Why I'm Considering Unassisted Birth

Holding my baby after his birth at home.

I've made no secret of my desire for an unassisted birth. I've posted about it a few times on here and many times on the Mamas and Babies facebook page. While it's an incredibly personal decision for me, I've wanted to be open with the Mamas and Babies following and hopefully help bring a new perspective to other mamas who may be curious about unassisted birth.

I'd like to explore some of my thoughts about unassisted birth, and how I've come to consider it.

I first heard about unassisted childbirth about two years ago when I was pregnant and planning my first home birth. Kasie shared her beautiful unassisted birth story, and I was deeply inspired by her experience. I thought she was an incredible woman and I admired her for following her gut and doing what she felt was best for her and her baby. I also thought that I probably wouldn't ever have an unassisted birth. My impression was that it was something women chose only if they didn't have access to good midwifery care for home birth. I had access to wonderful midwives and didn't see any reason I would choose to not take advantage of that.

As time went on I heard about other women giving birth unassisted and I started learning more about it. I realized that some women felt drawn to it and chose it even if they had other options available. It wasn't only for the woman who wanted a VBAC and couldn't find anyone who would support her, so she turned to birthing alone. It was something women were pulled to by some unseen force.

I found it interesting that the women I met who supported unassisted birth were not advocating for it. Each one said they wouldn't specifically recommend it to anyone, but it should be an individual choice. It seemed as though it was regarded as a calling of sorts rather than something to aspire to.

I had no aspirations of unassisted birth. I thought it would be really amazing to experience, and that it would make a nice next step in the progression of my birth journey I'd found myself on. However, it was definitely not a decision to be made quickly or lightly. To plan birth without the support of a trained care provider was, in my opinion, a very serious matter.

On the Mamas and Babies facebook page I sometimes found myself suggesting unassisted birth to women in certain situations, with a strong caution that the woman seriously consider all options and make the decision she felt was best for her and her baby.

I'd always believed I could handle anything in birth as long as I had the right support people. In the hospital that was my husband and my doula. For my home birth it was my husband and the midwives. I even had a moment during my home birth when I panicked as a contraction started and I realized I was alone. It was the worst and most painful part of my labor because I was scared and it made everything hurt worse. As I've reflected on that experience I've realized that I'd been depending on a false belief that I had to have certain people there to support me during birth. I've since realized that I'm capable and strong enough to birth even alone if need be.

I've had this feeling nagging at the back of my mind ever since I first read Kasie's story, and it's gotten stronger over time. I'm being drawn to unassisted birth. It's not something I chose; I feel I was chosen for it. I feel it's part of my personal journey.

When I was pregnant with my second miscarriage I had a strong desire to be left alone. I didn't even want to tell my midwife I was pregnant, and I didn't want to have any prenatal care until the second trimester when I'd be able to hear a heart beat and know that all was well. I wanted to labor and give birth alone, without anyone there but my family. I knew part of it was the fact that I'd only recently gone through my first miscarriage and I was terrified of going through that again. I was also depressed and I attributed my desire to isolate myself to the depression, but an interesting thing happened. After the miscarriage I was able to pull out of the depression and feel like myself again, but the desire for unassisted birth has stayed, steady and strong.

I've prayed about it for several months now. I've asked that if it's the best thing for me to plan for an unassisted birth with my next pregnancy then the desire would stay and I would feel peaceful about it, and if it wasn't best the desire would leave or I would feel uneasy. The desire is stronger than ever and I feel extreme peace about it. It's the same peace I felt when I decided to plan a home birth for my fifth baby.

I know from experience how important it is to follow my feelings. I didn't know when I planned a home birth that my baby would end up being breech. Being at home saved me from an unnecessary c-section. I couldn't have known that would happen, but I'm so glad I followed my heart and did what I knew was best. I have the same feeling about unassisted birth.

I don't know why, or what will happen. All I know is that this is what I feel I need to do. Maybe after the birth I'll be able to pinpoint a reason and say “That's why I needed to do this unassisted”, or maybe it will just be a beautiful empowering part of my journey. I know that I have things to learn still, and I feel that unassisted birth will teach me some of the things I need to learn. I'm not being presumptuous about this. It's not something I aspire to as an experience to check off some list of things I want to do. It's something I feel, deep inside my soul, I need to do.

There's a very spiritual aspect to this that I must mention. It's a key part of my decision, and I would be neglectful not to express it. I feel that embracing and planning an unassisted birth is part of my growing relationship with God. By letting go of the trust I placed in my doctors and midwives in the past and placing that trust instead in God, I'm growing. I'm learning to have more faith not only in myself, but in my Father in Heaven who loves me and wants me to be happy. I know that He is guiding me to choose this, and that He will guide me through my unassisted pregnancy and birth just as He did through my previous pregnancies and births. This is the next step, and I'm looking forward to it!

It's because of the resounding peace I feel, that I'm not worried. I realize that I can't possibly prepare myself fully for every possibility in labor and birth, but I'm OK with that. I'll prepare myself the best I can, but I'm not going to worry about the things that are out of my control. I have God for that.

I still don't know specifically what I'll do. I feel comfortable doing my own prenatal care, but I'm not sure if I will. I feel just as comfortable giving birth at home without the support of my midwife, but I'm not sure who else I will want to have there. For the first time since my first baby's birth I want to have my mother and my sister at my baby's birth. That's a big step for me, and I've already started talking with them both about my feelings and my plans because I want them to be ready to support me through labor and birth if that's what I feel I need. They're both cautiously supportive, and I know they're uncomfortable about the very concept unassisted birth. It will probably take some time and more prayers to get to the point of having their full support, but I feel good about it.

