in birth are more important than any education we hope to glean from their experience for our own gain.

In order to properly care for a woman, we must first be able to put her needs above our own wants. Anyone unwilling to do that already has the answer to their own question– they are not prepared to attend her. Let us not behave the way that doctors have which caused us to leave the hospital environment in the first place.

“Every woman is different, and so are her needs in childbirth,” you might say. Yes and no. Psychologically every woman is different. The complex thought processes that make up our personalities and make us especially human varies. On the primal level, however, all of our needs are the same.

We are all mammals, we have built-in instincts designed to protect ourselves and the species. We do not deny our other needs as “individual”– whether a woman needs food, water, oxygen, sleep, and shelter is not up for debate based on her individuality. We all require these things as our physiology dictates. As mammals, we have physiological and hormonal reactions to childbirth events and our environment– even over the subtlest of things– that may go unrecognized or misunderstood to the untrained eye. Since it is the primal nature which gives birth, not who we are psychologically, it is the primal which we should be careful to honor!

What a woman chooses is her right, but it sometimes becomes a battle of what she is willing to partake in on the psychological level versus her most primitive instincts. I would not want to battle with the instincts, personally. You cannot reason with them.

So, even if a woman planning a homebirth or freebirth is gracious enough to invite someone to her birth as an observer or onlooker, this does not mean it will not in some way have a negative impact on her birth. A woman would be unfair to herself to promise someone that she would be comfortable with their presence (and it would be unfair for the onlooker to accept, with that knowledge). The primal need for privacy and the intuition of the laboring woman will strongly overtake most conscious psychological desires she has to be sharing, educational, brave, outgoing, or accommodating. Even a peaceful, knowledgeable, and experienced freebirther may find such an invitation to be a naive and inhibiting undertaking in hindsight. Whether it becomes merely a nuisance or precipitates a crisis, the would-be birth attendant must ask themselves, “is it worth it?”

Anyone considering UC for themselves should likewise acknowledge and honor their deepest needs in childbirth and respect the science of the process. This is the way you give yourself the best, safest chance at the healthiest birth.



8 responses

9 01 2015

I am studying to be a midwife – I’m also a male. Are you saying that any type of observation has a negative effect on a birth? What about non-UC? Is it because this birth is supposed to be completely “UC” that you argue against observers? Are you targetting this post for non/low-experienced attendants? What about skilled attendants that know when to disappear, when to pop out of nowhere, when to be wallpaper, and everything in between? I think I understand your post, I’m just trying to figure out if you are saying that all observers/attendants at any birth is detrimental. What about the piles of studies showing doula-attended births have better outcomes?

So I’m guessing the fat bottomline, is the smart birth attendant asking the “is it worth it?” question with the primal needs at the forefront. Yes?

17 01 2015
♥♂►Elizabeth, ISOTP Birth◄♀♥

Out of curiosity, what drew you to becoming a midwife?

I advocate for UC as the safest form of birth. I do not advocate for attendants, I advocate for mothers taking back birth and deconditioning from the machine that told them birth was scary and dangerous and that they couldn’t do it without “expert help”. I work on helping women understand that they are (or can be) the experts. Not doctors, not midwives.

I would recommend to you Birth and Breastfeeding by Michel Odent, and maybe even my book, In Search of the Perfect Birth by Elizabeth McKeown, for more elaborate details and explanations for this.

Piles of studies showing doula-attending births having better outcomes completely neglect the primal woman owning her UC. UC’s haven’t been studied and I think they’d have a difficult time trying. But anyway, my husband is my “doula”.

18 01 2015

I also want women to understand they are the experts of their own bodies. Unfortunately, most people (especially women) can’t accept this reality. I think you agree. Wife and I did all the reading and self-education, but when it came down to the wire she had a less-than-ideal labor. Still achieved the VBAC but I think there was far more struggle than was necessary. Having an available care provider who understood our needs would have been the ideal solution. So now I want to train myself to be that provider for others. Well that’s my motivation.

I haven’t done much research into UC just yet. Sounds fascinating and wonderful, and I’m truly grateful people like you are pushing (back?) the boundaries of what it means to be human. I do feel that people should decide for themselves what to do with their bodies and children. Everything starts with birth. However, like I said earlier most women are not ready for complete mental freedom. The third trimester, second-time, VBAC-aspiring mother on the fringe of abandoning the wicked machine will have more ease in choosing a quiet physiological midwife than complete UC.

It’s a pleasure reading your blog. I’ll be looking into your books 🙂

19 01 2015
♥♂►Elizabeth, ISOTP Birth◄♀♥

I do believe most people can accept the reality, it’s just a matter of getting there. Cheers to you on your journey to getting there.

