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Open Letter to Janet Fraser (JoyousBirth.info)

(Janet Fraser, owner of JoyousBirth.info, recently reportedly labored for five days before delivering either a stillborn baby or a baby that died at the birth [facts haven’t been clear yet]. Janet was having an unassisted birth, aka “freebirth.” She has long been a proponent of natural and homebirth as well as a biting critic of hospital, physicians and nurses. Having had a cesarean for her first birth, she is especially venomous regarding cesareans. Reading through her site and the forums, you can see the disdain for midwives, too, making it seem a magnetic draw for those that want to eliminate all interventions/technology from their birthing experience. 

Janet and I have had numerous discussions regarding birthrape and birth abuse. I have my “Checking Your Own Dilation” article on her site; I hadn’t realized quite how deep the UC fervor had gone since I hadn’t read the site in awhile.

Here, then, is an open letter to Janet regarding her choice to UC.)

Dearest Janet,

While you were still in labor, I read the piece the reporter was doing on you. Having had some emotional and cognitive shifts regarding my support for UCs, I squirmed a little in my chair and sighed reading things were going slow and you said, “I could do this for days. My daughter's birth was 50-something hours. You just do it — it's just birth, a normal physiological process." Sadly, you have learned it wasn’t “just birth,” but it was also the normal physiological process of death. Very sad.

I know this must be a very difficult time for you and I am sorry, but I feel compelled to talk with you anyway, perhaps touching you in sore and raw places, but knowing you, you would expect that from me – and even welcome it.

You’ve said, “How do we organise a revolution without offending anyone?” and “If I’m offended by something I look to myself first to see why I’m responding that way. Let’s take responsibility for our own actions.” 

It is in these words that I feel I can speak freely to you.

How do you feel? Are you healing? Have you had time to reflect on your choices and your actions and see if you might have done things differently? I (and I am sure many others) look forward to hearing your thoughts on homebirth, UCs and even midwives after your experience. Have you changed your mind?

In your essays, you have talked about the pain (emotionally and physically) of hospital births, cesareans in particular. I’ve read through the boards and have listened as woman after woman rails against her birth experience, each one more horrifying than the last.

Yet, playing armchair quarterback, many of the stories can be explained, not excused, but explained as to why the births unfolded the way they did. As contrary as it might seem, doctors do not hate women (as a whole). I agree some are horrible; I have seen them, but the majority do care and want women and babies to be safe during the labor and birth. Sure, their orientation is different, they are surgeons and do cut more than they should, but women have to take some responsibility for that because so many sue doctors for not doing a cesarean soon enough. If women sued doctors for doing cesareans, it might be a different story, but when the birth story is told in front of a jury, the doctor did do what was right, protecting the mother and baby, even if the mother was traumatized by the experience. In our culture, we expect perfection and when we don’t get it, someone is to blame. History blames it on the doctor.

But, you epitomize what UCers say: I will take the responsibility on myself. If my baby dies, I am the only one to blame. How does this feel? Is the weight heavier than you expected? Will you be able to eloquently convey what the responsibility actually feels like when it happens? This isn’t to say women should go to OBs so they can blame someone... not at all... but to bring close to home what it means to accept the blow of a child’s death in your heart.

So, if going to an OB is traumatizing and the pain lingers long past the delivery, what are women to do? Is there even the option of going to a midwife where she lives? Would you now consider a midwife? Do you now believe there is a point where a long labor might be too long? Diverse questions that all need to be answered by each individual woman.

Reading the posts on your site, I read with interest, the disdain women had for midwives as well as the doctors. One thread in particular highlighted a midwife releasing the woman from care for non-compliance and the midwife’s being unable to satisfy the woman’s requests for a totally hands-off birth. No understanding of the midwife’s position was expressed, only derision and hatred for her actions. Fairness doesn’t exist.

I also found other things on the site that were equally disturbing. Groups of women with no or very little midwifery or medical knowledge were giving advice (not just information, but actual advice) that could lead to women losing their lives or losing the lives of their babies. Telling women to lie to their providers, skip appointments, fire the midwife, “do what your body tells you to do,” and other equally sad threads were easy to find.

Midwives are hired to be the lifeguard at births. How is she supposed to be that guardian if she isn’t permitted to do even the most basic procedures such as listening to fetal heart tones or be in the room during the labor and birth? Do you believe that a midwife at your labor might have saved your baby’s life? Was the risk of an “interfering” (by listening to heart tones) midwife worth the damage that was caused by losing your baby? Is there a tipping point where having a midwife, even if she is so intrusive as to listen to the baby throughout labor, becomes preferable to a dead baby?

I’m confused why UCers ever go to the hospital. If the body is perfect, why not stay home until the body completes its task, even if that task is a mother and baby dying? What drove you to the hospital? Did some self-preservation kick in? If the body is so perfect, how do UCers explain placenta accreta, placenta previa, PIH, eclampsia, miscarriage... any illness for that matter... a cold, the flu, cancer? Do UCers forego treatment for all illnesses/imperfections, relying on the body’s “perfection” to heal it? If birth is not like illness, is a normal function of the body, why do mothers and babies die at all? What if there is a heart defect that can be repaired with surgery, do UCers still believe in the body’s ability to heal itself? That the baby has the power to create a whole heart?

I also believe birth is normal - to a point. I believe we work well without help... for awhile, but eventually some assistance can be beneficial. Bodies are not perfect. Birth is not perfect. Birth is not as safe as life gets. Birth can be precarious, as you have learned first-hand.

I do not say these things to be a scare-monger, a “med-wife” among the homebirth midwives. Those that know me, have utilized my care, know I am judicious in my interventions on the norm. I have skills I rarely use, but am damn glad I have those skills. I have skills I use all the time, insist on using and if the potential client asks me not to, I will not accept her as a client. I will not be responsible for her child’s death as I sat by not listening. I am being hired for a reason. I sit quietly unless the labor needs help or the woman asks for help. If labor slips out of the realm of norm, I am there to gently nudge it back in so the homebirth desire can continue. If it steps even further outside and safety becomes an issue, I do not hesitate to move into the hospital. My very low cesarean rate (less than 5%) and my very low transfer rate (less than 10%) speaks for itself as does my intervention rate. Most midwives have very similar beliefs and numbers.

