Before Natalie Krueger even became pregnant with her second child, a boy named Callahan, she knew she wanted to give birth at home. She’d had a hospital birth with her first child, Sawyer, that didn’t go how she envisioned.
Initially, Krueger planned to have a midwife attend the second birth.
“It wasn’t until my pregnancy with Cal that I realized how difficult that would actually be,” Krueger said.
Krueger lives in Osmond, a rural town in northeast Nebraska less than an hour from the South Dakota border. Laws in Nebraska make it illegal in some instances to give birth at home with a midwife. Krueger said at the time of the birth, there were only two midwives who served her area. She hired one.
Krueger is a doula. Doulas support parents emotionally through pregnancy, birth and the postpartum period. They are not medical professionals. During her pregnancy, Krueger shared a client with the midwife she hired for her own birth.
“When I was about 20 weeks pregnant with him, I attended a home birth where she was the midwife,” Krueger said. “During that birth I pretty quickly realized that she was not the right fit for me.”
Krueger decided to give birth at home without the help of a midwife. She said at the time, she didn’t realize the other midwife served her area.
When a person intentionally has a baby without the aid of a medical professional, it’s called a free birth or unassisted birth. Free birth is controversial and relatively rare. But it’s gained traction online from social media influencers who promote it.
Experts say freebirth is dangerous and potentially deadly. But supporters say unassisted birth is misunderstood.
Caitlin Linscheid is an OB-GYN in the Kansas City area. She said some of the most common emergencies during birth are shoulder dystocia, when a baby’s head is born but a shoulder is stuck, or postpartum hemorrhage, when a person rapidly loses blood after birth.
“You can lose liters of blood in mere minutes and go from being perfectly fine to bleeding to death,” Linscheid said. “If you don't have access to a physician or a medically trained midwife who can intervene urgently, then that can be a life-threatening situation.”
Health officials don’t track free birth, but home birth in Iowa, Kansas and Missouri has increased in recent years.
Natalie’s story
Pierce County, where Krueger lives, lacks access to maternity care. The March of Dimes, a nonprofit that focuses on infant and maternal health, defines it as a maternity care desert, meaning the county doesn’t have a birthing facility or obstetrician. According to the March of Dimes, people in 1 in 3 U.S. counties don’t have access to maternity care. Most of these counties are rural and located in the Midwest and South.
For her first birth in 2020, Krueger opted for a hospital birth. Because her hometown hospital doesn’t have a labor and delivery unit, she traveled to Yankton, South Dakota, about 45 minutes away. At 40 weeks, she had an afternoon appointment. The doctor told her to come back in the evening for an induction.
“I ended up staying in town because it was January, and we were afraid there was going to be a snowstorm coming in,” Krueger said. “So I ended up laboring in a Walmart and a restaurant.”
Krueger said she didn’t need an induction because her labor progressed on its own. She said she hoped to avoid an epidural, but she felt pressured into one from her labor and delivery nurse.
Overall, Krueger said the birth wasn’t traumatic and went smoothly.
“It was just that I had hoped for an unmedicated experience,” Krueger said.
She said her husband felt out of place, and the constant rotation of nurses coming in and out of the room was less than ideal.
“Privacy is more important to me than I first realized it was,” Krueger said. “I was really uncomfortable meeting new people in labor and then having to trust those people to take care of me.”
This experience is why she opted for a home birth the second time around. Krueger’s husband was anxious about a home birth, so she agreed to hire a midwife.
Nebraska has some of the strictest midwifery laws in the country. It’s the only state where it is a felony for certified nurse midwives, or CNMs, to attend home births. CNM is one of the highest levels of midwifery education. They are registered nurses who typically hold an undergraduate degree in nursing and a graduate degree in nurse midwifery. They’re the only type of midwife recognized by Nebraska law.
Regulating CNMs created a loophole that allowed other classifications of midwives with less education to attend home births. Other types of midwives include Certified Professional Midwives, or CPMs, and lay midwives. CPMs aren’t required to have a nursing degree. They train through accredited midwifery schools and apprenticeship programs. Lay midwives, also called traditional midwives, are not certified and typically train through apprenticeships.
