Updated: Mar 29, 2020
Picture by Indie Birth. Shared with generous permission.
The aim of this blog is to try and clarify the difference between these two terms, whether they are interchangeable or not and why it matters to know where they come from and how to use them.
If you are preparing to give birth or perhaps you are someone studying to be a birth worker, like a doula, you have probably come accross the idea of physiological birth. Nowadays we, in the birth world, avoid using the term "natural birth" because its original meaning - that birth is a natural process, which may have seemed obvious a few decades ago - is not evident anymore. With the advent of medicalized birth and all its interventions, it has become adamant that all those involved in birth, especially the women and individuals giving birth and birth workers in general, revisit birth physiology.
The term physiological birth refers to how our bodies as mammalians have evolved over the last 175 milllions of years reaching this optimal physiological design in our ability to generate, gestate, give birth and nurture and nourish our babies. When studying birth physiology, we learn about how the body is designed to give birth: the hormones involved and the mechanics of it all. However, it is important to note that when a woman is in the process of labor and birth, no one can really "know" what exactly is going on inside of her because this process is an intricate dance between her body and her baby's. All we can do from the outside is to observe and maybe try to guess what is going on - and that is how all the apparatus and techniques were invented from a figure of authority on the outside which ultimately disrupt or disturb the process. This may have gotten off on a tangent, but bare with me.
In Brazil, where I am from, we hear that a traditional midwife or the wise woman in the village who attended births would bring a comb and a ribbon to a birth. She would stay with woman and comb her hair and tie it for her: being a parteira or midwife ("with woman") meant staying with a woman in labor until she gave birth, loving her and taking care of her. That's all. There is a lot of wisdom in this simple action of "being with woman" this way: it brings our focus to the woman and reminds us that there is only so much we can do when she is the one laboring and giving birth. Contrary to this, in the technocratic model, we have been collectivelly brainwashed to view birth as an imminent disaster and, as such, something that needs interference and "fixing".
I believe there was an extreme need to bring a term such as "undisturbed" to the realm of birth. It suggests that humans have been disturbing a process that has moslty worked without interference for the vast majority of the population over time. Before Fréderick Leboyer's and Michel Odent's, his most famous pupil, groundbreaking works were published, respectively in 1974 (Birth Without Violence) and 1984 (Birth Reborn), little was known about how the hormones of labor and birth worked. Both of these obstetricians' practice, research and work set the stage for what was to be revealed in the following two decades in regards to understanding birth physiology, the motherbaby dyad and all the hormones involved in the birth process more in depth.
In 2009, Australian Dr Sarah Buckley published Gentle Birth, Gentle Mothering - A Doctor's Guide to Natural Childbirth and Gentle Early Parenting Choices, a remarkable piece of work. She established the parameters of what undisturbed birth is: that to give birth as nature has intended her to, a woman needs privacy, she needs to feel safe and unobserved. In chapter 6, she explains in detail how the hormones of labor and birth work and how they are primed so that mother and baby can have the optimal experience that they need in order to leave a blueprint of safety and set the tone for what is to come next: bonding, attachment, breastfeeding and the whole parenting journey.
When a woman feels safe and has the freedom to labor and birth as her body is guiding her to, without anyone telling her what to do or not to do, she has a better chance of experiencing a physiological, and potentially ecstatic, birth experience. The more someone else interferes with "instructions" or "protocol procedures", the less likely she is to give birth without intervention or assistance. Why? Because the more she is interfered with, the less undisturbed she is, meaning that the perfect orchestration of hormomes that nature has equipped her body with will not work as harmoniously. What favors an undisturbed birth? The answer is safety, privacy and not feeling observed or judged; basically feeling unconditionally loved! To learn more about Sarah Buckley's work, please visit her website here, or read this brief explanation on the hormones of birth here.
What about the term unassisted birth? And what does it have to do with undisturbed birth? Laura Shanley published her book entitled Unassisted Childbirth in 1993. She coined the term, which is interchangeably used with "freebirth" nowadays. Giving birth unassisted, or to freebirth, means to give birth without anybody with either medical or midwifery training present at the birth. Alledgedly, one who chooses to give birth this way would be free from another's authority, manipulation and control since they are not only far from insitutionalized birth, but also from rules and regulations that bind licensed birth workers when attending. This way, most people would think that these births would be undisturbed, thus facillitating the process of labor and birth. However, one could argue that having a freebirth does NOT equal having an undisturbed (or physiologically ideal) birth for a number of reasons.
Therefore undisturbed birth is not synonimous with unassisted birth. You can be assisted by a calm birth attendant or midwife who does not have a hidden agenda and thus will not interfere with the process, but who is able to "do" something (because she is trained and experienced in all things birth) as gently and respectfully as possible in the rare occasion that something is needed of her. Are all unassisted births undisturbed? Not always. Often women giving birth with their partners only or a friend may leave the experience feeling traumatized. There is so much going on internally with a woman in this process, and with the people around her, that if they are unaware of their feelings and fears this can cause disturbances in the process as well). It is true, however, that women who are prepared to give birth unsassisted, have done the inner work and feel confident about it and surrendered to the experience, usually have a satisfying one: good job! But unfortunately, this is not always the case, especially if the decision to freebirth was made out of fear, for example.
Does one have to go unassisted to get an undisturbed birth? Not necessarily. Let me clarify that simply "being with woman" and witnessing her while she opens completely to birth her child or children is usually all a woman needs. Remember: she must feel safe, protected and unobserved to be able to give birth intuitivelly, as nature has intended. A skilled, but quiet, loving and respectful midwife can do this even from another room if this is the woman's desire. Can one give birth undisturbed in a medical facility be it a hospital or a birth center? Well, maybe. Although chances are slim. The mere fact of transporting a woman in labor disrupts the process because taking her from the safety of her own home into a strange environment, surrounded by strangers, is the first intervention that can ultimately lead to a cascade of interventions (if you don't know what I mean, please read this).
Yes, "birth is set up to work when no one is there", as Karen Strange teaches us. But that doesn't mean that women are destined to birth alone! A woman is entitled to give birth wherever she chooses: a hospital, a birth center, home, in her garden or in the wild, assisted or unassisted. I believe this experience belongs to her, she is the one in charge. My attempt here is to simply clarify a confusion that people may have when preparing to give birth. Especially those people who have studied birth physiology and understand or simply know in their hearts that they must be undisturbed to be able to give birth the way they have dreamed. So I urge you to please know your options, ask all the questions, and most importantly, go within and find out what it is that YOU want for your birth, find your voice and your truth. This is the only way women can really reclaim birth as our own, inviting those who are important to us, who love and believe in us to support us in this magical journey of birth.