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I wonder...

How much of having no antenatal care and no trained care provider at the birth, is about being able to plead ignorance in the event of injury or death to the mother or child?

If evidence based care is the best antenatal and labour care, and some evidence based care leads to interventions, and intervention - any intervention - is perceived as a terrible thing, then if no one checks you or you baby, and no one says, "Hmmm, there is evidence of a problem here...", then when a problem does arise, you can say, "Well, there was no evidence - to my untrained eye, so I didn't know to seek assistance..."

That way you avoid intervention AND you avoid responsibility for something going wrong, because you didn't ignore medical advice by refusing intervention...

Or am I being cyncical?

Comments

Stitch Sista said…
Well with all due respect that's about the craziest thing I've seen you write...

Really?

I'm inclined to think that those who go it alone are actually the *most* informed, and of course, take the ultimate responsibility when things go wrong.
Spiralmumma said…
'I'm inclined to think that those who go it alone are actually the *most* informed'

I don't see how that statement can possibly be qualified Rach. I know you are giving a personal opinion, and not stating a fact, but I'd be highly dubious that's actually true.

I don't believe freebirthing is often in the best interests of the mother or baby. For the majority it probably goes fine. But what when it doesn't? Is that just the baby's bad luck? I recognise the right of the mother to birth any way she chooses. But at some point, don't we have to question whether the baby has rights too?

I personally don't understand freebirth. Why not give birth at home with a midwife, who is trained to know when medical care is called for?
Stitch Sista said…
I should qualify that. I mean the most informed amongst birthing women. I didn't mean to imply that they are more informed than midwives or other practitioners...

But really to suggest that people don't seek antenatal care to somehow abdicate responsibility seems ludicrous to me.

FWIW I'm not a supporter of freebirth for myself. But the current system has forced the hand of many women and I do have some empathy for their position.
Kebeni said…
certainly an interesting post.

I guess there are people out there who feel the same way about homebirthers and then there are people who feel the same way about those who don't have OB care. Each to their I say and you know, sometimes it doesn't matter who attends, babies die, mothers die and it is tragic no matter what the scenario
april said…
"Why not give birth at home with a midwife, who is trained to know when medical care is called for?"

If only it were that simple!!!
For a lot of women there aren't any midwives where they live!
Or the ones that are near are crap!

Sif, did you have a midwife at your homebirth so that you could blame her if something went wrong? Is that what having a midwife is all about, having a scapegoat?

Yes, you are cynical, and possibly close minded...

What happens when a woman wants to birth at home and there are no midwives? Or the midwives nearby aren't satisfactory? Should we FORCE women to birth in hospitals against their will? FORCE women to return to a place that has previously caused them trauma and harm? Just so that the responsibility can always be put onto someone other than the woman herself?
No matter where you birth, the responsibilty is always on the woman.

"sometimes it doesn't matter who attends, babies die, mothers die and it is tragic no matter what the scenario"

yeah that.

I wonder...
why you take so much interest in something that you wouldn't do.

I wonder...
why can't you just ask a freebirther instead of speculating about stuff you don't know on your blog...
Spiralmumma said…
Yeah I get that for some women their choices are severely limited and they have no other choice if they want a home birth. Which truly sucks. I don't understand it as a conscious choice,(ie where the woman does have access to independent midwifery care) especially for a first baby or following difficult previous birth experiences. I feel like it's making it all about the mother and not considering the rights of the baby to medical care in the event of an emergency. But that's just me :)
Sif said…
I often wonder about stuff that I wouldn't do, sometimes by wondering about stuff on an open forum, I can find out a lot more than simply asking one person, yk?

Wondering isn't the same as stating a fact, it's merely expressing a question that has come up when trying to figure out why things are as they are...

That's kind of the point of philosophising...

Some people don't feel the need to wonder about anything that doesn't directly concern them, I guess I'm just not that kind of person.

This question arose from a thread I read on a forum about who was liable in the event of a death in a homebirth/freebirth. It seemed you could be held accountable if you went AMA, but not if no one suspected there was an issue, which is why I was wondering if not seeking antenatal care provision might serve more than one purpose...

WRT my midwife, no I didn't hire her as a scapegoat at all because I ackowledge that not everything can be seen or evidenced. Having her simply meant that I had someone at hand who might recognise issues I couldn't recognise, and might be able to do something like resuscitate me or my baby if one of us was worse for wear. That's what midwives do. My focus was on birthing, not on having to be my own midwife and engaging the frontal lobe...
Spiralmumma said…
Yeah Sif I was unaware it was a crime to be interested in topics which don't correctly concern you as well. Damn, must stop worrying about child abuse, global poverty and world hunger. Better stop that philosomaphisin' young lady, thinking can only get ya into trouble :P
april said…
"This question arose from a thread I read on a forum about who was liable in the event of a death in a homebirth/freebirth."

