The autonomy of birthing women in the COVID era is at risk — will they push back?

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Amidst the COVID-induced global upheaval, one aspect of life remains certain: women will give birth and babies will be born. The question is, where?

As hospitals no longer feel safe and pregnant women across the world are changing their birth plans, COVID-19 is revealing the deep misogyny embedded in the medicalization and regulation of birth. There are many layers to the betrayal that birthing women are navigating right now, and the options available to them are diminishing daily. COVID-19 is undoubtedly changing the culture of birth, but it remains to be seen if this pandemic will further entrench state power over women’s bodies, or if it will spark a birth revolution.

Across Canada (as well as the US and UK), hospitals are limiting each birthing woman to one support person, leaving women to decide between their partner or doula. Increasingly, hospitals are banning support people altogether. We know that even in the best of times, when hospitals are fully staffed and under no stress, hospital births are rife with violation and abuse. Practicing informed consent seems to be challenging for hospital staff in ideal circumstances, so many women are rightfully terrified of what they will experience during a pandemic when hospitals are stretched to capacity.

The thought of facing this alone is enough to turn any women away from the hospital. Adding to this the very real risk of exposure to COVID-19 means women are rethinking whether it makes sense to give birth in a place that in all other circumstances is for sick people.

As of March 30, the province of Nova Scotia “suspended” midwife-led home birth until at least April 30 to “support provincial efforts to minimize the spread of COVID-19” and “protect small teams, like the midwives and birth attendants.” If countries like the UK are an example of where we are headed, Canadian women can expect other provinces to follow suit. As COVID-19 cases increased, the UK National Health Service announced it was suspending home birth in several areas, and according to a survey conducted by the Royal College of Midwives, over a fifth of respondents reported that midwife-maternity units had closed while a third of the areas were also either stopping or restricting home births. While new numbers have not been released, on social media women are reporting more cancellations, and it seems that the trend is towards a country wide suspension of home birth in the UK. Birthing women across Canada are anxiously wondering if their province will be next.

Ironically, during a time when an unprecedented number of women are wanting to birth at home, many midwives and doulas are choosing to align with the increasing regulation and medicalization of birth, and refusing to attend home births. The COVID-19 crisis has revealed the contradiction at the heart of regulated midwifery: a midwife cannot be “with woman” (the original etymology of the word) and with state. Despite CJ Blennerhassett, president of the Association of Nova Scotia Midwives stating that “she wasn’t aware of any evidence to suggest that home births put patients or midwives at greater risk,” and despite the spike in demand for home births, the midwives of Nova Scotia are sending women directly back to the hospital. In a time of crisis, regulated midwives and doulas in the system are revealing that the rules and regulations of the state are more important than the wishes of mothers.

Birth workers in the system may be falling in line, but many women are refusing to accept that their only option is to birth in a hospital. Since birth is not normally a medical event and home birth is statistically as safe as hospital birth, women are questioning why they would choose to willingly enter a hospital during a pandemic and, as a result, many will be birthing at home, midwife or not.

Waves of women are putting the safety of themselves and their babies first and are actively resisting the patriarchal lie that the state or any governing body has the power to “suspend” home birth. On social media, home birth and freebirth groups are being flooded with women seeking guidance and support. Women are refusing to bow down to the state dictating their birth location and are choosing to freebirth — that is to say, to birth outside of the medical system.

Freebirth, sometimes called unassisted birth, is a term used to describe the choice of a woman to intentionally give birth without the presence of doctors or midwives, typically at home with the support of her family or close friends. Since freebirth occurs totally outside of the system, it is inherently challenging to collect accurate statistics on the number of women making this choice. The “Free Birth Society” podcast has over two million downloads, illustrating the depth of interest. Emilee Saldaya, the founder of Free Birth Society, told me:

“We at Free Birth Society have definitely seen an influx of women buying the course, listening to the podcast, and joining the private membership. As women are being abandoned by their medical midwives due to new COVID-19 restrictions, many of these mothers are using that as the last straw to birth in total sovereignty. Meaning, just staying home and planning a freebirth.”

There is no one reason why women choose to freebirth, but the through line for many freebirthing women is the decision to have total autonomy over their births and a desire to experience birth on their own terms, free of the discrimination and abuse so many have experienced in the system. Right now, the desire to birth in the safety of their COVID-free homes, combined with a lack of birth workers willing to attend home births, is pushing many women towards freebirth.

Of course, not all pregnant women are choosing to freebirth right now. Despite the pandemic, there are plenty of women still choosing to give birth in hospitals. The fact that women are willing to risk the exposure of themselves and their babies, as well as the potential trauma of birthing without support in a stressed hospital system, is a reflection of how deeply women have been convinced that childbirth must be a medical event.

While many pregnant women in the time of COVID are likely coming to freebirth because they have no other options, for many women, these birth experiences will reveal that perhaps they never needed hospitals or midwives in the first place. As the oppressive structure of our birth culture is exposed, and as women across the world experience the power of birth on their own terms, many women may never return to the system.

Governments have no business regulating birth — women own birth. No one has the power to “suspend” home birth — not states, not hospitals, not midwives. If there has ever been a time to resist the state control of women’s bodies and the regulation of birth work, it is now.

Freya Kellet is a regenerative livestock farmer and radical birth keeper from BC Canada. 

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