Maternity information for those considering giving birth unassisted by a midwife

Introduction

A Midwife’s role is to provide skilled, knowledgeable, respectful, and compassionate care for all women and birthing people, newborn infants and their families (NMC 2019). Midwives have a duty of care to attend women and birthing people and to provide personalised care (NMC 2015). However, giving birth without the assistance of a midwife is a legal choice in England. In the absence of a midwife, birth partners, including doulas and family members, may be present during childbirth, but under the law must not assume responsibility, assist or assume the role of a midwife or registered medical practitioner or give midwifery or medical care in childbirth. Our commitment at the Rosie is to ensure we listen to you, and respect your informed choices.

Going through pregnancy and giving birth without the assistance of a midwife is sometimes known as “unassisted birth” or “freebirthing”. You may be considering giving birth without the assistance of a midwife because that is your preferred choice. However, if you are considering giving birth without the assistance of a midwife because you are worried about the care you might receive from NHS maternity services or have concerns over care you have already experienced, or for any reason at all, please contact your named midwife or midwifery team to discuss your concerns as soon as possible. They can put you in touch with a consultant midwife or other midwife specialist if needed, to discuss your choices and preferences. They can be reached via email. They will be able to help you to make a personalised care and support plan that’s right for you.

If you are not satisfied that your needs can be met, you can contact your local Head of Midwifery through Cambridge University Hospitals telephone switchboard on 01223 245151 or via email by contacting us through the Rosie Hospital website. You can also seek support from your local Maternity and Neonatal Voices Partnership via the website (opens in a new tab), or email the Maternity and Neonatal Voices Partnership.

Maternity services available

Midwives are here to ensure a personal and safe maternity experience. They are always here to look after the health and wellbeing of you and your baby. Your midwife and other care providers can also support you in completing your Personalised Care and Support Plan (PCSP) to ensure your maternity care pathway is tailored to meet your individual needs.

It is important that you have all the information you need to make an informed choice about choosing unassisted birth. The list below outlines examples of the care a midwife would normally provide during labour and birth, whether you choose to birth at home, on the Rosie Birth Centre or on the doctor-led unit:

• Regularly monitoring your health and wellbeing, for example taking your temperature, blood pressure and pulse
• Regularly monitoring your baby’s health and wellbeing, for example listening to your baby’s heartbeat
• Providing information, support, advice and guidance in labour and following the birth
• Supporting with movement and positions
• Supporting with coping strategies, such as breathing techniques
• Facilitating safe and effective use of birth pools
• Providing pain relief
• Supporting the safe birth of your baby and placenta
• Ensuring any tears to the vaginal opening, perineum or anus are identified and any stitches required can be offered
• Supporting your baby to feed in the method of your choice
• Ensuring that if you or your baby require urgent medical assistance or resuscitation that this is recognised promptly and provided or accessed immediately
• Providing information about signs and symptoms that may require urgent care after birth

If you choose an unassisted birth

Please be reassured that you will continue to be offered and recommended NHS antenatal and postnatal care throughout your pregnancy journey and can choose or decline any or all appointments. You can change your plans at any point.

The NHS is here for you

You should call an ambulance as soon as possible if there are problems when you are giving birth so that immediate aid can be directed to you.

If you choose an unassisted birth, your baby’s birth must be notified to the Child Health Information Service within 36 hours. This is a legal requirement and provides your baby with an NHS number in case they require NHS healthcare. This process will also ensure you are offered appropriate new-born screening. If you are under the care of an Independent Midwife, they can assist you with this. If not, your local NHS Midwifery Team or your GP can assist you. Please be aware that if they have not seen you during your pregnancy, they may not be able to do this over the phone.

It is also a legal requirement to register your baby’s birth within 42 days, in the registry office local to where the baby was born. This ensures your baby has an official identity and that a birth certificate can be issued. You can find information on this process on the government website. (opens in a new tab)

Further information

More information on newborn screening:

NHS.uk (opens in a new tab)

More information about unassisted birth:

• Birthrights (opens in a new tab)
• AIMS (Association for Improvements in the Maternity Services) (opens in a new tab)
• RCM (Royal College of Midwives) (opens in a new tab)

References

NMC (2015) The Code Professional standards of practice and behaviour for nurses, midwives and nursing associates. Nursing and Midwifery Council, London.

NMC (2019) Standards of proficiency for midwives. Nursing and Midwifery Council, London.