“Safety Is Relative.” Said a Woman Who Is A Pretend Midwife.

A so-called “certified professional midwife” told the New York Times that “safety is relative.” In Ontario, 11 babies or newborns died in free births in 4 years. In obstetrics, safety is not relative.

In Ontario, 11 families buried babies. Remind me again what is relative.

Grace did not get a birth certificate for her son. She got a small white coffin.

She had hired an unlicensed free birth attendant. As Grace’s legs swelled and her blood pressure climbed, the attendant told her it was normal. Women’s bodies were designed for this. By the time she reached the hospital, her son was dead. Undiagnosed preeclampsia. Had she seen an obstetrician at 36 or 37 weeks, she would have been induced or delivered immediately. That is not a hypothetical. That is the standard of care that exists precisely because this happens.

Grace’s story appeared in the New York Times this week. It is not the only one.

What Free Birth Actually Is

Free birth means delivering a baby with no doctor, no midwife, and no prenatal care. Its promoters call it reclaiming childbirth from an over-medicalized system. What it actually does is remove every safety mechanism that exists because labor can turn lethal in minutes.

This is not a fringe curiosity anymore. The Free Birth Society, founded in 2017, now has 132,000 Instagram followers and a podcast with more than five million downloads. One of its signature courses costs $399. It teaches women that obstetrics is, quote, “the story of rape, abuse, harm, violation.” It teaches them that vaginal exams during labor are comparable to being fondled. It sells baseball caps that say Make Birth Great Again.

This is not education. It is radicalization dressed in linen.

The Deaths Are Not Anecdotes

In Ontario, Canada, coroners investigated free birth deaths between 2020 and 2024. They found 11 stillbirths or neonatal deaths and one maternal death linked to free births in those four years. In the five years before, there had been one. That is not a trend. That is a body count.

In Australia, a natural food influencer died last September of a suspected postpartum hemorrhage after a free birth. Postpartum hemorrhage is one of the leading causes of maternal death worldwide. It is also one of the most treatable conditions in a clinical setting. Minutes matter. Twenty miles to the nearest hospital, as Emily Laszlo-Rath discovered in her trailer outside Joshua Tree, is a different calculation entirely.

Even the founder of the Free Birth Society, Emilee Saldaya, delivered a stillborn baby at 41 weeks last August. She had promoted free birth throughout her own pregnancy on social media, rubbing her bare belly in videos superimposed with a list of all the prenatal care she had skipped. She has continued selling courses since.

The CPM Problem: Counterfeit Pretend Midwives

The New York Times quoted Mickey Sperlich, described as a certified professional midwife and associate professor of social work, who said this: “Safety is relative.”

I want to be precise about what a certified professional midwife is.

A CPM is not a certified nurse-midwife.

A CNM completes graduate-level nursing education, passes a national board examination, and is licensed in all 50 states.

A CPM does not require a nursing degree. The educational requirements vary widely by state. In much of the United States, CPMs are not licensed at all. Parents should know.

I call them Counterfeit Pretend Midwives. That is not a slur. It is a credential audit.

And this particular CPM told a national newspaper that safety is relative. For some people, she explained, safety means modern medicine. For those who have experienced mistreatment, safety “perhaps becomes something different.”

You might disagree with her statement on “relative risk”, but even doctors support the notion that “relative risk” is not something women considering a home birth should be worried about. The argument that absolute risk should guide physician participation in home birth and not relative risk sounds reasonable on the surface — but it collapses when the absolute risk it minimizes is a preventable neonatal death. Telling a family that the increased risk is “small in absolute terms” is a statistical comfort that arrives, if it arrives at all, after the funeral.

Tell that to Grace. Tell it to the 11 families in Ontario. Tell it to the husband in Australia who buried his wife.

