Pregnant women drawn to 'unassisted childbirth'

Andrea Salcedo's mother was at her side when her first child was born in a hospital.

But when the Calgary woman decided to have her next two children at home, without the assistance of a doctor or midwife, her own mother told her a hospital is the best place to have a baby.

"It was very disheartening," Salcedo recalled. "It took some time for myself to just kind of accept that it was the way they felt.

"With my third [birth], I offered for my mom to be there and she wasn't comfortable and I just accepted that. I needed people around me who supported me and I knew she would be there for me afterward."

Internet brings 'freebirthers' together

According to a recent article in the Canadian Medical Association Journal, a growing number of women are making the same choice as Salcedo, with chat groups and websites bringing people together who are interested in the "freebirth" movement.

In 2006, two-thirds of births attended by someone other than a midwife or doctor in 19 U.S. states were described as "planned," according to the US Centers for Disease Control and Prevention.

No such statistics exist for Canada, said Dr. Doug Wilson, head of obstetrics and gynecology at Calgary's Foothills Medical Centre.

A small percentage of Albertans are having babies at home with midwives, which he calls a  "very reasonable" option, when there are very minimal or no risk factors. Just over one per cent of births in Canada took place outside a hospital in 2006.

Wilson said he believes in patient choice, but he doesn't support having a baby at home without a midwife or doctor.

"I certainly would not support unattended, unskilled home delivery. I think a midwife, if you want a home delivery, is a much, much better choice," he said.

"If you look at countries where unattended home births are common, the death rate for women is one per cent. That's unbelievable that you are going to lose that many women."

Mother unhappy with hospital experience

After a "negative" experience having her first child in a hospital, Salcedo enlisted the help of a midwife during her second pregnancy. After a few months, she and her husband realized the midwife wasn't the right match for them. She talked to two friends who had unassisted births and decided to try it.

"Some people think that it is uneducated or unsupported and it is neither of those," Salcedo said. "I have a lot of doula training and other training and my husband read everything I put in front of him."

Her second and third children were born at home with the help of family and friends, but without professional help.

"We were very prepared for different emergency situations. I knew all of the signs for different situations that could happen. It wasn't like we were saying we won't go to the hospital if something goes wrong," she said.

Wilson cautioned that in some situations, there just wouldn't be time to get help.

"Sometimes in obstetrics, for fetal and newborn, it is minutes. We aren't talking half an hour. And for maternal situations, there are some things where the birth could go very well, but once you then need to deliver the placenta there are high risks of post-partum hemorrhage, there are high risks of high blood pressure. Those are sometimes risks which can't be anticipated."

'Birth is a rite of passage'

Although Wilson is head of obstetrics at a major hospital, he doesn't shy away from concerns by mothers about their hospital experiences.

"I think maybe we have over-medicalized certain aspects of delivery, and I think that is a reasonable criticism," he said. "I think there are ways to do things better."

Salcedo, who has three healthy children, is now training to become a midwife.

"Birth is a rite of passage and many people put more thought into their wedding than they do their childbirth experience. And it is something that will stick with you the rest of your life," she said.

"Unassisted childbirth isn't for everybody, but empowered birth, and safe birth and normal birth is for everyone."