The Guardian

在家里生宝宝目前已成为英国不少孕妇的选择。

Sarah Currie is just days away from giving birth, so when we meet our conversation turns, naturally enough, to the delivery. She is planning a home birth; we talk about where it might take place (she thinks the sitting room), about pain relief (she's going to walk around) and how long the labour might last. One thing we don't talk about is the midwife, because there won't be one. Currie, 27, decided a few weeks ago that she wanted to have her child without medical assistance.

If that sounds mad, bad or dangerous (or perhaps all three), then hear her out. Two years ago, Sarah, who lives in Peterborough, gave birth to a daughter called Anabella-Grace (her older children are Jack, seven, and Eleanor, three). She'd been planning a hospital birth, as her previous two had been, but towards the end of her pregnancy she became interested in home birth. The midwife said she wasn't considered "safe" for it because her first child was born by caesarean section. But Sarah looked at the research and decided she was willing to take the risk, which she thought was very small.

She booked a home delivery and called the midwives, as agreed, when she went into labour. "But the person who answered the phone said the community midwives were already at a birth so no one was available. She asked if I would come in to hospital. I had my heart set on a home birth, and everything was going well. No one had warned there might not be a midwife. So I said: 'I'm staying put.'"

The labour progressed well, but less than 10 minutes before her baby was born, a team of paramedics arrived. "They didn't interfere," Sarah says, "but it could have been very different. Some paramedics might have freaked out; they might have tried to get me to do something I didn't want to do. And they changed the atmosphere, because an ambulance arriving in the middle of a normal birth isn't ideal."

Few babies are freebirthed in Britain – the best guess is that there might be somewhere between 20 and 30 a year – but there's evidence that it is on the increase. The Nursing and Midwifery Council issued a statement on the practice last year, pointing out that a midwife has no "right" to be at a baby's birth, and that any decision to freebirth should be respected; it prefaced its position by saying that freebirthing was rising in popularity.

That's not currently the case in Britain, but there is a change coming here that may inflate the freebirth figures. Independent midwives, who have long supported women who want home deliveries and who, unlike NHS midwives, can guarantee availability on the day, are effectively being outlawed: they have been unable to sort out an insurance deal, and from October it's going to be illegal, under EU legislation, for any healthcare professional to practise without insurance. There are about 170 independent midwives in Britain, and they attend around 3,000 births each year. It's distinctly possible that at least some of the women who would have opted for a home birth will instead decide on an unassisted delivery.

Women such as Valentina Cruz, 37, who lives in Aberdeen. Six months ago, she gave birth to her second child using an independent midwife; her first delivery had been an emergency section after what she describes as a "cascade of intervention" in hospital. Her second child's birth, at home, was straightforward. If she got pregnant again, she'd think about freebirth, she says. "It's not something I'd actively want, but if there were no independent midwives – and the NHS midwives didn't support my home birth plan last time because of my previous section – then I'd be a lot less scared about having my baby alone at home than I would be about going into hospital."

The hardest thing about being in hospital, Cruz says, was feeling that the staff didn't trust her body's ability to give birth without intervention. The vast majority of women, freebirthers believe, could give birth more safely and happily without medical involvement. "In my antenatal classes, women looked at me as though I was mad when I said I was planning a freebirth," says Kate Tregellas, 36. "But so many of them had difficult deliveries, forceps and ventouse and even caesareans; they went into hospital and seemed to end up on this conveyor belt to intervention.

Purdie and other freebirthers believe that labour works best when it's not interfered with. "A woman's body knows what to do," she says. "I've watched cats giving birth, and they do it in a straightforward way because they're left to do what nature wants them to do."

Some of the women I spoke to got the distinct impression that the midwives they were in touch with supported their choice morally, even if they couldn't be seen to condone it openly. Natalie Rickman, who lives near Hexham, Northumberland, gave birth to daughter Isla on the same day in July as Kate Middleton had her son George. But while the duchess was surrounded by obstetricians and midwives, Natalie was at home with just her husband, Peter, an architectural technician, and a doula by her side. Isla was her third baby; she'd had a traumatic hospital delivery first time around, a much easier water birth the second, and says that by the time she got round to her third birth, she was "confident I could cope on my own". Natalie didn't spell out her plans to her midwife, but thinks she probably put two and two together. "She seemed supportive. She said things like, 'You probably won't even need us.'"

As things turned out, she did need a midwife's help, but only after Isla's birth, when her placenta got stuck. "We called the midwife, who came over straight away and was very impressed that we'd done it all on our own. It was only the GP, who came over a few days later to do the newborn check, who seemed gobsmacked."

It may be true to say that some midwives are sympathetic to women's desire to freebirth, but very few would advocate it. Jokinen's position is that it's a midwife's job to help a woman find a way to be as confident, relaxed and in tune with her body as she can, so that she can give birth as naturally as possible.

And "safely" isn't always how freebirth turns out. A year ago, an Australian coroner criticised a woman called Janet Fraser whose baby, Roisin, died after an unassisted birth at her home in Sydney. He said Roisin's death was probably caused by the cord becoming tangled round her neck during the delivery, and called Fraser, her partner Trevor Stokes and a friend who was with them "amateurs" who were not prepared for performing CPR on a newborn baby. Fraser "chose to rely on her own sociopolitical views about birthing and Roisin's chance of life was deferred to that decision", the coroner said.

Fraser – a long-time advocate of freebirth who ran a website called Joyous Birth – was unrepentant. She told the inquest she believed her birthing decisions were appropriate and proper. "There are no risk-free options," she said. "I chose the option with which I was most comfortable."

While in theory British women can have a freebirth if they choose to, the authorities sometimes intervene. Melissa Thomas, 27, who lives in Derbyshire, decided on a freebirth for her second child last year. She spoke to the local supervisor of midwives, who appeared to be supportive, but then a letter arrived from social services requesting a home visit. Soon after, her son Oliver was born in an uncomplicated, unassisted delivery. After the birth, social workers came on several unannounced visits, on one occasion even turning up with the police. "It was terrifying. I was looking after a newborn baby, and suddenly I thought my children might be taken into care. My husband dealt with it all really well and eventually they went away. Two days later, some midwives arrived, and they seemed very regretful about how it had been handled."

Fear of being hounded by social services means some women fudge their decision to freebirth by booking a home delivery and then leaving it too late before calling the midwife; their babies' arrivals are recorded as BBA, or "born before [the midwife's] arrival". Another category is known in freebirth circles as an "oopser", as in, "Oops, I forgot to call the midwife and now the baby has appeared."

Sarah Currie admits she was occasionally spooked by someone else's horror story, or pulled up short by a friend's reaction to her planned freebirth. But in the event all went well, and a few days after our meeting she gave birth to Temperance. The baby was delivered, as planned, on the sitting-room floor after a labour spent walking around the house. "If I'd been at all worried, I'd have moved to hospital," she says. Sarah laboured through the night and Temperance was born at dawn; Sarah's partner, Adam, cut the cord, and the other three children came downstairs about half an hour after the birth to meet their new sister. A few hours later Sarah phoned her midwife, who came over the next day. "She did the newborn checks and was very respectful of my choice," Sarah says. "What the experience has taught me, more than anything, is to trust my instincts."