Maternity care, birth trauma, and the rise of the ‘free birth’ movement
By an anonymous contributor
How can we keep mothers and babies safe, while ensuring women feel empowered and respected within the maternity care system?
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When we go into labour, we go to hospital right? Not necessarily. For some women, the hospital is the last place they want to welcome their baby.
Around 97 per cent of women give birth in a hospital, and one in three women will experience birth trauma. This can be physical such as a botched instrumental birth, or psychological, due to how they were mistreated.
A 2024 NSW Senate Inquiry into birth trauma received over 4000 submissions from women recounting how memories of feeling violated or coerced marred what should have been the happiest day of their life.
Disturbingly, one in 10 women report experiencing obstetric violence. This is any abuse experienced in the context of maternity care, labour or birth, and ranges from being shouted at to physical and sexual violence.
From the NSW Inquiry, 42.5% of women reported care providers performing invasive procedures without consent. Without warning, care providers roughly shoved fingers inside their vagina, saying things like ‘I’m just going to check your progress…’
Why is this happening? Standard medical misogyny explains some of this, with two thirds of women in Australia reportedly experiencing healthcare related bias and discrimination.
Our fragmented maternity care system is also a factor. Despite continuity of care with a known and trusted care provider being considered the gold standard, a rotating door of midwives and obstetricians oversee most low-risk pregnancies.
High-risk pregnancies - for ethnicity, ‘advanced maternal age’, conception through IVF, high BMI or pre-existing conditions - face even more scrutiny within the obstetrician-led care lottery.
Women in fragmented systems have no relationship with their care provider. If complications arise during labour or birth, little trust or rapport has been established. This makes tough decisions around interventions fraught, especially in an emergency.
This is particularly concerning when you consider what underpins many routine interventions, such as CTG monitoring (cardiotocography). CTG measures both contractions and the baby’s heart rate and aims to assess the baby’s wellbeing during labour.
The only problem is that since their widespread introduction to Australian hospitals in the 1960s, there has been no significant reduction in maternal or fetal mortality rates. CTG is, however, associated with higher C-section and instrumental birth rates.
So what do women do if they want to avoid a hospital birth?
Home birth is one option, where a woman labours and births at home under the care of qualified midwives. Some public hospitals have home birth programs, but these are often limited to capital cities for ‘low-risk’ pregnancies.
Meanwhile, private midwives are specially trained to manage most emergencies, and – most importantly – can determine when to transfer to hospital for emergency obstetric care. But they can be expensive and are very limited, with women in large swathes of the country unable to access this model. Women with high-risk pregnancies can also ‘risk out’ due to previous C sections, age, weight or pre-existing conditions.
This brings us to free birth. Free birth is when a woman gives birth without the oversight of a qualified health professional. Anecdotally, free birth appears to be on the rise, but official stats don’t track this.
Some women choose free birth based on a philosophy of birth as a natural, physiological process our bodies were ‘made to do’. This is a tempting idea, especially for those who have experienced a traumatic hospital birth.
While some women can and have given birth unassisted without any complications, the inherent unpredictability of birth means if things go awry, the consequences can be devastating.
In 2025, the ABC reported seven babies and one mother had died during free births between 2022 and 2024, in a small area of northern NSW and Queensland. According to the report, most of these deaths could have been avoided under the care of a qualified care provider.
So how can we keep mothers and babies safe, while ensuring women feel empowered and respected within the system?
Well, we could crack down on free birth influencers and ‘birth keepers’. But this won’t address the systemic problems driving women away from mainstream maternity care. It will likely drive unqualified, unscrupulous free birth advocates even further beyond scrutiny.
Women need access to safe, high-quality and evidence-based care, where they are adequately informed about the risks and benefits of interventions, and given time to make decisions free from coercion.
We need continued investment in continuity of care models proven to support better outcomes for women and babies and positive birth experiences.
We need to broaden eligibility criteria for hospital home birth programs, so women can birth at home with a safety net if things don’t go to plan.
We need more rebates and greater incentives for private practicing midwives to ensure they are compensated and protected to care for women and babies at home.
This is complex, but we know enough about what works to start rebuilding trust in qualified health providers and hospital systems.
About the author
This piece was written by an anonymous contributor who works in maternity care policy and has experienced a traumatic hospital birth. The author has requested anonymity in compliance with their workplace policy.
Perfect concise article explaining the problems and solutions in a nutshell!
I agree free birth is dangerous but 100% understand why women do it. I am a privileged inner city person who could afford a home birth. The system is broken
Medical and hospital trauma is such a large and (often) avoidable problem. Many people with chronic conditions know this from years or decades of dealing with the system - we know how fiercely you have to advocate for yourself, how much emotional prep is required, how educated and across things you need to be. But for many pregnant people, childbirth is their first substantial hospital admission - and of course they assume they're going to be treated with gentleness and respect and communicated to / consulted with about things being done to their bodies, especially when they're in such a deeply vulnerable state. it's unbelievably sad that expecting mothers in a country as lucky and privileged as Aus feel so untrusting of the system they'd rather take the risk of free birthing. and i can see why.