Free birth movement facing scrutiny following several deaths | 7.30

Key Concepts

• Free Birth: The practice of giving birth at home without the presence of medical professionals like doctors or midwives.
• Doula: A trained professional who provides non-medical support, information, and resources to pregnant individuals and their families before, during, and after childbirth. Doulas do not have medical training.
• Maternal Deaths: Deaths of women during pregnancy, childbirth, or within 42 days of the end of pregnancy.
• Neonatal Deaths: Deaths of infants within the first 28 days of life.
• Emergency Delivery: A childbirth that requires immediate medical intervention due to complications.
• ICU (Intensive Care Unit): A specialized unit in a hospital that provides critical care to patients with life-threatening illnesses or injuries.
• Oxygen Deprivation: A condition where the body or a part of the body does not receive an adequate supply of oxygen.
• Life Support: Medical equipment and procedures used to keep a patient alive when their body is unable to perform essential functions.
• Postpartum Hemorrhage: Excessive bleeding after childbirth.
• Prohibition Order: A legal order that prevents an individual from providing certain services.
• Registered Midwife: A healthcare professional who is licensed and qualified to provide care during pregnancy, childbirth, and the postpartum period.

Richa Ekka's Experience with Free Birth

Richa Ekka, in 2022, chose to have a free birth for her first child, influenced by the belief that hospitals are unsafe places for healthy pregnant women. She engaged a doula, whom she mistakenly believed possessed medical knowledge regarding baby positioning and Doppler use to assess the baby's position in the uterus or birth canal.

Labor and Complications

Richa's labor, which began in December 2022, was prolonged and inconsistent, with periods of intensity followed by slowdowns. Her doula provided only brief check-ins, lasting about an hour. After 50 hours of labor, Richa experienced a seizure. Her partner found her on the floor, unresponsive. An ambulance was called, and she was transported to Port McQuary Base Hospital, located 10-15 minutes away. Richa acknowledges that living further away would have likely resulted in a different, fatal outcome.

Emergency Delivery and Neonatal Tragedy

At the hospital, Richa underwent an emergency delivery and was subsequently admitted to the ICU for recovery. Her baby, Gia, suffered complications due to oxygen deprivation and was transferred to John Hunter Hospital in Newcastle. Gia was placed on life support to allow her family time to say goodbye. Gia passed away after only 9 days, stopping breathing within 2 hours of being taken off life support. Richa describes Gia's final moments as a "really big breath" that was simultaneously "scary and beautiful and sad and heartbreaking."

Regret and Advocacy

Richa now deeply regrets her decision to have a free birth, stating, "I don't want other women to make the mistake that I've made and lose the way I've lost." She is aware of other women who have experienced similar losses due to free births.

Medical Authorities' Concerns and Proposed Legislation

Medical authorities are raising alarms about the increasing number of maternal and neonatal deaths linked to free births.

Calls for Regulation

Zoe Bradfield, President of the Australian College of Midwives, highlights that these deaths are preventable and avoidable. Midwives and doctors are advocating for health ministers to enact laws that restrict labor and birth management to registered and appropriately trained health professionals. This is based on South Australian legislation, which could include significant fines and jail terms for violations.

Accountability for Unqualified Individuals

Dr. Nisha Cot, President of the Royal Australian and New Zealand College of Obstetricians and Gynecologists, emphasizes that the call is not to penalize women for their choices, including free birth, but to hold accountable those who are unqualified and present during these births.

High-Profile Deaths and Social Media Influence

The transcript mentions two recent high-profile deaths:

• Stacy Nightingale: Died in early May in Queensland after giving birth to her third child at home. Her son survived.
• Stacy Hatfield: Died in late September from postpartum hemorrhage in a hospital following a free birth at home. Her son survived.

Both women were influenced by free birth advocates on social media who promote the exclusion of medical professionals from childbirth.

Social Media as a Problem

The transcript identifies social media as a significant issue, stating that it hinders nuanced conversations. Registered midwives are sometimes portrayed as complicit in harming women by social media influencers.

Investigation of "Birthkeepers"

Emily Lal, a prominent social influencer and self-styled "authentic birthkeeper," is under investigation by the Victorian Health Complaints Commissioner for allegedly facilitating home births that endangered mothers and babies. She has been issued a prohibition order preventing her from providing general health services in Victoria. Emily Lal claims to have been trained by the US-based Free Birth Society, which has a large online following and podcast.

Opposition to Regulation

Renee Adair, founder of the Womb to Tomb Foundation, who has trained doulas for three decades, expresses concern that criminalizing free birthers and potentially doulas or birthkeepers who offer non-medical support could push these practices further underground. She clarifies that an accredited doula should never have a medical role, defining a doula as a professional offering non-medical support, information, and continuity of care.

Richa's Second Birth and Conclusion

Richa's doula reportedly disappeared after Richa was taken to the hospital, leaving her feeling "abandoned and betrayed." Five months prior to the interview, Richa gave birth to her second child, Slea, with the assistance of a hospital team of midwives and an obstetrician. She expresses gratitude for choosing this path and emphasizes the value of utilizing the existing healthcare system.

Synthesis/Conclusion

The transcript highlights the tragic consequences of free birth, exemplified by Richa Ekka's personal loss of her daughter Gia due to complications arising from a home birth without medical supervision. Medical professionals are increasingly concerned about preventable maternal and neonatal deaths linked to this practice. There is a growing movement to implement stricter regulations, potentially involving legal penalties, to ensure that childbirth is managed by qualified healthcare professionals. While some advocate for the continued practice of free birth and express concerns about criminalizing support roles, the overwhelming sentiment from medical authorities is that the risks associated with free birth are too high and that the established medical system offers essential safety and support that should be utilized.