While freebirths and planned homebirths both happen outside of a medical setting, they are different birthing experiences.
Separating them is important because they also come with "very different" potential risks, explains Hannah Dahlen, professor of midwifery at Western Sydney University.
She says knowing the risks allows women to make informed and safe decisions regarding pregnancy and birth.
"People wrap the two things together … we do need to educate [women on] the difference," says Professor Dahlen, author of Birthing Outside the System.
"I see people online playing on women's fears and trauma in a very unethical way to make them think [freebirths and planned homebirths are] the same.
"That can turn women off having [professional] support."
So what are the key differences of homebirths and freebirths, and why do women choose to have them?
What is a planned homebirth?
Homebirth is when a woman plans to have her baby at home and involves care from registered midwives, says Professor Dahlen.
"They care for women through the pregnancy, are on call to support them to give birth at home and continue care for about six weeks after."
The midwives can either work in the private sector (be self-employed) — which Professor Dahlen says is most common — or be employed by a hospital.
Women who are supported by hospital midwives must meet "strict criteria" to have a homebirth. This option is for "very low-risk women who live in close vicinity to the hospital," she adds.
There are about 20 publicly funded homebirth programs operated by hospitals in Australia, with a program available in every state and territory except Tasmania, although its government recently announced one is in the pipeline.
Andrew Bisits, obstetrician and former medical co-director of maternity at the Royal Hospital for Women in Sydney, says private midwives still have appropriate constructive links with hospitals, which they can transfer the woman to, if necessary, or seek advice from.
Professor Dahlen says a woman might choose to homebirth because she had a previous uncomplicated birthing experience in hospital, wants to avoid specific medical interventions, or has birth trauma.
What is a freebirth?
A freebirth is where a woman chooses to give birth at home, however it could also be in an alternative location of their choosing.
"It may be by river or in a forest," Professor Dahlen says.
What makes it different from a homebirth is the intentional planning "to not have a registered health professional there at the birth", she adds.
A freebirth is sometimes referred to as an unassisted birth or a wild birth.
It its "purest or most extreme form", Dr Bisits says a woman planning to freebirth would have no medical support throughout her pregnancy. However, some opt for antenatal care beforehand.
He says some women will freebirth alone or only with loves ones, while others may engage a non-medical, unregulated support person such as a doula or "lay birth attendant".
Women sometimes choose a freebirth for similar reasons they might choose a homebirth. However past trauma, birth related or otherwise, "drives freebirth much more than homebirth," Professor Dahlen says.
Up to one in three women in Australia have reportedly experienced a traumatic birth.
Professor Dahlen says women may be attracted to freebirth because they feel betrayed by — or mistrusting of — the medical system. They may also be "anti-establishment and anti-medicine".
"Most of the women [I interviewed in my research] are doing it because something has happened that has broken their trust or made them feel they can't get what they want from birthing in the system."
She observed a "real amping up of the freebirth rhetoric" during the pandemic.
Freebirthing may also occur because a woman who wants to homebirth can't access public health services or can't afford private midwives.
The risks of freebirthing
Professor Dahlen says while unregulated birth support workers like doulas can do an "amazing job" alongside a medical team, they "don't have the training, regulation or medical equipment and skills needed to manage emergencies".
Midwives, however, are highly skilled and carry resuscitation equipment and medications to deal with emergencies, she says.
"Things can go wrong, and they can go wrong fast. The skills you want of a professional in that moment are incredibly important."
In 2024 the ABC published an investigation into an increase in planned freebirths in Australia.
Among the positive stories about freebirthing, it revealed a series of catastrophic outcomes.
Ten catastrophic incidents were linked to freebirths between 2022 and 2024 in a small pocket of south-east Queensland and northern New South Wales, including seven baby deaths.
Homebirth safe with 'low-risk pregnancy and links to hospital'
Professor Dahlen says the research shows when women have low-risk pregnancies, planned homebirths attended by competent midwives with links to hospitals are safe.
She says for low-risk women and their babies, there is no difference in the risk of death between planned home and hospital births.
"Homebirth is very safe if we have [a low-risk pregnancy], right provider at the right time, and seamless pathways to hospital.
"The intervention rates are far lower in homebirths.
"Once you start to have risks like twins and breach, that risk at home substantially increases."
Dr Bisits says while homebirthing has become "much more mainstream" over the past two decades, stereotypes about women who opt for that care persist.
"Women who have a homebirth are then harshly judged if something goes wrong," he says.
"There is the view that homebirthing in Australia still very much a fringe part of clinical care for women — it's not."
He says when it comes to freebirthing it's important "the healthcare sector take responsibility for some of the pressure these women might feel" to birth without appropriate support.
"We have to take the hint that something has to be done with the way we work in hospitals and the way we talk to women and discuss approaches to birth."
Professor Dahlen says increasing education about freebirthing isn't about impeding on a person's reproductive rights, but making sure they are "is fully informed and given all the options available".
