Toward Conceptual Clarity

Out-of-Hospital Birth Practices and Freebirth Entrepreneurialism

Authors

Keywords:

regulated midwifery, unassisted birth, freebirth, birth justice, reproductive justice, birth care, New Brunswick, Canada

Abstract

There is a growing interest in giving birth outside of hospitals and healthcare systems. In our analysis of more than five years of qualitative research, we have noted the conflation of unregulated birth care with regulated midwifery care, a concern also identified by several professional midwifery associations in Canada. This is particularly concerning in a national context where midwifery remains insufficiently integrated and understood. Growing healthcare dis/misinformation and increasing politicization around healthcare have led to confusion for those choosing among different forms of birth care. In this article we differentiate among birth workers and practices, focusing on unregulated forms of care, including doulas, lay or traditional midwives, and other kinds of birth workers, as well as freebirth, or unassisted birth. This analysis paper provides information on the range of practices that healthcare providers may encounter and articulates areas of difference and overlap among forms of birth care. It also highlights strategies to address some of the unmet needs that are leading people to choose unregulated birth care.

Author Biographies

  • Krista Johnston, Mount Allison University

    Krista Johnston is Associate Professor of Feminist and Gender Studies and Canadian Studies at Mount Allison University, located in Mi’kma’ki, along the Bay of Fundy, New Brunswick, Canada. Her research focuses on the interface between social action and social policy. She has published on motherhood, settler colonialism, and midwifery care. Her work is grounded in anti-colonial feminist commitments to reproductive justice, with a broad focus on the politics of care.

  • Christiana MacDougall, Mount Allison University

    Christiana MacDougall is an Associate Professor of Sociology and Feminist and Gender Studies at Mount Allison University in Sackville, New Brunswick, located in Mi’kma’ki, the unceded territory of the Mi'kmaq people. Her research focuses on reproductive justice, mental health and mental illness, and the areas where these overlap. Christiana is committed to critically engaged research that can be used towards positive social change.

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Published

2026-04-29

Issue

Vol. 47 No. 1 (2026): “Healing is an Act of Communion”: Critical Perspectives on Women’s Health, Wellness, and Disease

Section

Original Research

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Copyright (c) 2026 Krista Johnston, Christiana MacDougall

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