After I read that your baby died, I wanted to see what your forums were saying about it. Nothing. Apparently some serious editing and back-room talking is happening somewhere. Note: Just because it isn’t being talked about publicly doesn’t mean it isn’t noticed. Believe me, people are watching – and judging – and if you don’t talk about it, then UCers will continue in the beliefs that birth is perfect when unhindered. It isn’t always true, especially when the birth simultaneously brings a death.

I am so sorry for your loss, Janet. I cannot imagine the pain you must be experiencing. I feel so sad for you. But, I also pray this time brings some reflection about your UC beliefs and a re-consideration about what constitutes a safe birth. I look forward to hearing the evolution of your grief and watch as you heal from an experience where complete healing is never possible. You are a public personality who is very vocal in your beliefs. If this happened to me, I would expect you to say very similar words in just as public a way. Both of us express ourselves publicly and vocally. Your future words are eagerly anticipated. And know that my heart goes out to you.

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Reader Comments (92)

I don't know what to say :-(

April 28, 2009 | Unregistered CommenterYasmel

My heart goes out to her for her loss.

But I don't understand...it was preventable. Just because you can go five days, doesn't mean your baby can. I completely understand about protecting the birth experience...but what happened to protecting our children. I have always felt that I would do anything (or have anything done to me) to protect any of my children. Because that's what being a mother is.

I don't get it. It's extreme and seems selfish. "Shame and Blame" - seems that Janet may be the one to experience this now.

April 28, 2009 | Unregistered CommenterCiarin

Excellent letter Barbara! I think the choice to UC is a pendulum swing away from the other end -- elective c-section; sanity and safety are somewhere in the middle. The way I see it, a midwife is a lifeguard at the birth. She is there to make sure everything stays normal (just as you said in your letter). But, how can you be a lifeguard when you can't even see the pool? Problems don't usually appear out of nowhere; they manifest over time, and can usually be detected by an observant midwife.
Midwives don't want to interfere with birth. Many of us come to midwifery because we have experienced interventive births and want to keep that from happening to other women. Midwives have been called "the guardians of normal birth." As guardians of normal birth, we're trained to know when birth isn't normal. I understand wanting a non-interventive birth, but I don't understand making the choice to UC. Midwives intervene in ways that are evidence-based to maximize safety. We ask ourselves, "does this (intervention) improve outcomes?" If the answer is yes, then we do it. If the answer is no, then we don't.
I'm not saying babies don't die when you have a midwife. Death is a part of birth sometimes. What I am saying is that babies and moms die more frequently with UC. Is it really worth it for the "experience" and "empowerment" the UC proponents keep talking about? I think the choice is clear -- UC is NOT worth the risk.
Intervention is a spectrum of choices. At one end is a highly medicalized interventive elective c-section. At the other end is unassisted birth. Risks are high at either extreme. If you wouldn't be willing to accept the risks at the medicalized end of the spectrum, why would you be willing to accept the risks at the UC end? Wouldn't you want to choose something between the two?
The rationale for UC escapes me. I hope that the UC movement is a short-lived trend (no pun intended). No baby or mother should die or be damaged just so the mom can feel "empowered" by birthing unassisted.
Thank you Barbara for speaking out about this. It is my sincere hope that women considering UC will carefully examine their motivation for their choices. Please, don't let ego or dogma keep you from having a safe birth.

April 28, 2009 | Unregistered CommenterKim Pekin

This is a really thoughtful piece Barb. you asked the questions that I have been wanting to ask.

Birth is normal, to a point. There comes a time when we sometimes need help. Making the decision to UC is a personal one, but one that has ramifications for all women. We are lucky, oh-so-lucky to have the CHOICE to UC. Too many of our sisters do not, and that is what rankles.

If you have the choice to have someone with you to nudge you back to normailty, or to call time on a long, possibly obstructed labour, please avail yourself of it.

How long will Janet keep her silence?

April 28, 2009 | Unregistered CommenterLiz

I'm not a nurse or a doctor. I am a mother, someone who has given birth with a doctor at the foot of the bed. Someone who will be giving birth again in October, to our third blessing, in a hospital.

I could not imagine laboring for five days. I agree with another commenter who said, "Just because a woman can labor 5 days doesn't mean a baby can."

As a parent this baffles and angers me. Because of her own desires and wants her child suffered and died. No parent deserves to have their child taken from them in this way, so I do feel very badly. But at the same time I have incredible anger that this happened because she refused help.

I think home births (with midwife or doctor present) are amazing and inspiring. But this is a whole other playing field when you're completely on your own. And unfortunately babies will die, even mothers may die, because they don't get help when they need it.

April 28, 2009 | Unregistered CommenterJoy

I'm sorry for her loss - but UCers scare me. I am having a homebirth myself - assisted by a midwife. I am a first time mother - she has attended over 700 births. Of COURSE she knows more than I do - and I know more about *my* job than she knows.

The thing that upsets me about UCers is the way they lump everything together - that midwife assisted birth is the same as C/S, and what have you.

It doesn't help women, it doesn't help any of us.

April 28, 2009 | Unregistered Commenternex0s

I found the comparison of UC to not treating cancer, etc, very interesting. That's so true....if the body was so perfect, so self-correcting, self-protecting, then why seek medical intervention for anything?

April 28, 2009 | Unregistered CommenterTracyKM

I don't really have anything to say about Janet's ordeal other than....ouch. That has to be a horrible burden she is carrying now. A child's death alone would wrack any of us with unbearable grief...but I can't imagine how I would feel if my actions were responsible for that death. :(

This is a little off-topic, but I don't think it's fair to blame women for doctors doing so many Cesareans. So many OBs say, "Just sit back and leave everything to me, don't worry your pretty little head, I'll get that baby out for you safe and sound." And then when baby isn't safe and sound, whose fault do they think it is? The OB, of course, the one who filled them with empty promises. So in essence, I think OBs themselves are to blame for creating an environment in which women are SUPPOSED to expect the perfect baby.

Also, the health care system in this country is so convoluted that sometimes, when the unthinkable happens and a baby is seriously damaged from birth, the only way parents can pay for its care is to sue. I'm hoping that the Obama administration will put an end to what appear to be "frivolous" birth lawsuits with universal health care.

Okay, off-topic rambling over, thanks for listening.

