I speak of autonomous/unhindered birth rather than homebirth or freebirth/unassisted birth because what matters is not birth location, or even birth attendants, but birth style and who has the power. I am not sure unhindered birth ever happens in hospitals (which is not to say positive, joyful births do not happen in hospitals), but it is not a given at home, either. Whether a woman has autonomy in labor, whether she is free of violations to her body and her humanity, should not depend on whether she needs medical assistance or would feel safer with the presence of a birth attendant.
I often use autonomous and unhindered birth interchangeably, but the terms have subtle distinctions. Autonomous birth refers to the woman being “in charge”, or at least centered, during labor and birth. This is most likely to happen in a free/unassisted birth, and some people do use the term specifically to mean birthing without a professional attendant, though I do not.
Unhindered birth is an alternative to the less precise, more historically loaded term “natural birth” (which has come to most often mean “birth without prescription pain medications”, and which some even use synonymously with “vaginal birth”, with or without medications). One of my favorite midwives describes it this way:
Unhindered meaning on your own terms, without direction or management by someone else, given privacy to do your own thing.
Unhindered birth is a birth without unnecessary interventions (not just without pain medications), in which the environment is structured to acknowledge and support the mammalian nature of the laboring woman, to not disturb the physiology of birth. It means that procedures are not done because they are “routine”, or to measure or encourage a “schedule”, and when interventions (such as fetal heart rate monitoring) are elected, they are done in a way to minimally disturb the laboring woman. The Mother Friendly Childbirth Initiative outlines the basics of what I consider unhindered birth.
I do not give a strict definition of what is or isn’t compatible with unhindered or autonomous birth because it’s not about a checklist, and I’m not interested in labeling others’ experiences. Rather, I hope to reframe the discussion to center women and respect for our autonomy and our bodies and our power in birth, without shaming women who need or desire medical assistance, while celebrating what most women’s bodies are capable of.