1. Printing: Your printer might not print the same way our printers do, so make sure to try a couple of test prints. If things aren’t aligning quite right, experiment with the Scale to Fit Paper setting. It’s located in the Print dialog – just click Full Page Slides to get to it. And did you notice we made fold marks for you? They are really light, but if you don’t like them showing on your brochure, click View, Slide Master, and delete them before you print. Customizing the Content: If you need more placeholders for titles, subtitles or body text, just make a copy of what you need and drag it into place. PowerPoint’s Smart Guides will help you align it with everything else. By the way, if you need to move or copy the red lines, you can select them by clicking the dotted outlines. Your role as a midwife The issues raised are understandably difficult for midwives. It is imperative as a profession, that we listen and support women in the choices that they make, even when we do not agree with them. Your professional obligations include; Supporting women in a non- judgmental way Understanding the legal framework Keeping the lines of communication open- provide information about emergencies, and offer appropriate telephone numbers Documenting your discussion as per your trust guidance Escalating to social services only if there is a genuine concern Understanding freebirthing A brief guide to support midwives, to support women. Claire Feeley Midwife & Researcher BSc (Hons), MSc, PhD Student. clfeeley@uclan.ac.uk References: (1) Feeley C, Thomson G. Why do some women choose to freebirth in the UK? An interpretative phenomenological study. BMC Pregnancy and Childbirth 2016;16 (59). (2) Plested M, Kirkham M. Risk and fear in the lived experience of birth without a midwife. Midwifery 2016. (In press) (3) Birthrights. Unassisted birth: The legal position. 2013; Available at: http://www.birthrights.org.uk/library/facts heets/Unassisted-Birth.pdf. Accessed 23rd November, 2015. (4) Birthrights. Facing criticism: child protection and maternity care. 2013; Available at: http://www.birthrights.org.uk/library/facts heets/Facing-Criticism.pdf. Accessed 13th March, 2016. (5) Birthrights. Consenting to Treatment. 2013; Available at: http://www.birthrights.org.uk/library/facts heets/Consenting-to-Treatment.pdf. Accessed 9th May 2016, 2016. (6) Feeley C, Thomson G. Tensions and conflicts in ‘choice’: Women’s experiences of freebirthing in the UK. Midwifery (Awaiting publication) Further information: http://blogs.biomedcentral.com/bmcseries blog/2016/04/12/giving-birth-going-alone- choosing-freebirth-uk/http://blogs.biomedcentral.com/bmcseries blog/2016/04/12/giving-birth-going-alone- choosing-freebirth-uk/ (Links to international literature too). Questions? Contact me! Copyright © 2016 [Claire Feeley]. All Rights Reserved. (Copying and redistribution is permitted but only in its entirety with acknowledgement of the author).

2. Printing: Your printer might not print the same way our printers do, so make sure to try a couple of test prints. If things aren’t aligning quite right, experiment with the Scale to Fit Paper setting. It’s located in the Print dialog – just click Full Page Slides to get to it. And did you notice we made fold marks for you? They are really light, but if you don’t like them showing on your brochure, click View, Slide Master, and delete them before you print. Customizing the Content: If you need more placeholders for titles, subtitles or body text, just make a copy of what you need and drag it into place. PowerPoint’s Smart Guides will help you align it with everything else. By the way, if you need to move or copy the red lines, you can select them by clicking the dotted outlines. Purpose of this guide This guide will provide a brief overview of: What freebirthing is Why women may choose it What the legal framework is Your role as a midwife Freebirthing …. Is characterised as an active decision to birth without trained health professionals present but where maternity care is readily available 1. Why? The decision to freebirth is complex and nuanced, however findings from research 1,2 suggest; A previous birth trauma-later compounded by another experience of poor maternity care Desire to minimize disturbance for a safer birth Positive decision involving the rejection of midwifery and medical models of care. ‘I do not believe that freebirth is a choice for everyone and it is something that I worked towards, rather than made hard, fast decisions about but I think it is crucial to stress that my choices were born out of positivity, a deep understanding of myself and intelligent reasoning.’ (Alex, pn-8, nar, In: 11–11). 1 ‘I felt ashamed, the only other thing I have ever felt ashamed of uh through the whole process, I was ashamed that I sounded like a pig that’s being slaughtered.’ (Cat, int, In: 25–25). Legalities In the UK, the law is clear, women have the right to freebirth 3. ‘ Women are not obliged to accept any medical or midwifery care or treatment during childbirth and cannot be compelled to accept care unless they lack mental capacity. 3 ’ Safeguarding issues, or not…. Freebirthing itself is not a reason to refer to social services as it is a woman’s right not to accept medical care 3. A referral to social services should only be made if there are concerns about the safety of the child following the birth, abuse, neglect, harm 4. Or if there are concerns about a woman’s mental capacity 5. ‘The obstructive behaviour by the community midwives, the lottery of who would turn up at the birth. If their behaviour was indicative of many of the midwives in the Trust then I could not trust that they were supportive of home births. I actually became fearful that they would turn up in time for the birth as they seemed more scared of attending a home birth than I felt about having a home birth.’ (Cat, nar, In: 8–8)1 Not being willing to engage with health services at every point they want you to is not necessarily a precursor to putting your child at risk, and they need to learn to make that distinction better. (Claire, pn-3, nar, In:4-4) 6