April 28, 2009 | Unregistered CommenterJill

Yikes. I don't know Janet, but I sincerely hope that she is somewhere safe right now, grieving her loss surrounded by those that love her, instead of checking on chatboards to see what the "movement" is doing or saying. Under the weight of such loss, I would highly doubt that she's too worried about the UC movement as a whole, what it thinks, what the world thinks for that matter.

A mother just lost her baby, whether by fault of her own or not. As a woman and a grieving mother, she deserves a time of silence. My goodness, and I would hope that for any of you as well.

I don't have any actual friends that UC, but the many of my friends do homebirths. I hate to say that some of them might have these same thoughts of a woman who chose to birth in a hospital. Isn't saying, "See! I told you so! You had a C-section and now you're infertile!" akin to saying, "See! You birthed alone and your baby died!" Sometimes being right isn't the most important thing. There is a time for being right and there is a time for silence and [genuine] compassion.

I don't think speaking out about this is wrong. In fact, it might save lives. But how can you all expect so much of a grieving mother?

All of us have our own thoughts an opinions about UC, but is there nothing sacred anymore? Does a death NEED to make a statment the very moment it occurs? Can't we just let some time pass so that Janet can now give her baby what he or she deserves: not an advocate to the world... just a mother.

April 28, 2009 | Unregistered CommenterRachel Clear

Does anyone else feel like this letter, while eloquent & making very important points (points I agree with) is a little like kicking a woman while she's down? Losing a child has got to be as far down as anyone can get, I can't imagine having this experience and then reading or hearing about this letter.

Doesn't the death say everything in and of itself? Do we really need the woman to stand up and say: "I take full responsibility for the death of my child (which I don't think we know was preventable yet, right?); I chose to have this undisturbed birth experience over the safety and life of my baby." I, personally, don't need that. The result speaks, so sadly, for itself.

I agree that 'undisturbed', unattended birth is a bad choice, but this letter feels wrong on an ethical & interpersonal level.

April 28, 2009 | Unregistered CommenterSarah

I think you miss the point. Though you have interesting Qs, not sure they are the right ones.
Birth IS safe as life gets. That is, birth is not perfect and life certainly doesn't go to plan always.
There is a chance of something going awry in a normal birth. That is why we have hospitals and medical resources.
Personally speaking I rather have a stillborn at home. I am a fatalist. Itrs about choice, control and automony. Others get in the way and can influence the outcome. I have experienced hospital and unattended birth. Taking the responsibilty is a momentous step.

April 28, 2009 | Unregistered CommenterFree

Rachel and Sarah, I agree. That is mostly what I meant by my "ouch" in my first post. :( I should have elaborated but I got sidetracked.

I am reminded of a friend of mine whose second son died of a rare heart defect after being born at only 30 weeks. She had been doing her own prenatal care and planning a UC. Even though he was born in the hospital, she still had to face the "you deserved to have a dead baby!" comments.

Janet will have to live with this the rest of her life. That should be punishment enough.

April 28, 2009 | Unregistered CommenterJill

I appreciate the opportunity to reflect on some of the issues in unattended birthing. At the time that Janet's story appeared in the local newspapers I wrote about it in my blog http://villagemidwife.blogspot.com/2009/03/birthing-alone.html, with some valuable discussion.
I believe that in writing about this and other similar events that we know about midwives can be respectful, yet uncompromising, in arguing the basic need every woman has, being attended by a skilled midwife in her birthing journey.

April 28, 2009 | Unregistered CommenterJoy Johnston

I don't think it is fair to assume that the death of Janet's third child was preventable, you can't know that.

I also don't think it is fair for you to assume that Janet is responsible for the behaviour and opinions of the hundreds of members who participate in the joyous birth forums

I'm amazed that you think the following conduct of one particular midwife is ethical, a midwife whot 1) dumped a pregnant mother at full term, breaking her agreement with the woman, 2) charged her double what is the standard fee for having an independent midwife attended homebirth in Australia usually is and 3) is now refusing to refund this money.

I don't believe that your heart is in the right place with this post at all. This post demonstrates the same lack of empathy, respect, or thoughtfulness for pregnant and birthing women that is inhernet to obstetrics and I really expect better from midwives!

Don't be fooled by the Australian media, they are not a reliable source of accurate information. They are in the business of sensationalising and creating drama to make money. I am dumbfounded by the number of people the media have fooled, in particular I'm amazed at how successful they have been at making homebirth midwives and homebirth families turn against freebirthing families in the same ways many hospital birthers are against them!

April 29, 2009 | Unregistered CommenterGrace

Since when are braxton hicks labour? Had you really read her forums, you would all know Janet was not 'in labour' The jornalist came to the conclusion. But then, saying she was in labour is much more enticing I guess, more dramatic.

April 29, 2009 | Unregistered CommenterGrace

The Australian media has zero to do with why so many are "turning" against freebirthers. It is the tragic consequences of UC births that are presenting themselves for the world to see.

If Janet's UC wasn't responsible for the death of her child, why is it being kept quiet by the UC community, then? If there was something dramatically wrong with the baby, why hasn't there been an announcement of some sort. I don't buy it that the UC community is just letting her mourn. It is filled with just as many curious on-lookers as the rest of the world.

April 29, 2009 | Registered CommenterNavelgazing Midwife

Here is some data that I found regarding perinatal death rates (all expressed per 1000). Perinatal death is the death of a child under one week of age (0 to 6 days) or a stillbirth of 28 or more weeks of gestation.

1) UC birth: 10 stillbirths per 1000 (4/400)

Note: This data is mostly prospective and self-reported; it does not appear to include deaths in the first week of life or preemie deaths (over 28 weeks gestation but less than full term). Therefore, the perinatal death rate for UC birth is very likely to be higher than the one reported here.

Reference: “Born free: Unassisted childbirth in North America” by Rixa Ann Spencer Freeze. December 2008. Table 10, page 214: Mothering’s UC Roll Call.

2) Midwife attended births at The Farm
Perinatal mortality: 6.4 deaths per 1000 (13/2028)

Note: Includes outcomes for all mothers who were given prenatal care by the Farm midwives. Out of 2028 births: 5 lethal anomalies, 4 deaths during labour, 4 deaths in the first week of life.

Reference: “Ina May’s Guide to Childbirth”, by Ina May Gaskin. 2003. Appendix A, pages 321-322.