A Nebraska Supreme Court ruling in 2024 closed the loophole, ruling midwives can’t practice without a license, but the decision was reversed in 2025. Both CNMs and CPMs in the state are advocating to remove restrictions from the practice. Krueger said she knows of unlicensed midwives who were prosecuted for attending home births. She said this forces midwives to go “underground,” which she thinks makes out-of-hospital birth in the state more dangerous.
“We’re kind of forced to either choose an underground midwife and really keep quiet about it because it’s not like we can crowdsource for opinions or experiences because then we’re putting her name out there and that’s a huge risk to her,” she said. “Or we’re forced to give birth without a midwife.”
In 2023, after Krueger dismissed her midwife, she gave birth to Callahan in her living room with her mom, mother-in-law, friend, son, husband and a photographer in attendance. She said the labor was a lot shorter than her first birth.
“My second birth was like the most perfect birth,” Krueger said. “If I could give birth and I knew that it was going to go like that every time, I would have 10 kids.”
This year, Krueger had her second free birth with the arrival of her daughter, Aurora, in April. She said it was not as smooth as her first free birth. Krueger said from the start of her pregnancy, she sensed it was going to be a difficult labor.
“I actually went back and forth about maybe I just needed to be at the hospital, but I felt so unsafe with the idea of going to the hospital,” she said.
Krueger said she was afraid she’d be pushed into unwanted interventions or touched without her consent in the hospital. She said a traumatic experience as a child makes her uncomfortable with being touched without notice.
The labor was long and painful. Krueger suspected Aurora was face-up, which typically leads to a more difficult labor. She said she went to the hospital to make sure the baby was OK and that she was progressing. The doctors confirmed the baby was face-up and strongly recommended Krueger stay at the hospital given how far into labor she was.
But Kreuger returned home after signing an Against Medical Advice form that hospitals ask patients to sign if they choose to leave the facility before they’re cleared to. When the baby finally crowned, her cord was wrapped around her neck. Krueger said she lifted it over Aurora’s head, and then she was born.
According to the Cleveland Clinic, an umbilical cord wrapped around a baby’s neck (also called a “nuchal cord”) rarely causes complications but needs to be removed during delivery so the baby doesn’t lose oxygen or blood supply. Krueger said she was ready for this scenario, as well as several others.
“I did a lot of planning for emergencies with her. I made my husband watch specific videos,” she said.
Krueger said she and her husband learned from a respiratory therapist how to revive a newborn and discussed what would constitute calling an ambulance to transport them to the local hospital a few blocks away. Krueger said her role as a birth worker and the dozens of births she’s attended also helped her prepare.
But Caitlin Linscheid, the Kansas City-area OB-GYN, said regardless of how much a person plans, birth can be unpredictable. She said obstetric emergencies can happen quickly and sometimes need immediate intervention to save the baby and mother’s lives.
“Even though it's a natural process (birth), it doesn't always go smoothly, it doesn't always go well,” Linscheid said. “I think because interventions happen in a hospital, it's tempting to think that the hospital caused it. But I think in a lot of these cases, there was something else at play that was beyond either the hospital or the doctor or the patient.”
Linscheid said her own birth story is the reason she decided to become an OB-GYN. After moving to a new state, her parents couldn’t find a hospital provider they were comfortable with, she said.
“My mom talks about meeting a series of physicians who didn’t listen to her, who talked down to her, and ultimately in her attempt to take the best care of herself and of me, she decided to have a home birth with a midwife,” she said.
Linscheid said the midwife her mother hired was not medically trained (these are called lay midwives). Her mom had a long labor and ended up hemorrhaging. Linscheid said her mom recovered.
But she said her birth story stuck with her.
“I found myself really wanting to be the doctor that she should have had access to,” Linscheid said. “As OB-GYNs, historically, we haven’t listened to our patients and we haven’t given them the space and the respect that they deserve. We need to own that and reflect on how we ended up losing our way.”
Linscheid said in her own practice, she uses a trauma-informed approach and treats patients like experts on their own lived experiences. She said sometimes when people don’t feel listened to or respected by doctors, they look for care outside of the medical system.
Judgment faced by people who free birth
For Krueger and others who chose free birth, judgment from others is part of it. Krueger said people often automatically assume that parents are being reckless and putting their children’s lives in danger.
