Peak health body flags worrying rise in freebirthing in Victoria

A peak Victorian health body has warned the worrying trend of freebirthing is on the rise across the state, despite “tragic” and “preventable” outcomes for mothers and babies.

Freebirthing has seen a “substantial increase” in recent years, a peak Victorian body has warned, with “tragic” and “preventable” outcomes for mothers and babies.

Victoria’s Consultative Council on Obstetric and Paediatric Mortality and Morbidity, an advisory body to the Victorian Health Minister, said in a report this month that “recent years have seen a substantial increase in women choosing to birth without the support of a registered health professional (freebirthing)”.

The report said this increase has resulted in “disproportionately worse outcomes compared to traditional maternity care”.

CCOPMM chair and Victorian maternity taskforce co-chair Professor Mark Umstad, in an exclusive interview with the Herald Sun, said he sees the “absolutely tragic” outcomes.

“I see it at the pointy end because I see the women who die from it, the women who end up in intensive care, the babies who die, and the babies who end up with a brain injury,” he said.

“The number of women that we see end up in intensive care with massive haemorrhages that are entirely preventable is just extraordinarily tragic.

“It’s a very small proportion [of births], but they have an incredibly high rate of adverse outcomes and many of them are preventable.”

Freebirthing is different from home births, which are attended by registered health professionals (typically a midwife).

The warning comes after several high-profile cases thrust the underground movement of freebirthing into the spotlight, including the tragic death of nutrionist and Victorian influencer Stacey Warnecke, formerly Hatfield.

Mrs Warnecke was rushed to hospital after a complication following the freebirth of her son, but could not be saved and died on September 29.

In October, freebirth advocate Emily Lal — who rented out a birthing pool to a woman whose baby then died in 2022 — was banned from providing any healthcare pending an investigation by the Health Complaints Commissioner.

The Consultative Council, which collects data on every maternal, baby and child death in Victoria, cannot say exactly how many freebirth cases have been reported to them in recent years for privacy reasons.

The council, which collects data on every maternal, baby and child death in Victoria, wouldn’t say how many freebirth cases had been reported.

But Prof Umstad said, across Australia, there have been “several maternal deaths, many stillbirths and brain injuries related to freebirth in Australia.”

“We just need to make them [women considering freebirth] aware of how dangerous it can be,” he said.

He said they recognised that previous birth trauma in the health system was one of the contributors, and the recent Victorian Maternity Taskforce made recommendations to address this.

“We’ve listened to women and we are acting on that,” he said.

Prof Umstad said the council was also concerned by unregistered birth attendants who step across the line and provide clinical care and hopes women considering this will instead turn to publicly funded home birth with a registered midwife who can provide “expert” and “personalised” care.

“It’s a far, far safer option,” he said.

Royal Australian and New Zealand College of Gynaecologists and Obstetricians president Dr Nisha Khot said home births were “absolutely” a great option for low-risk patients, but she finds it’s often patients, who are not low-risk, who ask about it.

“It’s very important that we all recognise women have autonomy to make decisions that they feel are right for them,” she said.

“But those decisions should be made on the basis of factual evidence and research.”

She said some women were not given factual information and unregistered birth attendants should be held accountable.

Homebirthing can be safe for low-risk patients.

“I really feel uncomfortable when other people misrepresent themselves … as being able to help when things go well, when they don’t have the training or qualifications,” she said.

She said another factor was tolerance of risk, and as individuals we think we will never be the 1 in 100 case, for example, of a life-threatening complication.

But a doctor, who sees hundreds of women a year, may feel differently about those odds.

Dr Khot said it was great for the “99 women to whom it didn’t happen”.

“In my practice I always say to women that the risk of whatever that might be happening may be one in a hundred, but when it happens to me, it is one in one.”

Australian College of Midwives midwifery adviser Kristy Watson said women who chose to freebirth did so because they genuinely thought it was the safest option for them and their baby.

She said women’s experiences of birth trauma was leading to distrust in the system, and this needed to be addressed, plus home births – with a registered midwife – made more accessible.

“The public home birth services often have a strict criteria that make many women ineligible, and access to privately practising midwives does come at a high cost because there is no Medicare item for home birth,” she said.

“[This] does make it unattainable for some families and is likely part of decision making that is having women feel forced to choose free birth.”

Originally published as Peak health body flags worrying rise in freebirthing in Victoria