I just finished reading the dissertation Born Free: Unassisted Childbirth in North America by Rixa Freeze, PhD, of Stand and Deliver. All 300+ pages of it. It was very interesting. I have understood for quite a while that some women give birth unassisted because they feel forced into it because of a lack of acceptable options (such as for a women who is going for a VBAC but the hospitals in her area have "banned" it, and DEMs are illegal in her state, or other situations like that) I used to not understand why some women choose unassisted birth (also called "freebirth") when a midwife-attended homebirth would be an option for them, though I always respected their right to choose it. I am ione who would, in the face of limited options, find the best attendant for a hospital I could and fight for the kind of birth I wanted over choosing to "go it alone" at home. Rixa's dissertation gave me insight into the way unassisted birthers think. Here are a few things I learned:
1) UCers believe, as do others in the NCB community, that intervention in the birth process increases the risk of complications occurring. Unlike the rest of the NCB community, they include things other than medical procedures as interventions. Instruction, support, or even the mere presence of a caregiver is seen by the UC community as disruptive to the birth process.
2) UCers highly value intuition. They believe that the parents of the child should be responsible to make all decisions about the birth. They trust that as they birth alone and as focused as possible on their bodies, intuition will guide them to seek out medical help if a need arises for it, which prevents anyone but them from deciding that an intervention is necessary.
3) They believe midwifery is misguided--midwives are trained to "do" too much at births. They also take issue with midwifery being a paid profession. They believe that ideally, birth knowledge would be freely shared among women so every woman can be her own midwife. There would be a few trusted experts who would sometimes provide assistance, but as a service and not a job.
There is a lot more in the dissertation, and I recommend reading it to anyone who is curious about it. I'm still not planning on having any of my own babies unassisted, but I do feel like I understand better where women who do it are coming from. Reading it also got me to think about some things I'd never thought about--questions about what role I would want a midwife to fill at a homebirth. Would I want her to coach me or stand back and watch? Be in the other room? Do I want cervical checks, occasional fetal heart monitoring monitoring, suctioning, etc? I always figured, if I had a homebirth, I'd avoid "unnecessary intervention" by being away from the hospital, but Rixa's dissertation helped me see that there is more to it than that.
So, Rixa, if you ever read this, thanks for sharing your dissertation and all of the insights in it.