For ten days now, the story of Lou, barely a few days old, and her sister Nausicaa, two years old, has been doing the rounds on social networks. The two girls were temporarily placed in a nursery by the Mother and Child Protection Service (PMI) after a report from the town hall of Vitré (Ille-et-Vilaine) when the birth of the youngest was announced at the town hall. A decision that both parents attribute to their choice to choose an unaccompanied birth (ANA) that is different from an assisted home birth (AAD) with a midwife present.
Since the takeover of the story by the media and on social networks, the excitement has been enormous. Without going back to the bottom line (perfectly summed up in Check News here), this story nevertheless raises many questions about the legality of home birth and the modalities of its implementation. Marie-Hélène Lahaye, lawyer and feminist activist behind the Marie blog, gave birth there and authored it Childbirth, women deserve bettersheds light on the subject.
Is it legal to give birth at home?
Legally it is very simple: women have the right to give birth wherever they want, however they want, including at home, unaccompanied, with their husband or whoever… There is no legal interpretation regarding this: no some law prohibits or authorizes ANA (unassisted delivery), so it is allowed.
Is home birth without assistance legal?
Yes, it is legally possible to give birth alone at home. What the Public Health Code only says is that a certain number of consultations are required after childbirth. Within eight days a pediatrician or doctor is obliged to examine the baby and within eight weeks the mother. Everything else proceeds as with a traditional birth: declaration at the town hall within five days, etc.
What about the safety of women and babies during a home birth?
What the science is saying is that a low-risk delivery, which represents the vast majority of cases, performed with the support of a midwife, carries no more risk of complications than a hospital delivery. These professionals who accompany women at home are trained to respond to a problem, bleeding, etc. When this happens, they take the mother directly to the hospital so she can be taken care of. That’s the difference with the situation 50 years ago, 100 years ago… When there was a problem, women had no story.
In addition, home midwives have the advantage of being on the mother’s side throughout the process, which is not the case in the hospital where they have to be shared with several patients at once. It is for all these reasons that AAD (home birth) is considered a common, normal practice by the government in many European countries (Netherlands, United Kingdom, etc.).
Yet France remains cautious when it comes to home births…
Yes, in France, on the contrary, we have a risk culture. For the nursing staff, the birth is automatically endangered. Only after birth will we assume that he was at low risk. We are really in reverse logic. This explains this ideology of mistrust surrounding deliveries outside hospital structures or beyond the control of a physician. Yet there are only 10% of cases where childbirth can lead to the risk of complications and generally they are identified before delivery takes place.
Why do women choose unaccompanied deliveries when they can be accompanied by a midwife?
There is a structural problem in France, that of home midwives insurance. All healthcare providers should have professional insurance to cover them in the event of a medical malpractice… This is completely normal. Except that in France, midwives have to pay the same as midwives who perform an emergency C-section or have to deal with extremely risky situations. They therefore have to pay 25,000 euros per year for professional insurance, which more or less corresponds to their annual salary. This is unaffordable given their low salary. Midwives can deduct costs from this insurance and have a much higher salary. It’s really injustice.
As a result, more and more practitioners do not take out insurance. However, in 2013, the ministry asked the College of Midwives to prosecute all uninsured home midwives. So there was a series of write-offs that caused a shortage of home midwives. Today, many of them ignore the profession or settle for labor preparation or perineum re-education.
Still, there’s been a real craze for physiological births for a few years now, right?
Parallel to this phenomenon of scarcity, there is indeed a new ambition of women to reclaim this event and want to give birth at home. An IFOP survey on the subject appeared in 2020, shortly before the incarceration. Of the 1,000 women surveyed, 17% said they would definitely give birth at home if given the chance. If we add up the percentage of those who would definitely give birth and those who would probably give birth at home, the figure rises to 36%.
I was very surprised myself to find that more than a third of women tended to have a physiological birth… There is a culture change in women. They no longer dream of medicalization as we could do ten or twenty years ago. They want to give birth in the privacy of their home, but there are no more midwives who can meet this demand. That is why there is a phenomenon that is developing in France and not elsewhere: that of unaccompanied childbirth. It is this phenomenon that we find in the background of the Vitré affair.
How do you explain France’s delay on this point?
I often compare the issue of home birth to the right to contraception or abortion: it is every woman’s right to dispose of her body. She should be able to choose whether or not she wants a child, and if she does have one, she should be free in how she brings it into the world. Anthropologist Françoise Héritier described patriarchy as the appropriation of women’s reproductive capacities. Ultimately, these women who give birth freely are a threat to patriarchy
Did you like this article? Discover the testimony of a midwife who helps mothers give birth in the peace and privacy of their home.