Trigger warning: Birth trauma, neonatal and infant death
The rise of unqualified “birthkeepers” in Australia’s birthing community is putting mothers and babies at risk. These so-called “sovereign” birth practitioners promote birthing practices that reject medical intervention, often charging thousands for their services while operating outside the healthcare system.
The difference between freebirth and homebirth
During homebirths, a clinical/medical practitioner (typically a midwife) is present for the birth. The practitioner is trained to assess whether homebirth is appropriate in the context of the pregnancy, manage the birth, monitor vital signs and, if necessary, arrange a transfer to hospital.
Freebirths, on the other hand, occur without a clinical practitioner present. Often a “birthkeeper” or doula will attend. These individuals generally have no (or very limited) medical training and may not be competent to recognise the risks and complications that arise during birth.
The rise of freebirths in Australia
In February 2024, the ABC reported details of a tragic story of a freebirth in which a midwife was contacted by a doula and asked to attend a freebirth at a property in the Sunshine Coast hinterland.
The midwife attended and advised that the baby was in the posterior (backwards) position. After discussing strategies for the birth, the midwife recommended that the mother present to hospital if the baby was not born in the next few hours.
Around ten hours later, the midwife was contacted by the doula, who advised that the contractions had slowed down. The midwife again recommended that the woman present to hospital.
The mother continued to labour and presented to Sunshine Coast University Hospital the following day. The baby was born via emergency caesarean section with thick meconium (which can be a sign of foetal distress). Tragically, the baby passed away within a few hours of being born.
Alice’s Story
The ABC has also recently reported on the experiences of ‘Alice’ and ‘Patrick’, who have both experienced traumatic freebirths.
Alice turned to freebirth after two caesarean deliveries left her traumatised. When private midwives refused to home birth her due to her high-risk history, Alice engaged an unqualified birthkeeper who referred to herself as a “sovereign midwife,” and charged Alice $5,555 for her services. When her contractions didn’t progress, Alice was reportedly told by the birthkeeper that her body was “testing the strength” of her womb. Alice’s labour continued overnight, and the following day she realised she could no longer feel the pressure of her baby’s head.
Alice then admitted herself to the hospital, where a midwife examined her and reported that the baby was in a diagonal position.
Alice underwent an emergency caesarean section, and her baby required resuscitation. Alice’s baby is now developing normally, however, staff at the hospital advised her and her baby’s life had been in danger.
Patrick’s Heartbreaking Loss
Patrick and his partner also sought an alternative birthing experience, engaging a birthkeeper within the same network as Alice’s. During labour, the baby passed meconium, a sign of distress. Despite the severity of the situation, the birthkeeper delayed calling for hospital assistance.
Shortly after, Patrick realised that the baby was in the breech position. The baby’s head became stuck, and an ambulance and emergency midwife were called. The baby boy was born unresponsive, and despite resuscitation attempts by paramedics, he could not be revived. Patrick later learned that with proper support, his son’s death may have been preventable.
Legal and Policy Responses
Recent investigations have linked at least seven baby deaths between 2022 and 2024 in northern NSW and south-east Queensland to freebirthing. A number of these deaths have been referred to the NSW and Queensland Coroners.
Australia is beginning to address the dangers of freebirth. New laws now allow health regulators to issue prohibition orders against unregistered practitioners posing a public risk. Under the prohibition orders, health regulators can restrict unregistered practitioners from providing services. Health regulators also have the power to prohibit individuals from using protected professional titles such as ‘midwife’.
Additionally, the government is supporting homebirths with registered midwives through providing indemnity insurance for midwives attending homebirths, ensuring safer options for families seeking alternatives to hospital births.
It is important to understand that many women choose to freebirth following experiences of birth trauma. In order to combat the risks of freebirthing, the government must also focus on improving the standards of maternal health care across Australia.
Policymakers and health advocates must work together to rebuild trust in the healthcare system and provide safer, evidence-based maternity care.
DISCLAIMER
This article reflects the current law at the time of publication. It is intended for informational purposes only and does not constitute legal advice. The actual decisions in each case are summarised for general understanding. For specific legal guidance in relation to your situation, please consult with a qualified legal professional.