It's funny that I'm planning this when I'm not even pregnant yet. The timing is very interesting. I don't know if I would have been prepared to do this if either my first or second miscarriage had remained a viable pregnancy. Somehow, I think this is all connected and I definitely feel there is a higher purpose to everything I experience. I'm grateful to know that, and I'm so glad that my life is being guided by an omnipotent being rather than the imperfect person I am.

Differences Between Physician and Midwife - My Personal Reflections

I'm 30 weeks along in my pregnancy and doing well. This is my fifth baby, but it is a new experience for me because I am planning my first home birth and working with a midwife for the first time.

I had a prenatal checkup yesterday, and with each visit I am increasingly amazed at the difference in care I'm receiving from my midwife compared to what I've experienced with my obstetrician. At each prenatal visit, my midwife does the urinalysis, checks my blood pressure, weight, measurement, baby's heart rate, etc. She does all of the clinical things that my obstetrician (or his nurse) would do at a prenatal checkup. But she does much more than that.

Visits with my obstetrician generally lasted no longer than 10-15 minutes at the most. The majority of the visit was used for the clinical work I mentioned above, with a few minutes to talk with the doctor. My midwife reserves about an hour for each appointment. Very little of that is taken up by clinical procedures. The majority of the visit is spent talking. There is so much that a pregnant woman goes through. From my personal experience, I feel that the obstetric approach addresses mainly the physical changes in an expectant mother, and the midwifery approach looks at the woman as a whole and tries to address all concerns; including physical, emotional and mental.

My midwife asks questions that I don't remember my physician ever asking (in 4 previous pregnancies). She asks me about my diet, what I had for breakfast, lunch, and dinner the past day. She asks about my family, how my husband and kids are doing and how we are getting along. She gives me nutritional advice to help with my concerns about iron levels, getting enough good nutrition to help me feel better and have more energy. I feel that my midwife really cares about me personally, and that deep sense of care is reflected in the way she talks with me and conducts each prenatal visit.

I have a good obstetrician. He has always taken care of me, answered my questions and addressed all of my clinical needs. I've never had a complaint about him. The difference in care with my midwife is more emotionally fulfilling for me. I can talk with my midwife about anything, but when I go to a physician I tend to keep the questions on a purely clinical or medical level. I also have the comfort of knowing I can call my midwife at any time, with any concern, and she will answer the phone and answer all of my questions.

I'll put it in a nutshell: with my midwife I know that all of my clinical and medical needs are being taken care of as they would be with a physician, but I also have the added security of feeling emotionally and mentally supported as well.

My midwife only attends home births as a midwife. She has 15 years of experience as a direct entry midwife. She is also a doula and attends hospital births in that role, so she is familiar with all different birth settings. I am comfortable with her because I know that her views on childbirth match my own, and I feel completely supported in my plans for a home birth. Our prenatal visits are in her home, which is beautiful and comfortable.

Midwives differ according to their certification, training, office set-up and more. Certified Nurse Midwives only attend hospital births and most often work under the supervision of a physician in an office. In general, CNM's are more clinically focused and may not be able to schedule a long appointment for open discussion, depending on the office procedures and how busy they are. If you are looking for a prenatal care provider, please see my earlier post: Choosing a Prenatal Caregiver: Doctor or Midwife? Please also consider putting together a list of questions and concerns to use in interviewing caregivers and considering your options.

Continuous Support in Labor and Childbirth

Anyone can offer continuous support to a woman in labor and childbirth, but seldom in the United States today is this available in the medical setting of a hospital. Nurses most often are attending to several patients at once and cannot devote continuous support to just one woman. Physicians are not present during labor other than occasional contact with the nursing staff or brief visits, until delivery, and then leave once the baby has been born and the mother is stitched up and settled. Even partners (husbands, family, etc.) may not be able to offer the support a woman needs. A birth doula is trained specifically in labor and birth, and specializes in offering continuous support.

According to the Cochrane Reviews, continuous support in labor and birth facilitates a better labor experience and more positive outcomes in childbirth.

"Continuous support in labour increased the chance of a spontaneous vaginal birth, had no identified adverse effects and women were more satisfied."

Original studies done on continuous support were done by having a woman simply sit in the room with the mother for the duration of the entire labor and birth. The woman did not speak or interact with the mother, but her simple constant presence in the room yielded significant results. If you are interested in reading more about these studies and about the role of doulas, please read The Doula Book by Penny Simkin (also listed on the right side of the page under Recommended Reading). It's a relatively short book and is full of important information.

Birth Doulas, of course, do much more than just sit silently in the room with a laboring woman. We are trained to provide non-medical, continous socio-emotional support through labor and birth. We come prepared with a vault of knowledge and expertise in the process of birth, as well as extensive understanding of possible complications, medical interventions, comfort measures, emotional needs and ways to address them, physiological needs and assistance, and more. We work with the mother, her partner, and the care provider and staff in helping to promote the best birth experience and positive outcome as possible.

I am eternally grateful to my doula and her irreplaceable help to me in my birth experiences. I'm so excited to offer this support to others, and most of all, to let every woman know that she can get the support she needs to have a positive birth experience!