Can you link us so we can read the thread for ourselves?

"which is why I was wondering if not seeking antenatal care provision might serve more than one purpose..."

Personally i'm a little shocked that you are alluding to woman/parents using freebirth as a way to escape responsibility of what happens at the birth.

Though I guess its just like how seeking antenatal care serves you more than one purpose, and that one of those is a scapegoat in the unfortunate event that something goes wrong.

Whether in hospital, at home with a middy, or at home with no middy, at the end of the day if the baby dies, you made the choice to be where you were.

I never said it was a crime to wonder about things, I merely wondered why you would. You don't have to be rude about it or insinuate nasty things about people in the process though yk.
Spiralmumma said…
I wasn't intending to be nasty April :) I have a bit of a sarcastic sense of humour sometimes is all. Nothing personal, not even intended directly at you. I see a lot of people on the internet say 'Who cares' and 'why should you care so much' about an issue simply because it doesn't affect them. Who said something needed to affect you personally in order to have an opinion and make comment? This is Sif's blog, I reckon she can say whatever the hell she damn well pleases on it :)
Stitch Sista said…
Jayne, just wanted to speak to your issue of the rights of the baby.

I definitely support a baby's right to be born safely - but it's the thin edge of the wedge isn't it?

Imagine if there was legislation from the time of conception that put the baby's rights and safety always ahead of the mother.

We know how that goes don't we?

(BTW I should say I don't have an answer to that, but being pro-choice it has to be considered. And do you remember the story of the woman who had to go into hiding b/c they didn't want to give their newborn a HepB vax and docs were threatening to seize the baby? Who *is* responsible for a new baby...? Sticky questions)
april said…
Spiralmumma my comment was in general not at you specifically.
I never said Sif shouldn't "say whatever the hell she damn well pleases" on her blog I was merely "philosomaphisin'" that she may get more answers if it were not posted on a blog, but perhaps on an actual forum where more people frequent. Cos yk...there is what, 1 freebirther in this conversation so far? As cool as I am, I don't dare assume I speak for us all ;)

Stitch Sista, yeah it is very sticky territory, putting the rights of the baby first scares the bejesus out of me. I am not merely an incubator for my baby and without me there would be no baby, yk. Do we really want forced c-sections???
Joy Johnston said…
Sif and all
I have enjoyed reading this discussion. I suppose most of you have read my comments at http://villagemidwife.blogspot.com/

Sif, I would like to question your reference to evidence based care. I can't do that here, but will work on it!

Knowledge brings responsiblity. One of the items midwives and doctors check prenatally is blood pressure. If I know that a woman's blood pressure is higher than 'normal', I am responsible to take certain actions - recording it, discussing it with the woman, and making a professional recommendation as to what action would be appropriate in this situation. My recommendation may be that we wait and see; it may be to do with diet or supplements. Now you could go to the local pharmacy and buy a BP machine, and check your own. You could even find sites on the wonderful web that tell you everything there is to be known about BP and pregnancy. So what are you going to do if you record 140/90 or higher?

The same for fetal heart rate monitoring - you can buy a little strap on monitor and listen to your baby's heart beat as much as you like. It's part of the DIY mentality isn't it.

When we give birth our intiutive nesting instinct tells us to get ourselves and our space (nest) ready. Ready for what? Ready to give birth - so that we don't have to think about anything, and can yield or surrender or harmonise with our birthing, whether it's quick or slow, painful or ecstatic.
Pagan Rach said…
"...AND you avoid responsibility for something going wrong..."

I'd say it's exactly the opposite... a freebirther is taking all responsibility upon themselves, not avoiding it, or passing it to someone else.
Zoe said…
I think you are way off the mark here Sif. Choosing to birth without a midwife means accepting more responsibility if something goes wrong- not less.
Sif said…
I was referring to responsibility in the eyes of the law... I guess we have a test case happening right now, so we shall see...
april said…
how compassionate and respectful of you to refer to a greiving family as a test case.
I am still waiting for you to link us to this 'forum thread' you referred to earlier that this post is supposed to be based on...
Sif said…
April, the thread was on Essential Baby last week. I believe it was in the What Do You Think? section, but having gone back over 35 pages of back threads, as well as using the keyword function, I'm unable to find it now. I wouldn't be surprised if it was deleted - others who have posted here also saw the thread, so they can vouch for it's existence if you like.

