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November 4, 2025 14 mins

Health experts have joined forces to call on the Government to introduce national legislation that would make it illegal to give birth without a doctor or midwife present. It comes after several recent deaths linked to a practice known as freebirth. 

Today, we’ll explain what that means, where the push for regulation has come from, and what experts, advocates and lawmakers are saying about it.

Hosts: Emma Gillespie and Sam Koslowski
Producer: Orla Maher

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Transcript

Episode Transcript

Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Already and this is the daily This is the daily
ohs oh, now it makes sense. Good morning and welcome
to the Daily Ours. It's Wednesday, the fifth of November.
I'm Emma Gillespie, I'm Sam Kazlowski. Health experts have joined

(00:22):
forces to call on the government to introduce national legislation
that would make it illegal to give birth without a
doctor or midwife present. It comes after several recent deaths
linked to a practice known as free birth. Today we
are going to explain what that means, where this push
for regulation has come from, and what experts, advocates and

(00:43):
lawmakers are saying about it.

Speaker 2 (00:49):
And this is a really interesting story. It's been in
the headlines for last couple of weeks and well due
for an explainer on it. Before we get into the details, though,
of what health experts are calling for, can you explain
what free birth actually means.

Speaker 1 (01:04):
Yes, So, a free birth is the intentional practice of
giving birth without a registered healthcare professional like a midwife
or a doctor present. So it's a birth outside of
a traditional maternity context.

Speaker 2 (01:18):
Right.

Speaker 1 (01:19):
It might happen at home, but a free birth is
different from a home birth. That's a really important distinction
to make. A home birth is a planned birth at
home with a registered healthcare provider. So, just to be
really clear, home birth involves a qualified midwife or doctor
attending the birth at someone's home, whereas a free birth
is when someone chooses to give birth without any registered

(01:41):
medical professional at all.

Speaker 2 (01:43):
And give me a sense of how common free births
are in Australia at the moment.

Speaker 1 (01:48):
Well, they aren't tracked nationally, which makes it how much
tricky yeah to put an exact number on it, But
the peak bodies for obstetricians and midwives, as well as
various state specific health bodies say that there has been
an increase in free births, particularly since COVID nineteen.

Speaker 3 (02:04):
What we do know is that they are rare.

Speaker 1 (02:07):
Ninety seven percent of births in Australia happen in hospitals.

Speaker 2 (02:10):
Wow, okay, So between free births and home births, we're
talking about a general pool of about three percent.

Speaker 1 (02:17):
Yes, exactly, but there is a lot of nuance within
that three percent, you could say. The latest available national
data shows that there was a one hundred and thirty
percent increase in home births between twenty nineteen and twenty
twenty three. Again, home births not free births, and an
average of fourteen percent of those required a mid berth
hospital transfer. So something happened, something went wrong, there was

(02:41):
some medical complication. As I mentioned, though this doesn't include
free births. But I think those numbers on the popularity
and risk levels of home births give us a bit
of an insight into the kind of non traditional birthing
options in Australia and the interest or growing interest in them.

Speaker 2 (02:59):
So talk me through some of the risks that experts
say are associated with free births. So those unassisted births
at home.

Speaker 1 (03:08):
Yeah, these are considered the highest risk environments to give
birth and according to the Department of Health, free birth
can increase the chance of multiple health problems for both
mother and baby, with risks including excessive bleeding, tearing complications
if the baby doesn't start breathing, including long term health
issues or even death. Without a midwife or doctor present,

(03:31):
birth complications and specific emergency challenges can go undetected.

Speaker 3 (03:35):
Right, that is really critical. What may seem okay.

Speaker 1 (03:39):
In one minute may turn into something that is extremely
dangerous the next.

Speaker 2 (03:44):
Or even a couple of hours later.

Speaker 3 (03:45):
Well exactly hours or days later.

Speaker 1 (03:47):
The World Health organization states that around fifteen percent of
all pregnant women will develop a potentially life threatening complication
that calls for skilled care. Some will require major interventions
to survive, and of course that intervention is only possible
with medical professional care. Tragically, we have seen several deaths

(04:09):
linked to free births. A twenty twenty four ABC investigation
identified seven babies and one mother who died during or
after free births across parts of New South Wales and
Queensland in the space of eighteen months.

