When Giving Birth, Opting to Go It Alone

Matthew Jasper, 35, a poet from Farmington, N.H., had a brainstorm.

After the birth of his second child, he said to his wife, "Next time why don't we do this by ourselves?" So they did.

At 5:30 in the evening on April 11, 1999, Beatrice Jasper delivered Eudora in the playroom. The videotape camera was rolling. Mr. Jasper and their two sons, 2 and 4, watched.

"My first child was born in the hospital and the second at home with midwives," Mrs. Jasper said. "This just seemed the next logical step. When I was 7 months pregnant, I got on the Internet and found all of these references. The more I read, the more it became clear that this is what we needed to do. To have a mother's hands be the first ones to touch her baby seems so important to me."

The Jaspers were alone at the birth of their daughter, but far from alone in the birthing style. They are linked to a close-knit network of parents across the United States and abroad who are choosing do-it-yourself deliveries. The parents call it unassisted childbirth. National statistics are not available, but the Internet provides an abundance of Web sites, chat groups and links to books and home videos.

About 40 couples have gathered at two national conferences, the first in 1998 in Charleston, S.C., and the second in July in Louisville, Colo. At the meetings and on the Web, women who have unassisted births share their accounts and photographs and offer advice on practical matters, like cutting an umbilical cord.

The movement for unassisted birth is small. It hardly rates being described as a movement. But it demonstrates, in an extreme fashion, a dissatisfaction that some women perceive with obstetrics. Millions of new mothers are grateful for their prenatal care and the obstetrical expertise that helped them through difficult deliveries. But there also seems to be a yearning for more naturalness to childbirth, that most natural of life's events, and a feeling by some women that the emotional support that they crave in pregnancy is somehow lacking.

Those women often use midwives or birthing centers. But now a few, to the dismay of many physicians and nurses, are choosing to give birth solo. The women say they are not fighting the establishment, but simply avoiding it.

Many do not even have prenatal care.

Doctors strongly object. But the women say they believe that they are making the healthiest choice for themselves and their babies.

Husbands help some of the women, but many mothers do not want any help. They usually squat, allowing gravity to ease the baby through the birth canal, and then reach down and let the baby wriggle into their hands. When everything goes smoothly, babies will glide out of a mother without nudging by a doctor or nurse.

"We know 20 percent of all previously normal pregnancies turn into complications and high-risk situations during the course of labor that could result in serious adverse outcome to mother and baby, including death," the president of the American College of Obstetrics and Gynecology, Dr. Thomas Purdon, said. "I cannot imagine a woman in the United States wanting to take that chance."

Dr. Purdon, also a professor of clinical obstetrics and gynecology at the Arizona Health Sciences Center in Tucson, said he sympathized with women who were uncomfortable with the coldness and sterility of some hospitals.

But he said obstetricians and nurse midwives had recently made major efforts to make birthing rooms cozier and to intervene medically as little as possible.

No statistics are available on complications after unassisted births, because many women do not tell their doctors that they are delivering their own babies.

Deanne Williams, executive director the American College of Nurse-Midwives, said she could not condone unassisted births, but understood the desire.

"I think we are taking a turn for the worse where women are not getting the personalized attention they need," Ms. Williams said. "We made gains in the 90's in the number of nurse midwives and women's voices grew, and hospitals really started to pay attention. But now I think there is a push to more technology. These women feel empowered to make a statement, but it is a sad statement. The majority of births are normal and healthy. So it's hard to appreciate that things can go wrong."

Although people involved in unassisted birth networks vary in age, education, religion and geography, they have similar attitudes about pregnancy, delivery and child rearing. They say a vast majority of complications are inflicted, not prevented, by doctors.

Mothers say they are relaxed in pregnancy and labor because they focus on the pleasures of creating life rather than dwelling on dangers, an attitude that they say lets them avoid pain.

Delivering one's baby is not illegal, according to the American College of Nurse-Midwives. But in some states, including New York, an unlicensed midwife is not allowed to deliver a baby without a physician or licensed nurse midwife present. That means that women can do whatever they want themselves. Women who have delivered their own babies know they can always report that the baby was born accidentally, not intentionally, without help.

Dr. Charlotte G. Borst, who wrote "Catching Babies: The Professionalization of Childbirth 1870-1920," published in 1995, said, "The sad part to me is that there is no historical precedent for doing it alone."

Even before the days of midwives, women had groups of friends or relatives nearby. Dr. Borst, also a professor of history and the dean of arts and sciences at Union College in Schenectady, N.Y., said she was "sort of astonished that any woman would choose to give birth alone."

Shira Levy, 40, of Weston, Fla., a mother of three, said she had initially planned an unassisted birth but went to a hospital when she learned that she was carrying twins. Ms. Levy delivered her third baby at home without medical help.

"I gave birth squatting down on the left side of the bed with all sorts of sheets and waterproof things," she recalled. "My husband caught him, and we cut the cord about an hour later with dental floss and sterilized scissors. We didn't call anyone until that evening. We just wanted to be our little family."

Lori and Marc, a couple from upstate New York who asked to be identified by just their first names, had a "lotus birth." They did not cut the umbilical cord. It stayed attached to the baby for two days and then dropped off.

"I personally wouldn't videotape myself," Lori said. "But I am grateful to women who have, because it helped me to get rid of the ideas of what birth is. I think women are creating their own fears. I am not denying that things could happen. We just didn't think about it."

Laura Kaplan Shanley of Boulder, Colo., author of "Unassisted Childbirth," published in 1994, has delivered five babies by herself. One was born five weeks early and died of a congenital heart defect shortly after birth. Ms. Shanley said a coroner told her that the baby would have died even if she had gone to a hospital.

Home videos of Mrs. Jasper and Ms. Shanley, along with those of other women, appear in a documentary, " A Clear Road to Birth," directed and produced by Judy Seaman.

"I gained tremendous respect for their courage to go against the grain of society," Ms. Seaman said. "After meeting the women who chose this kind of birth experience, I think the important ingredient is the acknowledgment that this is her birth and that she does not have to follow a blueprint."

Mrs. Jasper delivered her fourth child, Albion, on Feb. 25 at 6:53 p.m. "After Dora's birth," Mrs. Jasper said, "one of the first things I said was: `That was fun. I want to do it again.' "