As for insinuating my lack of compassion and respect, I don't see how my comment lacked either, to be honest.
Sif said…
Just reading back - again, trying to figure out what you mean, April... I wasn't referring to the grieving family as a test case. I was referring to the inquest as a test case. Two different things altogether.
Kate said…
I saw that thread too, but gave up reading after about 10 pages because there seemed to be a lot of going around in circles re. the law and freebirth/homebirth (which in itself was being debated as many don't seem to understand the difference between the two).

The OP was about the legalities of freebirth should a mother/baby not survive (as in, what charges may be faced etc) and the timing was, I think, fairly deliberate. Which may be why it was deleted? Given the inquest taking place I'm guessing the forum owners didn't want it there given that it did name the family involved and link to the media article of a few weeks ago.

there were a number of posts in that thread which suggested that if a stillbirth occurred in a freebirth situation (wherein the mother had had no medical contact whatsoever during pregnancy, so the pregnancy itself wasn't 'on record' as such) then the baby may just be mourned in the family circle and no authorities ever be notified at all, so to the rest of the world the baby never existed iykwim?

There was a fair bit of back and forth about this with a few legal types weighing in with various opinions.

So I took this blog post to be extrapolated from that thread as the idea of pleading ignorance in the instance of a tragedy was raised there.

Obviously this is a very emotive issue regardless of your birthing preferences. I can't imagine anyone who is aware of some things going on right now isn't feeling sadness... the loss of a child is a tragedy under any circumstances.

But the issue IS being debated fairly widely and I think this is a valid exploration of some of the ideas being presented.

A little OT but the thing I find worrying atm is the apparent confusion being expressed about freebirth/homebirth, and how this will impact on midwife registration and the availibility of homebirth as an option for women in this country based on a misconception.

From a personal POV, I don't *get* freebirth at all. But then I've 'won the lottery' more than once and had ecstatic hospital births. I'm interested in reading about it all... but worry that some of the more extreme views (from both ends of the spectrum) will merely alienate women further from the idea of homebirth, as they alienate women from the hospital system, and we will end up with a pretty unsatisfactory middle ground and very little actual CHOICE at all.
kate said…
Apologies, I stand corrected. The thread as actually started a few days after the news item, and not in response to the events which followed. So the timing was inadvertantly bad and not deliberately.
Sif said…
Kate did you find the thread? I thought it started several days BEFORE the current events leading to the inquest, but then that story was drawn into the thread by an EB regular (not me)...

Whichever it is, I completely agree that there needs to be a very strong distinction made between freebirthing and homebirthing. Whereas in homebirthing situations there is a care provider who can possibly identify issues during pregnancy and also deal with emergencies during labour (instead of the distressed parents having to maintain cool heads in such a situation), in a free birth the parents do take it upon themselves to play both rolls of labouring woman and midwife. Responsibility is taken by the parents in both situation, btw - at least, I took my responsibility very seriously in my homebirth (which is why I had someone with expert knowledge to be *with* me (and she, in no way, interfered with my labour, never once touched me, except for a greeting hug when she arrived),,,

Responsibility in the eyes of the law, in the event of a tragic outcome is a seperate matter. My concern is that free birth situations that end badly will restrict the rights and options of ALL pregnant and labouring women if free birth is equated to home birth - the two are quite different.
april said…
Your first comment mentions nothing of the inquest Sif, so I couldn't have known exactly what you meant, could I?

As for the thread LMAO, I insinuated nothing other than that you referred to a thread, I asked to see it and you didn't link it. I don't hang out on mainstream forums so had NFI where to even begin to look...yk...hence why I asked you to link it for me!

As for freebirth vs homebirth, I don't think its fruitful for either group of birthers to be clashing against one another.
Just because you don't agree with something doesn't mean it should be taken away as an option for everyone.

Can you imagine the outcry if elective ceasareans were made illegal?
Sif said…
April, you jumped to a conclusion, and based on that you made a personal attack, it is not my responsibility to prevent you jumping to conclusions, let alone acting on those conclusions.

You seemed concerned that I hadn't poted a link to that thread, so I felt the need to reassure you of it's existence when I was unable to locate it for you - so you knew I wasn't just "stirring the pot" so to speak.

LOL, it's funny you should mention making elective c/s illegal, as I personally feel that extreme is also a dubious "option" for women, and if not withdrawn, then should only be offered pending psychological assessment and in-depth counselling... Many of my close friends disagree :).

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