THE death of Australian wellness influencer Stacey Hatfield in September last year sent shockwaves through the online communities that championed her philosophy of low-intervention, natural living.
Hatfield, 30, chose to give birth to her son Axel at her Melbourne home with no antenatal care, no midwife and no doctor present, a practice known as freebirth that is rooted in the belief that childbirth is inherently safe without medical oversight.
But is it true that freebirth is safe because childbirth is a natural process?
Verdict:
FALSE, BUT
Hatfield, who built a following around her brand Natural Spoonfuls, gave birth successfully to Axel in the early hours of Sept 29 with only her husband Nathan and a doula named Emily Lal present.
A doula is a non-medical birth support worker who provides emotional and physical comfort during labour.
Lal had been paid around A$6,000 (about RM17,400) for a freebirth support package covering preparation and attendance.
Shortly after delivery, Hatfield began bleeding heavily, eventually losing approximately 1.5 litres of blood.
She was found on the floor beside a large blood clot, clammy and in an altered state of consciousness.
As Hatfield's condition worsened, Lal asked three times over a roughly five-minute window whether to call an ambulance.
Hatfield declined the first two requests, at one point telling Lal she did not want her to leave.
By the time an ambulance was called and she was transferred to hospital, nothing could be done.
A coroner's hearing in June confirmed the cause of death as severe postpartum haemorrhage.
Postpartum haemorrhage is a known and treatable complication of childbirth. Hatfield's death was not a freak accident outside the bounds of what medicine can anticipate. It was precisely the kind of emergency that skilled birth attendants are trained to recognise and manage.
The freebirth movement that Hatfield was part of traces its origins to 1950s America, at a time when childbirth had become heavily medicalised and women felt they had little say in how they gave birth.
The term "freebirth" was coined in 1974 by Jeannine Parvati Baker, a spiritual midwife who framed unassisted birth as a liberating act rooted in bodily sovereignty and holistic wellness.
The movement found its footing in countercultural circles before gaining significant mainstream traction in the social media era.
The Free Birth Society, founded in North Carolina in 2017 by former doula Emilee Saldaya, became one of its most prominent voices, building an audience of over 132,000 followers and a podcast downloaded more than five million times.
Neither Saldaya nor the organisation's instructors hold medical qualifications, yet its content makes medical claims, downplays the risks of serious complications and advises women to avoid antenatal checks including ultrasound scans.
A year-long investigation by The Guardian in November identified 48 cases of late-term stillbirths, neonatal deaths or serious harm involving births linked to the organisation's teachings and community.
The central premise driving all of this is that birth is natural and therefore safe. It is a claim that does not survive contact with history.
However, before modern obstetrics, childbirth was one of the leading causes of death for women of reproductive age. In pre-industrial England between 1650 and 1800, maternal mortality averaged 10 per 1,000 births, roughly 50 times higher than today's rates in high-income countries.
In the United States around 1900, approximately 850 women died for every 100,000 births. By 1997, that figure had fallen to 7.7 per 100,000, a decline of nearly 99%, driven by advances in skilled birth attendance, antiseptic practice and emergency obstetric care.
Between 1935 and 1945 alone, the introduction of modern obstetric care produced a more than 20-fold reduction in maternal mortality in developed nations within a single decade, with perinatal mortality falling from as high as 14% to 0.4%.
The killers that claimed so many mothers before modern medicine were haemorrhage, hypertensive disease, infection, asphyxia and placental abruption. They remain the same complications that skilled attendants are trained to detect and treat today. The difference is that today, in a hospital setting, most of them do not have to be fatal.
Malaysia's own history reflects this global pattern.
The country's maternal mortality ratio stood at 540 per 100,000 live births in 1957. By 2023, it had fallen to 25.7 per 100,000, a transformation driven in large part by the expansion of skilled birth attendance across the country.
In 2023, 99.6% of Malaysia's 419,590 registered births were attended by trained personnel. That figure represents not just a health statistic but generations of mothers who came home alive.
Yet unassisted home births are rising in Malaysia despite the country's accessible and affordable birthing facilities.
A peer-reviewed study published in BMC Pregnancy and Childbirth found that Malaysian women who chose unassisted birth were driven by four recurring themes: a preference for a particular birthing experience, a belief that birth is a natural process, a desire to express autonomy, and faith.
These motivations deserve to be taken seriously rather than dismissed.
Many women who choose freebirth are not acting from ignorance alone. They are often responding to genuine and documented grievances about the maternity system, including experiences of feeling coerced, unheard, or subjected to procedures without meaningful consent.
The desire for full bodily autonomy during one of the most profound experiences of a woman's life is not irrational.
What the evidence does not support is the conclusion that removing professional care makes birth safer.
The research distinguishes sharply between midwife-attended home births and freebirth. A systematic review and meta-analysis published in eClinicalMedicine covering approximately 500,000 births found no increased risk of perinatal or neonatal mortality for low-risk women who planned home births in settings where midwives are well-integrated into the healthcare system.
But that finding depends entirely on the presence of a trained professional. Freebirth removes that safety net altogether.
The American College of Obstetricians and Gynecologists states that hospitals and accredited birth centres are the safest settings for birth, and that even planned home births carry a more than twofold increased risk of perinatal death and a threefold increased risk of serious neurological problems in the newborn.
The Society of Obstetricians and Gynaecologists of Canada notes that as many as 15% of all births, even in developed countries with full prenatal care, involve potentially fatal complications.
Postpartum haemorrhage, the complication that killed Stacey Hatfield, is one of them.
It is natural.
It is also, without immediate intervention, fatal.
Sources:
1. https://pmc.ncbi.nlm.nih.gov/
2. https://www.ajog.org/article/
3. https://www.cdc.gov/mmwr/
4. https://www.thelancet.com/
5. https://www.sciencedirect.com/
6. https://pmc.ncbi.nlm.nih.gov/
7. https://open.dosm.gov.my/data-
