The Pros and Cons of Unassisted Birth

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The Unassisted Birth Trend

There's a definite trend in maternity wards, and in society at large, to make giving birth a more natural experience, more like some think nature intended it to be: quiet support, little intervention, and a mobile woman in charge of her own body.

Taking that trend to the next step is the much smaller movement toward unassisted birth, which is giving birth at home without the assistance of any type of medical professional, including midwives. Instead, the mother may be assisted by her spouse or partner, a relative or good friend, or she may just be alone.

The Right to Choose

The reasons a woman would choose to give birth unassisted are varied and complex. When Laura Kaplan Shanley, author of Unassisted Birth, chose to do so in the 1970s and 1980s, she insists it wasn't a "hippie" decision or any kind of social protest—she merely wanted to get back to basics in the area of childbirth. She and her husband had been studying the history and psychology of childbirth, as well as birthing options, for two years before she ever became pregnant. When she did get pregnant, they felt there was no one else who could ensure they got the birth experience they wanted.

"At that point we'd already learned so much it seemed like we would have to educate and train anyone we brought into the process," Shanley says. "We felt we had a good, intuitive understanding of why things go wrong in birth, and, intellectually, we felt we could do this."

The Shanleys went on to have four more children at home (one of whom did not survive due to a genetic condition that had nothing to do with the birthing process), and Laura Shanley became an advocate for unassisted childbirth. She says that since then, although birthing rooms have been made homier and other aesthetic improvements have been made to the birthing atmosphere, women still have few choices once they either go to a hospital or allow a midwife to become part of their birthing experience.

"A lot of the reason women feel compelled to have medical births is because of the false perception that newborns are inherently weak," Shanley says. "In fact, many of the problems we see associated with newborns are a result of the stresses of a medical birth, including drugs and the negative effects of the lack of control a woman has over the experience. Your body produces hormones that are beneficial to the birthing process, but these hormones can be suppressed by a stressful birth experience."

Other Reasons for Unassisted Birth

Beyond theories about hormones and the effect of stress on labor, many women make the choice to give birth without professional assistance for financial or other medical reasons.

Jennifer Block, author of Pushed: The Painful Truth About Childbirth and Modern Maternity Care, first points out that the number of women giving birth unassisted is miniscule, but says many of those who do so, choose that route because the system is not giving them a legal or affordable alternative. She gives as examples women who don't have insurance and can't afford even a midwife at home, much less the full hospital experience, as well as women who want a VBAC (vaginal birth after Cesarean), but find their local medical establishments forbid even the attempt. These women may be taking chances, but they have few other choices.

"The majority of women who are going unassisted are pushed out of the system because they can't find the care they want in traditional obstetrics and maternity wards," Block says. "These women are rebelling and they're saying, 'I'll be at home and if anything goes wrong I'll be at the emergency room.' In my opinion, this is not ideal. Most women should have a trained professional at their side, but we should be looking at these women not as risk-takers, but as a signal that these things are broken and need to be fixed."