What is a 'hands off' birth?

For many pregnant women the presence of midwives and other medical professionals at the birth can be reassuring and comforting.

But for others continuously checking your dilation, the baby’s heartbeat and other medical checks can be somewhat off-putting.

However, there is a way of giving birth without your midwife even touching you. What’s more so-called ‘hands off’ births are becoming increasingly popular.

“A hands off birth is also known as a low intervention birth or a non-medicalised birth,” explains Liz Halliday, Deputy Head of Midwifery at Private Midwives. “It can occur in any birth setting but is more usually experienced at home or in free standing birth centres.”

“When pregnancy and labour are normal, birth is a physiological process and can be supported as such without medical intervention,” she continues.

“Usually, the midwife will still undertake some clinical checks such as blood pressure, pulse and temperature and she will listen in to the baby’s heart regularly to make sure everything is ok.

“However, the midwife does not perform vaginal examinations, break your waters, perform midwife led or purple pushing, put her hand in the perineum for birth or perform routine episiotomy.”

Liz says this approach can have huge benefits for women who often feel more supported and in control of their labour, leading to a lower incidence of postnatal depression, anxiety or PTSD, and an easier transition to parenthood.

One advocator of the hands off approach to birthing is nurse and midwife, Deb Fiore, from North Carolina, who wrote a post on her Facebook page describing what’s involved in a low-intervention type of birth.

“I rarely touch a woman during her labor/birth,” she wrote. “I don’t ‘check her cervix’ unless needed (which is rare and typically only needed with first time mums). I don’t tell a woman that ‘it’s time to push’ or that she needs to start pushing. I don’t ‘massage the perineum.’ I don’t ‘catch’ the baby (unless requested to by mum).”

Fiore believes most mums have all it takes to birth their babies themselves and it is rare that she needs to intervene.

“It has been my experience (in 18 years of practice) that we do not need our hands on perineums or babies when they enter the world except in the rare scenario where they are having trouble with the journey (shoulder dystocia, tight nuchal cord, ect [sic]),” she explains.

But are hands-off births safe?

“As women are still supported by an experienced midwife in low intervention births, there are no clear risks to planning this type of birth,” Liz Halliday explains.

“The midwife should recognise if anything is not normal and then discuss with their client what the options for intervention are if required.

“The key is to have a trusting partnership between woman and midwife (which often comes from having a continuity carer throughout pregnancy), to have discussed other care pathways that may present during labour and to remain flexible should medical attention be required.”

Though they won’t be for everyone, hands-off births do offer women the opportunity to take control of their own births and put their trust in their own bodies to deliver their babies.

Equally, women may prefer the comfort of knowing their midwife is continuously checking them and their babies, and that’s fine too.

The important thing to remember is it’s your birth, and ‘hands off’ or ‘hands-on’ the main thing is that your voice and wishes are heard.

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