The Legitimate Grievance Underneath a Dangerous Movement

I have been in obstetrics for more than 50 years. I know that the medical system has failed many women. A 2019 survey published in Reproductive Health found that one in six women who received maternity care in the United States reported experiencing mistreatment. That number is not acceptable. The fear of hospitals, the distrust of institutions, the sense that something was done to you rather than for you -- these are real, documented experiences.

But “the medical system has sometimes failed women” does not lead logically to “therefore, deliver alone in a trailer with no prenatal care.” That is not a conclusion. That is despair dressed as empowerment.

The correct answer to obstetric mistreatment is better obstetric care, better access to certified nurse-midwives, better accountability for providers who harm patients. It is not to tell women that their instincts will protect them from preeclampsia, fetal growth restriction, postpartum hemorrhage, or uterine infection. Nature did not design labor to be safe. We spent two centuries building the infrastructure that made it survivable for most women.

What Prenatal Care and Skilled Attendance Actually Do

Preeclampsia, the condition that likely killed Grace’s son, has no symptoms in early stages. You cannot feel a rising blood pressure. You cannot see elevated liver enzymes. What you can do is measure both, at every prenatal visit, precisely because they can progress silently and quickly to a state where the baby cannot survive and the mother cannot either without emergency intervention.

Fetal growth restriction -- when a baby is not growing properly -- can be identified only by ultrasound. A baby that is not growing is a baby at elevated risk of stillbirth. You cannot detect this by monitoring fetal movement. You cannot detect it by trusting your body. You detect it by measuring the baby.

Postpartum hemorrhage -- the condition that killed the Australian influencer -- can begin within minutes of delivery and become fatal within an hour. The treatment is oxytocin, uterine massage, and if necessary, surgical intervention. None of these are available in a home setting without trained personnel and prepared medications.

These are not rare edge cases. They are among the leading causes of maternal and neonatal death. They exist on a spectrum from mild to catastrophic. The difference between the mild and the catastrophic is often measured in minutes and in the proximity of someone who knows what to do.

My Take

The Free Birth Society sells a $399 course that teaches women that obstetrics is violence. It then provides a disclaimer that the instructors are not medical providers and that the content is not medical advice. That disclaimer is not a legal technicality. It is an admission. They know they are not qualified to give the guidance they are selling. They are charging for it anyway.

When a CPM tells the New York Times that safety is relative, she is not offering a philosophical observation. She is providing cover for a movement that is killing babies and mothers. The philosophical flexibility ends at the autopsy report.

Respect for patient autonomy is a cornerstone of medical ethics. I have believed that for 50 years and I still believe it. But autonomy requires accurate information. Informed consent requires that the person making the choice understands the actual risks of the option she is choosing. What the Free Birth Society provides is the opposite of informed consent: it is misinformation designed to amplify fear of medicine and suppress fear of the one setting where patients have no safety net.

Emily Laszlo-Rath arrived at the hospital septic, dehydrated, and in active labor. She left with a healthy son. She knows exactly what saved her. “I just didn’t listen to my own mom,” she said. “I decided to listen to all these other people that I didn’t even know.”

Those other people are still selling courses.

If this post matters to you, subscribe to ObGyn Intelligence at obmd.com. Evidence-based obstetrics for clinicians and patients who want the truth, not the trend.

References

1. MacKeen D. ‘Free Births’ Are a New Pregnancy Trend. Critics Warn About Serious Risks. New York Times. 2026 Apr 22.

2. Vedam S, Stoll K, Taiwo T K, et al. The Giving Voice to Mothers study: inequity and mistreatment during pregnancy and childbirth in the United States. Reprod Health. 2019;16(1):77.

3. Office of the Chief Coroner for Ontario. Free birth-related deaths 2020-2024 [reported in New York Times, 2026 Apr 22].

4. American College of Obstetricians and Gynecologists. Planned Home Birth. Committee Opinion No. 697. Obstet Gynecol. 2017;129:e117-e122.

5. National Center for Health Statistics. Births: Final Data for 2024. National Vital Statistics Reports. 2025.