3) Perinatal death rate in Canada, 2006 : 6.1 deaths per 1000

Note: I chose Canada because I’m Canadian.

Reference: Statistics Canada. Table 102-0508 - Perinatal mortality and components, Canada, provinces and territories, annual, CANSIM (database).

April 29, 2009 | Unregistered CommenterElisabeth

I'm so sorry to learn about the death of Fraser's baby, even more if that baby's death was preventable. Having been through my own struggles, I think I understand the feelings of violation, rage, betrayal, and fear that linger after trauma, but I cannot understand the position of the Unassisted Childbirth community, which seems to believe that there is no benefit to having a medical practitioner present at a birth; if there was no benefit, we would not now have midwives and UC would be the norm, but our medical system and the practice of midwifery have evolved just because the body is not perfect and birth, like all bodily functions, can be messy or go wrong! I'm not supporting hospital-only births and I am appalled by the notion of elective c-sections, but I think it's important to acknowledge our imperfection, birth's imperfection, and seek the middle path.

April 29, 2009 | Unregistered CommenterJackie

"If Janet's UC wasn't responsible for the death of her child, why is it being kept quiet by the UC community, then? If there was something dramatically wrong with the baby, why hasn't there been an announcement of some sort."

Really?? You really think your "need" to know comes before this woman's need to mourn the DEATH OF A CHILD - something that will be her jlourney for the rest of her life? Seriously? The finger pointing is what is most important here?

If you made a decision, Barb, that resulted in the death of a child, what - you'd run out and make a t-shirt describing all the details to share with your community of supporters? Wouldn't your first priority be the mourning mother?

I think of midwives as being one of the few sacred and trusted gaurdians of women and the female experience left on this planet - your lack of empathy in name of your desire to bring down the UC movement is troubling, to say the least.

April 29, 2009 | Unregistered CommenterSarah

I am not trying to "bring down the UC movement." I want women to THINK.

And I know Janet, okay? And I know ME. And yes, if I was part of a movement that spoke loudly about something... say, homebirth midwifery... and I had a dramatic experience (like I have), I would absolutely share it... and expect others to want to know about it, too. It's part of what happens when one is a public persona.

As I wrote Janet, it isn't like I expected a quick response back -if at all- but my thoughts and comments, most of which are being said anyway, want to be heard. All of us are accountable. It is to whom that changes. She isn't accountable to me, but does need to consider being accountable to her community of UCers.

I am very, very sad for her loss. Not having had a baby die, I cannot imagine the pain. But, I have come close. And in my talking about this UC topic, I hope women and their partners are really thinking about their choices.

As my great apprentice Donna said, if they are REALLY committed to UCing, nothing I say (or anyone says) will dissuade or scare them. If, after all their research, thinking and consideration they still choose to UC, then so be it. It is the romantic-notioned, I-wanna-tell-a-great-story-on-MDC'd women that need some emotional shaking.

April 29, 2009 | Registered CommenterNavelgazing Midwife

THANK YOU, both for your response above AND for the original post.

There's nothing in the MDC UC forum yet either. I wonder if they'll ever acknowledge it.

April 29, 2009 | Unregistered CommenterAnne

Very good post - powerful. This will bring up some interesting discussions for all of us and we all can learn together. Thank you.

April 29, 2009 | Unregistered Commentermarinah

""I believe that in writing about this and other similar events that we know about midwives can be respectful, yet uncompromising, in arguing the basic need every woman has, being attended by a skilled midwife in her birthing journey."" From Joy

You assume a mdiefe is tha basic need for every woman. Some Obs will say 'they' are the basic need for every woman.
Interestingly, neither groups are actually asking woman what women want.
What is so hard for you all to understand that every women has their own needs for their own births. Why can;t you all respect that and support each woman how THEY want to be supported.

I personally am pleased to have midwives near me who support what I need. They ask me my feelings, what it is I need in labour and birth. They do not assume to know.
My best friend feels exacly the same way about her Ob. Despite her being healthy and fitter than me. Her choice though. She does what shee feels is best for her.
It is a woman's choice. Can we focus on supporting the individuals? or is that too hard to fathom?

April 29, 2009 | Unregistered CommenterSara

this entry is in such poor taste I don't even know why I am commenting on it.

and what's hard is that while I agree with some of your points, Barb, the fact that you approached this topic by exploiting the death of her baby has taken my respect for you to a new low. it's heartwrenching.

heaven forbid YOU, barb, YOU, ever get a client for a homebirth and that baby die. heaven forbid some rabid blogging OB gets ahold of that story and bitches out and blames the mother for killing her baby because of homebirth. do you see a similarity here at all? in my eyes, the realities are the same.

I would love to dialogue on many particular (and important to me!) issues in this entry, but the blatant attention-whoring that comes from exploiting a woman's deepest grief keeps me from taking anything you say seriously.

I'm appalled and deeply disgusted with humankind.

April 29, 2009 | Unregistered Commenterpamela

I do wonder what many bloggers hope to gain by openly assuming the media representing Janet Fraser's story have the actual facts, as it is all hearsay until the family feel open enough to tell their story until then honestly allow the family time to grieve there is absolutely nothing worse then losing a child NOTHING. There is also only speculation that birthing unassisted has anything to do with it at all.

As for them not having told their story for all the inquiring minds, why should they? For it to be picked a part! Aren't you all having more fun assuming you know what happened and how you could have prevented it by being there or by having a midwife in attendance would the same who ha be blogged about had a midwife colleague been present? I would assume of course not!

I am not surprised that there is no public announcement made in the spotlight at joyous birth, why would there be a mother has lost her child, a family is in mourning they owe the public nothing. Besides if there was such a thing wouldn't it then feature in the next opinion piece that needs to attract an audience and debate!

A little understanding wouldn't go astray and some credit about the intelligence of other women thinking of or having had an unassisted birth wouldn't either, each and every woman needs to make the best decisions for herself and her baby. I wouldn't think for one second that the realities are glossed over in any way I myself know of a number of women who have had stillbirths in varying settings but then I suppose that goes with the territory of of working with women.

April 30, 2009 | Unregistered Commentergloria


The above is your own words. What you have written still happens everyday, to many birthing women.

Yet you go round and round about freebirth, assuming all women 'need' midwives.
Can you not see that what you have written can traumatise a woman soo much, that she can never trust a care provider in birth again? That the very thought may terrify her?

