Home birth advocate's baby dies during free birth: Do you blame or show compassion?

BlogHer Original Post

Janet Fraser, a home birth advocate and founder of the site Joyous Birth, recently experienced a personal tragedy when her baby died at her home in Australia on March 27 during her free birth or unassisted childbirth (where a woman gives birth at home without the aid of a midwife or doctor).

When a tragedy like this occurs, people are often left scratching their heads wondering how something like this could happen, what went wrong, and lastly, who's to blame? I don't know if we need to point a finger to make ourselves feel better, but it seems to be human nature to ask, "why did this happen?"

While I did not consider giving birth at home without a midwife in attendance for my home birth, I know a handful of women who chose an unassisted birth and I respect them for it. I believe these women did a great deal of research in advance, knew what they were doing, trusted their bodies and their babies and were prepared to go to the hospital if any issues arose. Although I don't know her, I trust that Janet Fraser would fall into this category as well. Not everyone agrees with me though and some, like Amber Watson-Tardiff, are suggesting that what Fraser did by having her baby unassisted was "reckless, neglectful and borderline criminal."

Jessica Gottlieb of Eco Child's Play says, "I support women who chose a home birth. But a free birth? I cannot see the wisdom in it. Neither can Ms. Fraser’s baby."

Watson-Tardiff goes on to say, "I hope she is at least subject to an investigation for child endangerment."

Ronda Kaysen of MomLogic says she sees the value of home birth as a way of reducing medical intervention, but believes giving birth without medical assistance is "absurd."

Fraser's "free birth" argument, which on the surface appears feminist, is actually the opposite. It doesn't empower women to take control of their own bodies. It sends them and their babies into the dark ages of medical care - where women give birth with no medical care at all and face the very real possibility of death as a consequence.

For the record the police are investigating the death and have said "it was not clear whether the baby was stillborn or died after delivery. If a baby is stillborn, there is no autopsy. If a baby is alive at birth and dies soon after, it is considered a matter for the coroner."

I guess I give Fraser the benefit of the doubt and assume that like most mothers she was doing what she thought was in the best interest of her baby. Although she coined the term birth rape (birth interventions done against the woman's wishes), I don't believe she would put her child in harm's way rather than accept a potentially life-saving intervention. Then again I don't know Fraser and have not spoken to her, so I can only speculate just as others are doing, but I prefer to give her the benefit of the doubt. However, I do believe that whenever a child dies, there should be an investigation into the death.

While many are blaming Fraser for her baby's death since she did not have a doctor or midwife in attendance, no one seems to mention the fact that babies die in the hospital, where doctors are present, all the time.

Laura Shanley, author of the book Unassisted Childbirth and owner of the Bornfree! website who blogs at Letters from Laura - Thoughts on Unassisted Childbirth, brought up that point and shared another perspective many of us may not have thought of when she shared the following statement with me:

I don’t know Janet, but of course my heart goes out to her. An Australian friend of mine has told me that despite what the media is saying, Janet’s baby was stillborn and the outcome wouldn’t have been different had the baby been born in the hospital. Regardless of whether or not this is true, I find it sad that so many people are blaming Janet for her baby’s death. A baby is stillborn in an American hospital every fifteen to twenty minutes. According to a story on my local newscast, this is double what it was ten years ago. Yet almost no one blames hospital birth mothers (nor should they) for these babies’ deaths. This is because it’s assumed that if a baby dies or is stillborn in the hospital, everything possible was done to save the baby’s life. The possibility that at least some of these deaths might have been caused by early inductions, c-sections and other interventions is rarely discussed.

I can tell you, however, that as a homebirth advocate I have received numerous letters over the years from grieving mothers who wonder if their hospital born baby might have survived (or avoided injury) had they been born at home. The fact is, in most cases we may never know. Sometimes medical intervention saves lives, and sometimes it takes them. This is why I encourage parents to do their own research and decide for themselves where and with whom they want to give birth. In my case, I chose to give birth at home unassisted because from the research I had done I felt that the majority of problems in birth – both now and in the past - could be traced to three main causes: poverty, unnecessary medical intervention, and fear which triggers the fight/flight response and shuts down labor. Despite what most people believe, the act of birth itself is not dangerous. But our cultural beliefs and practices can make it so. In the end, it’s a personal decision. And just as the death of a hospital-born baby doesn’t mean that no baby should ever be born in the hospital, the same should be said for babies born at home. Regardless of the outcome of this case, I will continue to speak out about unassisted childbirth as I believe that in most cases it’s the safest and most satisfying way to give birth.

Genie, an Australian blogger who writes at Home Is Where the Heart Is, blogged extensively about her thoughts regarding Janet Fraser and defends her choice to have her baby unassisted at home. She feels the insinuation that women who birth at home do it to feed their own ego at the expense of their child is "a crock."

Women choose to homebirth with their baby’s best interest at heart. They do it FOR the baby, not in spite of the baby. Yes they want to feel empowered and blissed out, but the lack of trauma and the satisfaction a mother gets after a natural birth all benefits the baby too. A mother’s health and well being has a HUGE impact on the baby. So why should we ignore the interest and well-being of the mother?

In the wake of this tragedy and surrounding media coverage, some feel the need to point out that there is a difference between home birth and free birth. Dr. Meredith Nash of The Baby Bump Project says homebirth and freebirth are not the same.

The media has failed to differentiate between freebirth or unassisted birth (no midwife or doctor) and homebirth (a birth at home, usually with a midwife or homebirth doctor). For the most part, for low-risk births that are attended properly, homebirth has been proven to be a safe alternative to hospital birth. Freebirthing is significantly more risky (sorry, I'm a supporter but also a realist). It is essential to make this differentiation. Now that homebirth is on the precipice of being banned given that independent midwives are likely going to be denied indemnity insurance from next year, the suggestion that all women who homebirth are crazy radicals or that homebirth represents the majority of birthing women in Australia (only about 2%) is ridiculous. If anything, midwives and their ability to attend homebirths will be the saving grace of the Australian maternity system. Rather than convincing the small proportion of women who avoid a medicalized birth, why not support these women in their choices by making homebirth safe and easy?

Summer Minor, who blogs at Wired for Noise and gave birth to her daughter at home a little over a week ago, references the recent Nederlands study that says home birth is as safe as hospital birth. "A new study is out from the Netherlands that gives us home birthing mothers a nice little pat on the back. Despite the labels of 'dangerous' and 'unsafe' by some, once again it’s been found to be just as safe as giving birth in a hospital." From the BBC:

The largest study of its kind has found that for low-risk women, giving birth at home is as safe as doing so in hospital with a midwife.

Research from the Netherlands - which has a high rate of home births - found no difference in death rates of either mothers or babies in 530,000 births.

I think that Shanley said it best when she said, "In the end, it’s a personal decision. And just as the death of a hospital-born baby doesn’t mean that no baby should ever be born in the hospital, the same should be said for babies born at home." We all must do our research and make the choices that we feel are the best for ourselves and our babies and then, find peace with our decisions.

I offer Janet Fraser and her family my deepest sympathy. My thoughts are with them.

Contributing editor Amy Gates blogs about green living, attachment parenting, activism and photography at Crunchy Domestic Goddess.

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