Why do some women choose to freebirth in the UK?

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As a midwife, one might ask why I would be interested in the phenomenon of freebirthing, for this is a decision whereby women make an active choice to不是have a midwife (or doctor) present at the birth.

However, my knowledge as a woman, mother and midwife tells me that childbirth choices are not made in isolation. Rather, they are deeply embedded within cultural, political and social landscapes. This caused me to wonder to what extent a woman’s choice to freebirth was a reflection of poor maternity care or provision.

当然，“独自一人”或自由分娩存在潜在的风险，因为在出​​生时可能会发生不可预见的临床事件，从而威胁着母亲和婴儿的生命。

当然，“独自一人”或自由分娩存在潜在的风险，因为在出​​生时可能会发生不可预见的临床事件，从而威胁着母亲和婴儿的生命。这些通常很少见，但确实需要训练有素的产妇专业人士及时干预。

也就是说，我们确实知道，出生干预措施的指数增加，例如促进劳动，增加劳动（加速他们的努力）和剖腹产。尽管许多人为许多人挽救了生命，但它们的过度使用与最近的发病率和死亡率相关Lancet Series.

Themedicalization of childbirthis a topic of great debate with passionate arguments from both sides. What is agreed is that the safe passage of mother and baby during childbirth is the priority.Howthat is enabled, however, is of great contention.

我们做了什么？

Within this context, I carried out a literature review of qualitative research to answer the question“为什么有些女人选择自由分娩？”The search identified only four studies (three undertaken in America and one in Australia), none of which were based in the UK.

This review identified common motivations to freebirth including: a rejection of the medical and midwifery model of birth, a previous distressing/traumatic birth experience and a faith in the natural birth process. In addition there was a prevailing sense of women opting to freebirth in order to retain choice, control and autonomy over their bodies during the birth process.

The aim of这项研究was to identify and explore what influenced women’s decision to freebirth in a UK context.

In order to see whether UK women held similar issues, the aim of这项研究was to identify and explore what influenced women’s decision to freebirth in a UK context.

We recruited ten women to the study, all of which had freebirthed at least once in the UK. The findings were complex and deeply nuanced as the decision to freebirth was based on multiple factors.

What do our findings show?

Largely our findings supported those of themetasynthesis这是surprising as maternity services are configured very differently in the UK. For many their decision was borne out of a previous negative or traumatic birth experience, which was sometimes compounded by further negative experiences with maternity services (such as when making attempts to book a homebirth).

尽管这可能是助产士理解的挑战，但这是必须尊重的选择。

这些妇女描述了她们如何对产妇服务失去信心，以向她们提供所需的照顾或认为需要的照顾。

妇女经常提到她们如何认为自由分娩是唯一可以摆脱干扰并感到安全的选择。从助产士的角度来看，这一方面非常关注，表明助产士哲学和护理交付。

For other women their decision to freebirth was borne out of a positive experience where they wanted to enhance their birthing experience and a midwife was considered redundant. Whilst this may be a challenge for midwives to understand, it is a choice that must be respected.

Improving maternity services for all

The fact that women choose to freebirth in order to create a calm, quiet birthing space that is free from clinical interruptions and that enhances the physiology of labour, contributes to the body of evidence which seeks to improve maternity services for all.

在过去的几年中，国际对这一现象的兴趣已获得势头。来自英国,Holland,Australia和爱尔兰are all providing valuable contributions to the phenomenon of freebirthing or birth that sits outside of the current norms of maternity provision.

Whilst the numbers of women who freebirth are relatively small, it does raise important questions regarding how maternity care is provided, how midwives can re-connect with women who have lost faith in our care and whether our practices always support physiological or optimal birth.

Acknowledgements

这项工作得到了妇女与皇家助产士和伯迪特信托基金会（ELS505授予）的福祉的支持。我要亲自感谢吉尔·汤姆森（Gill Thomson）对本文的出色监督和贡献。