April 30, 2009 | Unregistered CommenterLois

Wow, Pamela... some strong feelings there. It's kind of sad to me that no one else is writing about the situation, talking about it. I was told the thread on MDC was even removed. It isn't that people want to leave Janet alone to grieve, but that people are being shushed when they ask questions and express concern. How will we know the *real* story unless we hear it from Janet? I am not even asking for a response, but encouraging introspection and letting her know what I... WE... are thinking. Maybe not you in particular, but a lot of other "we"s.

We are very different midwives, you and I. It is well-known what you think of me anyway, so it isn't surprising that I have gone to a new low for you. I gave up long ago trying to befriend you even though we have a lot in common; we have a lot *not* in common, too. And I'm okay with that. There is a midwife for everyone. I wouldn't be the right one for you.

I know my post was gentle and kind. In reading Janet's own words on her website, she is extremely vocal in her insistance on being blunt and clear and making people squirm re: their choices and experiences. I don't want Janet to squirm, but wanted to share with her the concerns I have regarding her choices, wondering if she would make the same ones again. If she would, then she would! If she wouldn't, then her followers deserve to know that. Maybe not now, but eventually. Just like you, Pamela, a public persona on the web, you have also chosen to have your life examined by strangers and friends alike. So have I - and I certainly have been picked apart for my opinions and thoughts! It's a huge difference between us; I am vocal and have women smack me hard with retorts. You, however, have women who only adore you. Lucky you! But, I want to make women THINK.


If women still do decide to UC after weighing all the information, then they will UC and that's the end of it. Of course I acknowledge that women have been traumatized by doctors and midwives and are terrified to deliver with them again. But, without ALL of the information, including imagining what it might be like with a situation that might have been helped by a TRUSTED care provider, she isn't making an informed choice. All I am asking is that women be informed. I am not saying that no one should UC. Not saying that at all. But, I am saying that without informed consent, she might be surprised when something untoward occurs.

April 30, 2009 | Registered CommenterNavelgazing Midwife

Wow. I am completely appalled to find that you wrote a letter in such poor taste to a woman who just lost her baby and posted it on the web for her and everyone to see!!!

I can understand why you want women to take a closer look at what it truly means to be responsible for ones birth (I believe every birthing woman should, no matter how she chooses to do it), but in the wake of Janet's tragedy - this was not the way. You raise some valid points but you should have approached this differently and perhaps in a different time. Like another poster said, this is like kicking her while she's down. Shame on you.

April 30, 2009 | Unregistered CommenterJenne

Obviously, I see what I wrote as completely different than some of you. Blessedly, there are others I love and trust who have read the post and said it was tender and respectful, so I am not pulling it even though a very few of you find it offensive.

April 30, 2009 | Registered CommenterNavelgazing Midwife

From Gloria: As for them not having told their story for all the inquiring minds, why should they?

Well I for one have lost a baby. It was a planned homebirth, that never happened. She died before birth and I chose to have a c-sec at a hospital to deliver her. That was best for me at that time. Why share my story? Because the RUMORS about her death were HORRIBLE!!! AWFUL and down right hurtful! By my speaking her truth, my truth it lets the TRUE story be known. My babies truth, my truth. Does it change what happened? No, but it honors my daughter instead of the horrible crap what was said.

Does Janet have every right to keep her story to herself? Absolutely, but she also must realize by not telling her story, she is opening herself up for MORE judgement and speculation. Also I think the fact that she is a "public figure" in this community, there is some responsibility in that.

April 30, 2009 | Unregistered CommenterCristina

Wow. I'm embarrassed for you while reading this post. It's a shame you aren't more embarrassed for yourself.

I'm not even a big supporter of UC, but would never be so disrespectful and mean-spirited as to post something like this so soon after the death. Give her time to grieve and process a little before you assault her, if you have any kindness in you at all.

April 30, 2009 | Unregistered CommenterChristy

It's so interesting how you all read my words. So wild that some people hear it as kind and respectful, yet others of you feel I am clubbing a baby seal. There was no malice at all as I wrote, loving sadness and honest questions. I have nothing to be embarrassed about!

What bothers you all the most? The questions? The timing? That UCs are being examined? What would be the proper time to wait? 2 months? 6 months? A year? How about the mothers who need to think before that; is it right to keep questions sequestered?

I believe the biggest issue is the topic being discussed at all. I think no matter when I wrote I would have been lambasted. I think that my asking questions, no matter how gentle, makes a lot of you squirm. I'd encourage your looking at *that* instead of reading a tone into my words that simply are not there! Enough people that don't even know me at all have said I was kind and respectful, so since my intention was that exactly, I can't do anything with you all that are so angry but shrug.

April 30, 2009 | Registered CommenterNavelgazing Midwife

honestly, since you asked - what bothers me the most is not your questions or your timing: it is that this post is addressed directly to the woman in question. A blog is personal. Would you say all these things to her face, right at this moment?
A close second is that you seem to have made a judgement without knowing the facts about the circumstances of her labour and birth.

I've never heard of Janet, I don't know her, and while I have to respect a woman's fully informed choice to do what she likes with her body, I think unattended birth is too risky for me (and for most) - so I'm not approaching this trying to defend freebirthing.

April 30, 2009 | Unregistered CommenterQoB

So, if I wrote it while just referring to her it would make it all better?

April 30, 2009 | Registered CommenterNavelgazing Midwife

And I wouldn't hesitate for one second sitting with her and talking with her about what happened. I *have* sat with mourning UCers and have asked them how they feel about it. I would absolutely talk with her. My hands would be holding hers and I would look her straight in the eyes. I don't think Janet would find it offensive at all to explore her sadness. I could be totally wrong, but we can't know that, can we. When she is ready, I don't doubt she will let me know exactly how she feels.

April 30, 2009 | Registered CommenterNavelgazing Midwife

When I first read this post to Navelgazing Midwife's blog, I immediately thought "too soon, too soon," like many of the other readers, but then I thought about it and had to admit that there would never be a time that would be truly appropriate to ask a grieving mother to examine the circumstances of her child's death so closely, so why not now? I'm sure she is already questioning her choices, reliving the event, perhaps also justifying and rationalizing her decisions (no doubt some were good and, obviously, others were not). I think this open letter to her was as kind as it could be and I don't think it's inappropriate to post it to a blog.

