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What does radical responsibility mean in childbirth?
We often hear that “birth is unpredictable,” and while that’s true, what’s often left out of the conversation is how much power women actually do have in shaping their birth experience.
This is where the concept of radical responsibility becomes so important.
Radical responsibility in childbirth doesn’t mean taking the blame for how your birth unfolds. It doesn’t mean doing everything “naturally” or rejecting medical support. It doesn’t mean striving for a perfect birth.
Instead, it means recognising and embracing the fact that you are the primary decision-maker in your birth experience. It means actively participating in your care, making informed choices, and surrounding yourself with a team who respects your voice and values.
Radical responsibility means:
When you choose radical responsibility, you move from being a passive patient to an active participant in your own birth story.
Choosing your care provider with intention
You don’t just go with whoever you’re assigned. You interview midwives or obstetricians.
You ask:
If the answers don’t sit right, you explore other options.
It’s worth noting that some hospital midwives make sweeping statements like, “Private practising midwives work collaboratively with obstetricians,” which may give the impression that PPMs are subordinate to the medical team. But let’s be clear – private practising midwives (PPMs) are not medical handmaidens to obstetricians. They are autonomous, primary care providers who don’t answer to hospital hierarchy or follow orders from Obstetricians. While they do collaborate with obstetricians when medically appropriate – especially if transfer becomes necessary – they are not employed by them, and they don’t require permission to support women in physiological birth. PPMs work for the woman – not the system – and they are skilled at navigating the fine line between collaboration and independence, all while keeping the woman’s preferences at the heart of care. They’re not there to smooth the pillows for doctors – they’re there to stand beside women and hold the line.
It’s also important to be aware of another option offered to women: midwifery-led care within a clinic setting, usually operating privately and often in partnership with an obstetrician. These midwives provide antenatal and postnatal care, but they do not attend the birth – and this is a detail that’s not always communicated clearly. Many women assume their midwife will be present at the birth because of the relationship built throughout pregnancy, only to discover – often too late – that someone entirely different will be at the birth of their baby. While these clinics can offer lovely continuity outside the birth space, the lack of transparency around birth attendance can lead to understandable confusion and disappointment. In these cases, women are effectively receiving midwifery support under an obstetric model – not the autonomous, continuity-based care they may have been seeking. This can still be a valuable model of care for women who are not expecting their midwife to attend the birth – but it is not the full continuity of care model that a private practising midwife can offer.
Here is a cheat sheet of questions you can take to your care provider interview:
Questions to ask prospective care providers
Questioning routine interventions
You don’t automatically say yes to every test or procedure. You pause, you ask:
You trust your instincts and don’t feel pressured into decisions.
Preparing your mind and body
You take childbirth education seriously. You learn about how labour works, how hormones support birth, and how body positioning can help your baby navigate the pelvis.
You might:
Setting boundaries
You write a birth plan that starts conversations.
You say:
Reflecting after birth
Even if things didn’t go as hoped, you reflect with compassion:
Radical responsibility allows you to process your birth without spiralling into shame or resentment.
It’s not about doing it alone – it’s about leading your team.
You are the leader of your birth team.
That might include a doula, midwife, obstetrician, birth partner, or student midwife. But you are the one they’re supporting – not managing. Radical responsibility means hiring people who listen to you, not override you.
And it means being willing to say:
Here are some simple, powerful ways to express your authority in the moment:
Radical responsibility is an invitation to step fully into your power as a birthing woman. It’s not about having a perfect birth but about having a conscious one – where you feel respected, prepared, and part of every decision.
Birth is not something that happens to you.
Birth is something you do.
And when you take radical responsibility, you don’t just go through birth – you lead it.
If you’d like to learn more about preparing for a confident and informed birth, check out my classes at www.backtobasicsbirthing.com.au or email me at [email protected]
https://vickihobbs.com/your-rights-as-a-pregnant-woman-in-australia/
https://vickihobbs.com/your-birth-plan-is-more-powerful-than-you-know
Choosing a care provider for your birth can be a daunting task | Back to Basics Birthing
https://vickihobbs.com/ten-tips-plan-healing-vbac/
https://humanrights.gov.au/sites/default/files/2020-09/sub_149_-_human_rights_in_childbirth.pdf
https://www.maternityconsumernetwork.org.au/
https://www.clearlightbirth.com/post/___26
If you have any questions or would just like more information please don't hesitate to get in touch by clicking the button below and filling out the contact form.
Contact Vicki