Speaker 2 (04:23):
So we know what can go wrong in a free
birth context, but I think it's important to understand why
someone would choose that path. What data or research is
there around why people would pick a free birth route.

Speaker 3 (04:36):
Yeah.

Speaker 1 (04:36):
Absolutely, I think it is really important to mention that
this is an incredibly personal decision for a lot of
expectant mothers and families. There are a lot of opinions
in this space, and you know, ultimately practitioners want there
to be some level of choice, but they want those
choices to be prioritizing the safety of babies and expectant mothers.
According to health experts, though many women choose free birth

(05:00):
after experiencing a previous traumatic birth in hospital. So research
does show around one in three Australian women do experience
birth trauma, and some of those women end up finding
the hospital environment, you know, overly clinical. They feel they
don't have autonomy over their own bodies during childbirth. They're
left with physical or psychological scars that lead them to

(05:22):
consider non traditional options for birth. There was a new
South Wales inquiry into birth trauma that received thousands of submissions,
mostly from others who said they were ignored, belittled, denied
the opportunity to give informed consent to certain procedures or medications,
So that paints a bit of a picture as to
the why. And cost is also a major factor. Publicly

(05:45):
funded home birth programs do exist, but they're not widely available.
There are limited spots and that might lead some families
to consider free births as well.

Speaker 2 (05:55):
And what you're alluding to there, it sounds like, is
the idea that there are some systemic issues in the
maternity system that are driving some of these choices right.

Speaker 1 (06:06):
Exactly, And many experts, including some midwives duelers, they argue
that this rise in free births is exactly what you've said, Sam,
a sort of a symptom of a broken system. So
the Australian College of Midwives has said that while they
don't support free birth, they do support home birth with
qualified professionals and they respect a woman's choice. If a

(06:27):
woman chooses free birth and then requires care, they should
receive non judgmental care.

Speaker 2 (06:33):
And one of the words you mentioned just then is
worth talking about in itself, a duela. Can you classify
what a doula is and how they fit into this discussion.

Speaker 1 (06:41):
Yeah, so the free birth discussion is not one you
can have without talking about duelers. I don't think this
is a birth support person who's essentially contracted by families
privately and they provide emotional, physical, informational support to someone
during pregnancy, during labor itself and after birth. But duellers

(07:02):
are not medical professionals. They're not trained to provide clinical
care or to respond to medical emergencies. Some duelers around
the country are members of various health bodies that have
their own mandatory codes of conduct and ethics, but the
duller industry is by and large and unregulated one. There
is no mandatory accreditation. Right to call yourself a duller

(07:25):
and to sell your services to expectant families.

Speaker 2 (07:29):
So let me just kind of take stock of where
we are. We have a system in Australia where largely
women are giving birth in a hospital setting and at home.
There's home births and free births, the big difference being
if there's a registered professional in the tendence or not.
Exactly why are we talking about this on the podcast
today with all of that context in mind.

Speaker 1 (07:51):
Yeah, So that increase in free births and also in
complications has prompted calls from two peak.

Speaker 3 (07:59):
Bodies within medicine.

Speaker 1 (08:01):
We've got the Royal Australian and New Zealand College of
Obstetricians and Gynecologists or RANDSCOG yep RANSCOG is what I
will call them from now, and the Australian College of Midwives.
They have released a joint statement calling on the government
to overhaul birthing outside of the system.

Speaker 3 (08:19):
That's another term you hear talking about free births.

Speaker 1 (08:22):
They want legislation to ban free births and to regulate
this space. And one of the most recent high profile
cases leading up to this moment you may have seen
online some commentary about this. It involved an ossie nutritionists
and wellness influencer her name was Stacy Hatfield. She gave
birth at home to her first child in September. She

(08:43):
was transferred to hospital shortly after the birth due to
an unforeseen and extremely rare complication according to her husband,
where she later died. So that kind of follows this
groundswell of interest conversation about this kind of maternity care
in a sty and is really kind of the driving
force behind this latest wave of conversation.

Speaker 2 (09:05):
I've definitely seen more conversations about this play out in media,
probably since the end of the pandemic where this trend
really did start to emerge, but it's clear we're talking
about it today because of those comments. What did the
health experts call for and what did they propose in
a bit more detail.

