Reflecting on the Contours of Freedom in Birth

Introduction

In this post, members of the Obstetric Violence Reading Group reflect on Rachelle Chadwick’s “The Many Faces of Birthing Freedom”. In this imaginative and plural account, Chadwick asks what birth would look like in a feminist world, outlining five “faces” of birthing freedom: freedom from oppression, freedom to labour, freedom to be-in-relation, freedom from violence, and freedom to imagine. Our reflections explore how these ideas provoke different ways of thinking about freedom in birth, and what they mean for ongoing debates about obstetric violence, structural oppression, and the possibilities for care.

Reflection 1: Freedom as Structural and Relational

Our first reflection centres on the structural and relational position of the birthing person, which impacts birthing freedom. Chadwick argues that birth can never be an experience of freedom unless the person giving birth is themselves free from oppression. Here, a structural view of oppression is suggested, drawing on the idea that people are oppressed not simply as individuals but as members of a socially and culturally marginalised group. This is useful in understanding how oppressive structures and overlapping vulnerabilities contribute to how someone experiences birth. When considering freedom, it is important to move beyond an individualist approach and instead consider how a person may be oppressed by virtue of belonging to a marginalised group. Birthing freedom is only possible when one is free from broader structures of oppression.

Chadwick also considers that birthing freedom exists in relation to others. What this means is that if the people who are involved in assisting with births, such as midwives, nurses and doctors, are themselves oppressed, then this will impact on the freedom of the reproductive subject too. The hierarchical nature of the medical profession, along with long hours and difficult working conditions, may mean that healthcare providers themselves are not free, which in turn hinders birthing freedom. Chadwick places an important emphasis on the collective rather than individualistic nature of freedom in birth, showing that it is dependent on both structural and relational conditions.

Reflection 2: Choice as Integral to Freedom

Our second reflection relates to Chadwick’s discussion on the centrality of choice. Discussions on the ability to choose, and what that means in the context of birth, have arisen in response to many birthing people’s reports of obstetric violence. These discussions tend to highlight the importance of women’s autonomy and freedom of choice during labour and childbirth. However, as we have discussed in a previous blog, grounding our responses to obstetric violence in individual choice (and by extension, individual consent) risks individualising the problem and shifting attention from institutional responsibilities to prevent harm during childbirth. Relatedly, Chadwick suggests, individual choice is more likely to be enjoyed and exercised by more privileged women, who are less likely to experience barriers created by “intermingling layers of power, history, violence, and … inequality that coalesce in the birthing room”.

While acknowledging the importance of choice in childbirth, Chadwick invites us to consider other values that may be more important in facilitating a “good birth”. These include “safety, care, community, cultural integrity, and respect”. These values emphasise the importance of relationships in the birthing room, and the role of cultural and institutional structures in facilitating either harm or care. Moreover, these values are critical for birthing people’s exercise of genuine choice.

Reflection 3: Birth Between Violence and Oppression

The feminist pursuit of freedom in childbirth is a complex goal. It goes beyond individual decisions and touches on deeper power structures and material conditions. In her article, Chadwick outlines five dimensions of birthing freedom. Here, we focus on the connection between oppression and violence as key mechanisms in birth care.

Chadwick reminds us that to achieve freedom in birth, we must consider both oppression and violence. Drawing on Marilyn Frye’s well-known metaphor, oppression works like a cage: it constrains and structures the conditions of birth for all reproductive subjects, even when individual experiences are not overtly harmful. Violence, by contrast, is destructive because it shatters freedom in particular moments and relationships. Obstetric violence is therefore not present in every birth, but when it does occur, it exposes and reinforces the broader structures of oppression. A Marxist perspective sharpens this distinction by framing birth as a form of labour: oppression estranges and appropriates that labour through systemic structures, while violence enforces and compounds this estrangement. Our discussion highlighted the importance of considering these concepts together. Freedom in labour depends not only on confronting acts of violence, but also on dismantling the systemic constraints that normalise and sustain them.

Conclusion

Our reflections on The Many Faces of Birthing Freedom have centred on three key themes: the structural and relational conditions that shape whether birth can be free, the limits of grounding freedom solely in choice, and the importance of distinguishing and connecting oppression and violence. Chadwick’s imaginative framework reminds us that birthing freedom is not only about resisting harm but also about envisioning new possibilities for care, relation, and labour. By situating birth within broader feminist struggles for freedom, her essay opens space for us to think differently about what we are fighting for in challenging obstetric violence and building more just worlds of birth.

Simone Gray, Lecturer and PhD candidate at the School of Law, University of KwaZulu-Natal.

Frances Hand, DPhil in Law candidate at St Edmund Hall College, University of Oxford.

Patricia San Juan, PhD student at Andalusian Interuniversity Institute of Criminology (Malaga Section), University of Malaga.

Camilla Pickles, Associate Professor of Biolaw, Durham University.

Georgia Speechly, DPhil in Law candidate at Exeter College, University of Oxford.