Some people apparently think blogs are private or "personal", but by their very nature they are absolutely open to the public and have become public forums for discussion and catalysts for debate, as this blog has; and when situations such as this are discussed "personal" is pretty much the only way they can be described, but perhaps it would be better to refer to them as "human," because it's human to have such a powerful emotional response to the death of a child- an infant!- and it's human to want to do everything possible to prevent the death of another child, even if it hurts someone's feelings along the way. I think it's much better to get everything out in the open as quickly as possible, especially for people who have made themselves public figures, as Navelgazing Midwife has done with her feelings on this issue, which is an issue very close to her heart and is an issue in which she has no choice but to be involved due to her livelihood and life's passion: midwifery, being "with woman."

Perhaps later we will learn that this baby had a congenital defect that made his or her death unavoidable under any circumstances, but until that happens I think it is not unreasonable for us to question Fraser's decision to avoid highly skilled assistance during the birth of her most recent child. Perhaps we need to all remind ourselves that birth is not something that happens every day, so it is not as normal as a trip to the bathroom or even as normal as a woman's menstrual cycle (both of which can go wrong in a variety of ways that may require skilled care) and it is the first big event in a new life, a life that should be given the best possible start. I am not advocating frequent pre-natal appointments or constant fetal monitoring during labor or anything of that nature, but it would behoove every expectant mother to do her best to put her own issues and wants aside and consider every side of the How to Birth Best argument, because I'm sure we can all agree that the best birth is the one that results in a healthy baby and a healthy, non-traumatized mother.

Yes, a highly medicalized birth can result in trauma, even birth rape, but the loss of a baby is traumatic, too, and not a wound that can ever fully heal.

April 30, 2009 | Unregistered CommenterJackie

Sarah grilled me this morning, forcing me to answer the questions: What do you expect to get out of the post? Why did you write it?

Jackie, you said something I had a hard time uttering and that is to help mothers and babies. It is a... a calling? a compulsion? Not in the I-Want-To-Rescue-The-World way, but in a I-have-been-asked-to-know-birth-and-watch-over-it sort of way.

Sarah reminded me that I absolutely *had* to accept a woman's right to UC, that this is America and she absolutely has that right. She is right and when I discuss this topic, I need to acknowledge that point more loudly. However, I speak because I have listened and heard incorrect, even scary, misinformation being shared amongst the UC community.

I admire those that impart correct information to each other... but how does one decipher who has the safest information? Pamela graciously gives of her skill and knowledge. I don't hide mine, but I am much more careful about how it comes out and to whom. I am much clearer about situations surrounding what is being asked about, role play different scenarios and stress that in the moment, too many women and partners really haven't known what to do and have paid a steep price for it.

This blog is a reflection of who I am as a woman: wondering, learning, changing... navelgazing. I share my thoughts, my worries, my concerns, my dreams and even my fears. It's what blogs are all about!

Hmmm... this is a blog note all on its own.

April 30, 2009 | Registered CommenterNavelgazing Midwife

I'm really getting a lot of insight from these comments... but the thing that strikes me most is this: Janet lives her life in a very public, vocal manner. She is evangelical in her beliefs surrounding unassisted homebirth. A terrible tragedy has befallen her and her family, and Janet has fallen silent.

Janet, if you are going to advocate something, put your name to something, encourage others to join you in a venture and if you are going to stress, time and time again, that UC is safe, normal and suitable for all women... then these women who follow you deserve an answer.

UC is not a one way street to blissville, things can go wrong, just like they can anywhere. So why are we not allowed to ask for answers from the guru of UC? What if we want reassurance that the UC did not cause the death and nothing more that that? What if women need to know the truth - that UC is a choice, and it can be a fatal one...

April 30, 2009 | Unregistered CommenterLiz

I've had a UC (that went right--very right) and I think your questions are absolutely valid and I read them in the gentle tone you intended.

I, too, have seen terribly scary advice given at MDC. I've seen questioning moderated out and threads where anything other than "support" given were pulled immediately. I've seen women come, seeking true support with real, hard questions needing guidance and answers who were told "trust your body and everything will be alright". I've seen dead babies swept under the rug.

And yet, I had a UC because it was the right choice for that birth. Then later, I had a midwife attended birth because it was the right choice for THAT birth. I like to think I am fully informed. When I first joined the UC board years ago it was populated by a bunch of extremely strong women who took birth seriously. I don't feel the same way about that board these days. I think it's VERY fair to hear of UC gone wrong, just as it's very fair to hear of home birth, hospital birth, and c-section birth gone wrong. If we don't own the real risks of each type of birth how can we hope to make the right choice for ourselves?

I know more than your average amount of UCers in real life. In my neck of the woods there are a couple of pretty darn scary midwives who do things like induce labor with Cytotec, another who is a pathological liar and has not even completed a course of study and decided she's a midwife and lies about her experience, and then there are two hospitals that won't even give you a c-section rate if you call and ask for it. I like to think I know this subject in a very 'real' way.

I do 'hear' what a pp was saying about how similar anti-UC midwives are to anti-home birth medical professionals. I think you all should trod carefully on this ground. But respecting a woman's right to chose how she is going to give birth does not mean that we should condone them painting an overly glamorous picture of unassisted birth. It is not perfect. Babies do die. I would imagine that some die that could have lived if they'd been born with a professional present. I also know of at least one little blond headed girl asleep in her comfy bed right now who would have died had she been born any OTHER way than UC! ;-)

My prayers go up for Janet. My heart aches for her terrible loss, regardless of whether her choice to UC was actually the cause of the baby's passing. Death is difficult and messy, no matter how it happens. I pray that she is given peace, in time, and that your gentle questions help her to process what has happened.