14 07 2015
Felicia Monroe

Searching for peace at 39 weeks.
I had a hospital water birth at 41 weeks 3 days. I think the threats of inducement help to trigger labor. I had a decent water birth. I actively labored in a nearby hotel in the shower and on the toilet until my waters bulged. I’d under estimated labor because my midwife who’d checked me six hours earlier said I wasn’t in labor. I had urge to push on way to hospital and while they quickly filled pool. I labored on my back for 45 mins. The worse part of labor, but the only way I felt I could keep her in. I got in pool and birth my 8 pound six ounce daughter in 4 contractions/ 3 pushes. I “caught” her myself and the new midwife was so hands off. She asked me did she need suctioning (no) and other questions. She didn’t touch her until I had to get out of pool due to a bleed. I think the combination of my husband sitting on cord (I felt a pull) and trying not to push may have help to cause it. They put me on table and she started to pull on cord, I told her to stop, she asked me to deliver placenta myself then and I pushed and another contraction popped it out. I had no tears that needed stitching and my poor baby lay on my chest trying desperately to latch. I asked my sister to latch her on but she was nursing her two month old and didn’t understand the urgency behind why I wanted her to nurse. I received a shot of pitocin. Did skin to skin for an hour, and hubby followed up with his. Besides feeling weak, it was great to have sis their to teach me how to breastfeed and I exclusively breastfed. She stopped at 19 months with encouragement due to current pregnancy.
Here I’m carrying her brother. My supplies are packed but I don’t ever want to set foot in hospital. New midwives are medical. I may have to birth with a man present. I’m GBS positive and they refuse to re test. I don’t want antibiotics, I may not even get there in time to consider it and that much time in a hospital is dangerous to a natural birth. If I refuse antibiotics one doctor said, they may want to give them in hospital to baby boy. That means my newborn away from me!? If I refuse for him she warned they may call cps. Crazy. Refuse treatment instead of monitoring. I’m searching for friendlier hospitals in nearby state. I am driving an hour already. I’m contacting hospital to discuss protocols for refusing newborn procedures. (I refused eye ointment hep b bath and delayed pku and other stuff until after bonding) I remember the social worker being sent in by pediatrician because I declined vitamin K. I caved, after telling her I knew she was there to intimidate me. I regret it, but they were delaying my discharge. I use my mothers address on hospital forms so cps couldn’t show up, and the empty room with my pool and supplies looks friendlier and friendlier. But what if I bleed. Birth in NC.

16 07 2015
♥♂►Elizabeth, ISOTP Birth◄♀♥

Stay home. DIY. North Carolina is a terrible state to give birth in. Bleeding is usually created by conditions others are giving you. You have a far better chance of not bleeding too much if you stay home. If you do have some bleeding, know how to manage it. If you are concerned about hemorrhage, hold a piece of placenta in your mouth for a while and then swallow.

There is so much literature you could have that would help you, but use the Emergency Childbirth book on my blog here in the links. Print it out and keep it, it’s free. Look up Michel Odent’s Wombecology website and read up on physiology. I think I had another blog post here about preventing post partum hemorrhage– read it! Lots of love to you. I will keep chatting with you if you need to talk things out. Staying at home IS an option if you can make yourself feel comfortable and prepared enough to trust yourself and trust birth. And it’s totally legal. And CPS can’t get involved if everything is totally well all by yourself. Don’t fear CPS, fear for you and your baby’s safety and do what you know you need for the best outcome!

16 11 2015

Hi I spoke to you when I was 39 weeks pregnant and being threatened/pressured by my doctors office about being GBS positive and having antibiotics during labor. I went on to deliver a healthy baby boy at 42 weeks 2 days gestation on August 8, 2015. He was born at the hospital after a quick 4 hour natural labor (nearly two hours of it in the car, 😖less than an hour at hospital). He was born all natural without even a Tylenol, delayed cord clamping and immediate skin to skin. I did not hemorrhage this time! I made sure to be very vocal about know pulling on cord and delivered my placenta without any traction. I also did not tear and had an easy recovery. The best midwife at the practice called me a few hours before active labor began and I told her I wish I could deliver with her that day and I did. She didn’t even bother to insist on vaginal/cervix checks, she just listened to me and when I told her I had the urge to push about ten mins after my water broke. she helped me into the water. I chose not to circumcise or get vitamin K at birth (I did ten days later because he was bleeding at belly button.) I have since been dismissed by my pediatrician for refusing hep b while my infant has been sick and had unexplained rapid heart rate and breathing (which resolved on his on) but otherwise I have a healthy happy baby. Thank you for your encouragement it really helped. Although I was not prepared to give birth at home your words really helped me to rediscover my backbone. I’m done have children but if I find myself pregnant again I will deliver right here in my bedroom. Sent from my iPhone


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