Birth Without Violence: a reflection

AIMS Journal, 2022, Vol 34, No 2

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By Antonita Kirubanathan

As a second-year midwifery student, the care we give is aimed at ensuring the birthing person has a positive birthing experience. Yet how much thought goes into a positive experience for the baby? Is this ever considered?? Frédérick Leboyer did consider the baby’s experience in his book ‘Birth without Violence’ (1974); an interesting read that makes one question one’s own thoughts and presumptions, possibly for the first time.

Leboyer’s message was a profound one, a call for normality to be returned to midwifery practice, and to aid in the gentle physiological transition of the baby. Midwife means ‘with woman’, but who is with the baby? Who is advocating for this small person to have a memorable and pleasant birth experience? Why is it so easy for some of us to understand that animals can have feelings and preferences, yet think that a newborn baby cannot possibly have?

Midwives can often detect the differences in certain noises women make during labour, ears pricking up when they hear noises that have been made during first stage transition to noises present during second stage. Similarly, women can often differentiate between the cry of their own baby amongst the cries of several babies. Is there then a difference between a baby crying in terror and pain, and a baby crying to begin a transition to extrauterine life? Leboyer argues that the birth experience for the newborn, when highly medicalised, causes stress and ultimately terrorises the baby.

Leboyer invited us to consider the experience of the baby using beautiful prose and illustrating this with photographs that need no words.

Images from: Leboyer, Frédérick. Birth Without Violence / Frederick Leboyer. New York: Knopf, 1976.

The book was written at a time where there was a shift in mindset from home being the typical place of birth to the hospital being the safest place for birth to occur. Highly medicalised births became the norm, with bright lights, enemas, regular episiotomies, immediate cord cutting, and newborn checks happening soon after birth. These aspects of midwifery practice were often unevidenced and are now considered ‘bad practice’.

A stark difference to the practice we see today - or is it? Do we still use routine practices where there isn’t sufficient evidence? The answer is yes and these actions will one day be considered as the ‘bad practice’ of our current time. Of course, it would be wrong to say that practices have remained static from when the book was written, however, it is not wrong or insensitive to say that there are a multitude of things that need to be addressed for midwifery to be what it was intended to be - the protection of women and babies from an experience of birth that leaves them either traumatised or feeling violated.

An emphasis is now placed on making birth an experience to be enjoyed and cherished, an experience to remember. Women are told they can make informed choices and are invited to make intricate birth plans. Sadly, and despite the rhetoric of choice, birth trauma is on the increase and is an experience to remember but for all the wrong reasons. Granted, there are times when medical assistance is unavoidable, and in those moments we rejoice for the life-saving procedures, but even then - especially then - there are a number of actions that can be undertaken as practitioners to make the situation more bearable and the care we give more compassionate for the mother and for her baby.

Leboyer, as a male obstetrician, wrote this book in a time when he might have been ridiculed for even having the thoughts he expressed. However, nothing can be achieved without going against the status quo. As such Leboyer was way ahead of his time, questioning non-evidence-based practice, making his book relevant for us still today.

Image from: Leboyer, Frédérick. Birth Without Violence.
ISBN 10: 0892815450 ISBN 13: 9780892815456
Publisher: Inner Traditions Bear and Company, 1995

Author Bio: Antonita Kirubanathan is a second-year midwifery student and mother of two. She is passionate about birthing people’s experience throughout the childbirth continuum. She is a keen advocator and loves embracing every opportunity and challenge to shape her experience.