April 30, 2009 | Unregistered CommenterUCer

i think what bothers me about both the post and your response, barb, is
(1) how smug and self-righteous you sound, and
(2) how willing you are to accept praise and support but "shrug" at feedback that is less-than-stellar.

you talk about your being a public person; a birth advocate. i believe that. i've read your blog for a few years, and have nodded my head in agreement and shook it vehemently both. and hey, it's your blog - you can say whatever you want, and also, you can deal with your commenters as you want. but as a public figure, we too are entitled to our thoughts and opinions. i guess what i haven't appreciated is that when you hear dissenting voices, you get pretty darn defensive - and more than that, you insist that you are not. we *are* thinking. just not the same things all the time!

i know you are a wise woman, that you have worked hard on your shit, that you acknowledge that you still have a ways to go. but one thing that has bothered me consistently is that you don't appear to understand that your intentions - in the case of this post, to be respectful and gentle - don't always translate. and that doesn't make people who don't 'get' your intentions wrong - just different. so enough with trying to convince us you are right, that you are just, that you are virtuous. accept what we have to say as what we have to say - without the vitriolic little jabs and personal comments.

as you said, you put yourself out here in cyberspace, and every time you write, choose the degree to which you share your self with all of us. you also opt to allow us to comment - so it would be so great if we could be afforded the respect you expect from both the real-life and virtual worlds (i acknowledge that this dichotomy is kinda false and simplistic!)

April 30, 2009 | Unregistered Commentermama_in_waiting

This blog entry is so insensitive I barely know where to begin. How dare you jump on the bandwagon and point the finger! How dare you demand that Janet go public with the horror of what happened, just to satisfy your own thinly-disguised voyeurism?

Of course she has gone silent. There is NO time limit for mourning your baby. There is no suitable time by which she will suddenly feel up to braving the crowds. Why the heck SHOULD she tell you, or anyone, what happened that night? Just because she has spent a lot of time in the public eye does NOT make her tragedy YOUR property. Or anyone else's.
The absolute LAST thing on my mind when my baby died, was telling the world about it. Especially so soon.

We are leaving her be, out of respect for her loss. And so should you.

Shame on you.

I am embarrassed on your behalf. This is such bad taste.

May 1, 2009 | Unregistered CommenterJessica Richards

I am sure that Janet will come out and talk when the moment is right for her. I think what bothers me the most, NM, is that we simply do not know what happened nor if the death was preventable. To then take the alleged facts of this death (right? everyone agrees no one really knows) and turn them into a weapon against UC almost, is simply ludicrous. But that is the real discussion you seemingly want to have with Janet, the discussion whether she still believes in UC.

It is hard to read your questions as honest questions, because, based on previous posts and exchanges, you seem to have an agenda against UC. This agenda makes your questions sound rhetorical, not honestly inquiring. This agenda is out of place imo at this moment, and even if you don't mean to have the agenda with this post, I am sorry, it is impossible for me to not see and feel it.

At this moment, comfort and privacy is all Janet needs. The questions can be asked later. That the UC world is quiet does not mean it is shutting its ears to this. It simply means it is respectfully waiting. There are no threads about the death, out of respect. If there is a mutual understanding between you, then you could have written her personally and asked her how she is really doing because otherwise, for now, everything else can wait. Out of respect. The agendas can wait. The lessons to be learned can wait. The whole exchange can wait. She does not even need to ever answer anyone's questions if she so chooses. She does not owe us anything.

Do people need to talk about UC and death? Yes, absolutely. But we don't need to wait till something like this happens to do this. In fact, it should always be part of preparing for UC, imo. You have brought these issues up many times before, but now, it is as if you expect Janet to either say 'I was stupid' as if it would be impossible for her to accept what happened, or for her to answer you with her soul laid bare. It's like voyeurism, really. Janet becomes a live guinea pig. It's cruel. The issue can be discussed without her being addressed or her tragedy being the center piece. How about asking any other mom who has ever lost a baby anywhere?

Why wouldn't a death happen in a home birth or a UC? UC-ers are not saying they can avoid death. I know more moms who have lost a baby while having prenatal care and going the general OB route than I know UC-ers who have lost a baby. Every 20 minutes there is a child still born in a hospital. Only in 40% of those cases, do they ever find out what caused the demise.

You write that you are confused why UCers would ever go to the hospital. I think that in order for us (at large) to discuss UC at all, it seems that there needs to be a better understanding of UC. Why wouldn't we go to the hospital when needed? UC is not about being reckless, but about autonomy and I feel that the lines 'trust your body, your body is perfect' are so taken out of context. Just as there are great midwives and OB, there are also stupid UC-ers I am sure. So, lets get out of the caricature making on both sides, so that we can really discuss things, if that is what you want.

May 1, 2009 | Unregistered Commentermaria

Hmmm. Barb, I think your questions are insightful, and agree that there is not a right or wrong time to ask them. I agree that Janet is a public figure, and as with all public figures, has lost a part of her privacy.
however, I am more interested in the dialogue between UCers and homebirthers in general, and midwives, around what our roles are and what they are percieved to be, and what the woman wants them to be, and what we want them to be.
I do not assume that Janet made any bad choices, nor that her choice to UC has any correlation to her loss. I have had a client lose a baby to stillbirth, with good midwifery care, and no answers. Sometimes, we can't save babies, even with all the medicine and technology in the world, and sometimes, we never know why. I would strongly advocate that a woman should seek out pathways to knowledge around birth befor deciding to UC.
I am fundamentally opposed to UC, if I didn't believe midwives were a good thing, I wouldn't be one, but I absolutely believe that for some women, the "right" midwife is not available, and the choice is then removed... how can you choose something which is not available? The Australian context is different to the American context, as the New Zealand context is different again.
I think maybe the discussion that needs to occur is not with Janet, at this time, in this place, but with each individual birthing woman. What are your comfort zones, what is your hope, what is your boundary, and most importantly, WHY? because it is in the why that the negotiation for a workable partnership, between the knowledge of the midwife, and the needs of the woman cane be achieved.
For those out there cosidering UC, Ask yourselves an honest WHY. is it certainty in your own body and ability? Or is it fear of how your body and ability may be undermined? Or is it because the option you WANT is not available to you? And if you could have the very best of all the worlds, what would that look like?
For the midwives, where does your need to "know" become an unfair disruption to the woman's process? and how do you resolve your professional ways of knowing with your intuitive ways of knowing? What are you honestly willing to do and or not do,in order to faillitate a workable relationship? How do you extricate yourself from a dangerous situation without abandoning the woman? And how do you overcome your own fear to support a woman to overcome hers?
And when will we stop fighting against each other, forming factions which are all ostensibly fighting for the same thing, but instead destroy any chance we have of ever achieving that goal?