Speaker 1 (09:21):
Yes, So that statement from RANSCOG and the Australian College
of Midwives has urged federal, state and territory health ministers
to one introduce and pass legislation which quote expressly restricts
labor and birth management to appropriately trained registered practitioners that
is obstetricians and gynocologists GPS midwives. They also want a

(09:44):
ban on unlicensed or unregulated practitioners from undertaking the management
of labor and birth that would include duelers. They want
regulatory frameworks across all states and territories to be aligned.

Speaker 2 (09:56):
So a national system there.

Speaker 1 (09:58):
Exactly to ensure that we're and receive the same protections,
the same level of care regardless of where they're giving
birth and for they want quote, transparency, accountability and safety
in birthing services to be promoted. In their statement, the
groups said that while choice and model of care are important,
such choice must operate within frameworks that ensure safety, quality

(10:18):
and accountability.

Speaker 2 (10:19):
So they're not calling for the end of home births specifically,
they're calling for the end of free births and the
profession of a dula being allowed to practice in Australia.

Speaker 1 (10:29):
Yeah, well, I mean under this framework dulas could still practice,
but they couldn't be the person that is calling the
shots right in a home birth, registered or qualified doctor
or midwife would need to be present as well as
a douller.

Speaker 2 (10:42):
And are there any states where this type of scheme
is currently being already enforced?

Speaker 1 (10:48):
Yeah, we actually have an example with South Australia. This
is the only state or territory with legislation like this, right,
but it is a criminal offense there for anyone unqualified
to provide clinical care during labor or childbirth. This has
been the case in South Australia for more than a decade.
So they introduced that legislation in twenty fourteen, and that

(11:08):
followed a coronial inquiry into the deaths of three babies
who each died separately after complications during home births.

Speaker 2 (11:16):
And just to tease out that nuance there, because I
think it's really important so that South Australian law correct
me if I'm wrong. But is that saying that a
duela can still be at a birth, just not delivering
clinical care, which would mean kind of leading the way
in which the birth plays out. Is exactly kind of right,
So it's not saying the duellers can't be involved.

Speaker 1 (11:37):
Yeah, none of these conversations are about kind of dismantling
the duela industry altogether. It's about saying, Okay, you might
want to work with a duela to support you through
your pregnancy and your birth, sure, but a qualified medical
person must be in the room when you are delivering
a baby.

Speaker 2 (11:56):
Got it, okay? And so one of the recommendations there
was about national system and unifying state and territory laws
that will inevitably involve the federal government. Has the government
said anything about an idea of a national framework, so.

Speaker 1 (12:10):
At the time of recording, we haven't yet heard a
response from the federal government or Health Minister Mark Butler.
It is I guess a bit confusing here because state
and territories ultimately make these decisions about birth, trauma and
maternity care. So this really would require a bit of
an overhaul of those processes and states and territories working

(12:32):
together with the federal government to commit to changes.

Speaker 3 (12:36):
Some changes already underway.

Speaker 2 (12:38):
You know.

Speaker 1 (12:38):
We've got states like New South Wales where there are
several recommendations being implemented relating to trauma informed maternity care,
expanded midwife access in rural areas. Queensland as well is
trialing public home birth programs, So some momentum has kind
of started to gain a bit more traction, But it's
that uniform national conversation that these peak health bodies are

(13:01):
calling for with urgency.

Speaker 2 (13:03):
So I guess from here and we kind of wait
for a response from the federal government. We keep track
of some of those state and territory activities as well
and see if there is movement in this space, and
I know that it can be quite a divisive topic,
especially i've seen in comment sections on social media, and
thank you for taking us through that in a way

(13:24):
that that makes a bit more sense.

Speaker 3 (13:25):
Thank you for having me, Sam.

Speaker 2 (13:26):
And that's all we got time for you on today's
episode of The Daily Os. We're going to be back
in the afternoon with some of those afternoon headlines, but
until then, have a great day. My name is Lily
Maddon and I'm a proud Arunda Bunjelung Calcuttin woman from
Gadigol Country. The Daily Os acknowledges that this podcast is

(13:49):
recorded on the lands of the Gadighl people and pays
respect to all Aboriginal and Torres Strait Island and nations.

Speaker 3 (13:55):
We pay our respects to the first peoples of these countries,
both past and present,
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