May 1, 2009 | Unregistered CommenterAnna

of course, I should have acknowledged, while explaining my own reaction to the post, that our first reactions are not always the most valid - I am absolutely willing to say that while not addressing Janet directly in the post would have "felt" better to me while reading it (less painful, less personal perhaps), it might not make any difference to others, and your way of addressing the issue is valid. You seemed to me to be asking, in the comments, why some commenters reacted as they did, and that was my response: whether responses such as I and other commenters had should prompt a revision of style/tone/etc. is entirely up to you, being your bog after all.

May 1, 2009 | Unregistered CommenterQoB

Mama in Waiting: At the risk of going in circles, I am not sure how I should answer dissention if it isn't to try and clarify my points and intentions in different words! Of course, I don't FEEL defensive, but just that I didn't explain myself well enough - and the other comments that say my tone did *not* sound kind reflect, to me, that I need to figure out a way to do better. I write like I speak and you cannot hear my tone or inflection in writing, but as a writer, that shouldn't matter; I should be able to convey thought and emotion with my words.

So, I *do* acknowledge I pissed off a group of people - I pretty much expected that (and said so in FB), but am not sure how I could have asked the same questions without sounding harsh to those same folks. I believe that many think I shouldn't have asked the questions at all, whereas others believe the timing sucks. This is good feedback, all of it, and I *am* listening.

But, since I really seem to have this "clarifying" issue only with controversial topics and not with regular ones like Vitamin D or birth stories, I can't help but believe that each of us comes with our own filters and those filters "hear" how they want/need to. I do NOT mean that someone is *wrong* in how they hear me, but I know that when I listen to controversial speakers (say, on FOX news), I hear them totally different than a Republican would hear them. I come with my own filters, too!

I *am* listening. I might still not be saying the answers or comments that you (or others) might want to/need to hear, but I really am listening with an open heart to the comments.

I very much appreciate the mothers here who have shared their stories... their painful and their great stories. I appreciate it so much.

As a writer of hot topics sometimes, I acknowledge that I am going to be (judged? misunderstood? - that's the paranoid part of me) a boat rocker and I brace myself when I know something I wrote is going to make an impact, good or bad. But, as a writer, I *can't* not write... I am *compelled* to ask questions, even if they are uncomfortable (even if they are uncomfortable to me!).

I don't want to be seen as smug or rhetorical, part of why I was explaining myself more in the other comments.

I am listening. I *am* listening.

May 1, 2009 | Registered CommenterNavelgazing Midwife

This is just gross. If you guys have such an open relationship that you actually feel entitled to ask her those questions then do it privately. If you aren't close enough to her to say those things in person then don't do it all. She doesn't need these words from you to make her think about what happened and no other woman will be helped by this.

How on earth could you say "I told you so" at a time like this? What if me or other UCers did this to women whose babies died in the hospital? It's just sick and wrong. What if a midwife had been there and the baby died just the same? What if YOU had been the midwife or the mother?

Distasteful doesn't even begin to cover this, I am utterly disgusted.

May 1, 2009 | Unregistered CommenterKrista

It’s a very sad situation. I feel deeply sorry for her and her family.
And sadder still if the officials are investigating Fraser for negligence.

Barb, I'm glad you finally felt compelled to write about Janet Fraser and her baby's death the way you did. You have done a service, a mitzvah to the UC community by addressing this topic in the past couple of months.

YOU alone have created a more balance and needed scrutiny of Unassisted prenatal care and birth. I've read a lot of misplaced outrage towards you for posting about this, I don’t agree with that outrage.

Why Fraser shouldn't’ be taken to task by the midwifery and birth community she criticizes with vitriol is dishonest of the UC community.

Fraser is more then a mom whose baby died. She is a public person; a symbol, an advocate for what she was doing, a voice to the unassisted birth community, and a person who routinely ridiculed the system that possibly helped prevent this tragedy.

No one deserves to be left grieving over their baby’s death, and the possibility of their baby's preventable death.

May 1, 2009 | Unregistered Commenterdewi

Anna, I love your post. This is what I was trying to convey but I think you said it so much better.
And I think that when we have that discussion, there is an opening of a deeper layer. The discussion should not be 'UC is dangerous because', and 'I am against or for because'. How women stand in life and view death has an enormous impact on their choices. I think when we get to that level, there can only be acceptance and respect, even when it would never be a choice we would make ourselves.
We can only do that though when we stop making monsters of people on both sides. Inasmuch as I can understand the anger and hurt of some women against birth professionals, if that is the main reason to UC and it stays there, then, in all respect, those women is not done growing. I think that when a woman finds her true autonomy, even after being hurt and birth raped, she can come to a place of accepting what happened, realizing she herself had to awaken as well. For some women, the only way to find that autonomy is through UC, but all autonomous women make real and true choices no matter where they give birth.

May 1, 2009 | Unregistered Commentermaria

wow. i think the only thing missing in this post is "SEE? I TOLD YOU SO?"

May 1, 2009 | Unregistered Commenterani

I've already weighed in, but I wanted to add something. This may or may not shed some light on the tone that others (including myself) readin this post.

I have always respected you, NM, even when I haven't agreed with you. This post is the first time I ever felt shocked, saddened, and (in some people's words) "offended" - completely. My instinct was to distrust you and be wary of you. Your tone seemed to be to be spoken with a purpose - a hurtful one. After reading all the other comments, and then reading your last response (which seemed sincere, truly), I feel like some of this is coming from sheer wording. And that's too bad.

One of the first things we learned when I was workig on my Masters in Counseling is that our wording can play a big role - a huge one - in how well we are understood. (obviously) Whether it's marital stress, child-parent relations, grief counseling - whatever.

The word "but" is almost like an eraser. When the word "but" follows a sentence, it is almost as if it erases whatever was just said. This isn't always intentional (sometimes it is.) In the English language, this is fairly commonly understood, even if it is never learned.

Think of classic break-up conversations: "I love you, but..." Know what I'm saying? Without being stated, we all know what "but" means!

The few times you express sympathy and kind words were immediately followed with a big glaring "but", making the reader feel like the part AFFTER the "but" is what you really mean to say. People might have responded better had your first post been "I am sorry for Janet's UC loss " -- questions to come later. Considering WHO Janet is and how she birthed, the loss speaks for itself. You'd be surprised how loudly is speaks for itself (even though we don't know any details yet).

May 1, 2009 | Unregistered CommenterRachel Clear

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