“But they have not witnessed the things that many of us have witnessed, especially birthworkers, when you’re getting care at the hospital or from a midwife,” Krueger said. “And not to say that those providers are doing anything wrong or bad, but the stories in hospitals of things going wrong are often glossed over.”
Krueger said people also often assume that people who give birth unassisted refuse all medical care, even in life-threatening situations. Krueger said this isn’t true. She said many people who free birth, herself included, receive prenatal care and would go to the emergency room if they needed to.
“There’s nobody in this situation in a birth at all who cares more about the outcome of the birth than the mother,” Krueger said. “If a mom is choosing unassisted birth, it’s because they truly think that that is the safest route for them and their baby.”
Chalé’s story
Chalé Turner agrees with Krueger. She said many of the women she knows who give birth without a medical professional are highly educated.
“For me a free birth is a woman taking that ultimate control and autonomy over her birth,” she said. “That doesn’t mean that they’re not going to seek assistance, it doesn’t mean that they’re just like, ‘I’m staying home, no matter what.’”
Turner lives in Topeka, Kansas, with her five young children. She gave birth to four of them unassisted. She said she always knew she wanted to give birth at home because her grandfather was born at home (her own mom couldn’t have a home birth because of underlying health issues). Turner had her first child, a boy named Sadrien, in 2016.
“We had the midwife, the doula, like the whole 9 yards. And it was a really great experience,” she said. “I had a very low-risk, non-complicated pregnancy.”
Turner learned about unassisted birth from her doula. She said her doula gave birth to her own kids unassisted.
“I started deep-diving into free birth with my second pregnancy and I just couldn’t get enough after that, I guess,” she said.
Turner gave birth to her second baby, a girl named Soraya, at home unassisted. She said the baby came really fast.
“I experienced more like early labor or prodromal labor over days and weeks and then all of a sudden, I’m in active labor and there’s a baby,” she said. “So that’s really fun. But also kind of part of my decision to stay home.”
For Turner, her identity also played a role in her decision to give birth unassisted. Turner’s father is Black and her mother is white and Ojibwe.
“My weariness of hospitals and the medical system doesn’t come from nowhere,” Turner said. “It comes from being a person of color, from being a Black person and having very Black parent, you know, a Black father and very proud Black grandparents who saw the Civil Rights Movement.”
Turner said in her mom’s indigenous culture, birth is viewed as a ceremony. She said free birth to her is a way of honoring that.
“For me it’s a way to protect them (the baby) and an act of love,” Turner said. “A family member being the first hands to touch them and care for them is really important to me.”
Turner runs a Facebook page for people in Kansas who are considering or chose free birth. She also works as a postpartum doula and is working toward becoming an International Board Certified Lactation Consultant.
Turner said she never pushes anyone to have an unassisted birth.
“I can only share my experience or kind of point you in the right direction,” she said. “I could never give you that answer. I’m like, ‘Only you can answer that question.’”
Turner said preparing for a free birth safely takes a lot of work. She said she spent months preparing for her births and creating safety plans — and that’s not something someone wanting a free birth should outsource.
Turner said in recent years, she’s seen disturbing content from influencers promoting free birth. Turner was part of the Free Birth Society Facebook page, a group exposed by the Guardian for its connection to multiple infant deaths worldwide.
Turner said she saw in real time members from the group advising a pregnant person who needed emergency medical care to stay home. She said she believes the woman’s baby was later stillborn.
Turner said groups like the Free Birth Society (which is still active, though the original Facebook page was shut down), stigmatize unassisted birth and can be a dangerous influence on women considering giving birth without a medical professional.
“I’ve kind of shied away from saying I’m like a free birth advocate. Because it’s not for everyone and I don’t think it should be for everyone,” she said. “Everybody is different and unique and special, and their circumstances are different.”
Free birth and social media
Even with preparation, free births can be disastrous. Australian wellness influencer Stacey Warnecke died last September after giving birth at home without the assistance of a medical professional. She hemorrhaged, and according to an inquest into the death, Warnecke declined an ambulance twice before agreeing to one.
Emily Lal, a woman connected to the Free Birth Society attended the birth as a “birth keeper.” Birth keepers are unregulated birth workers who do not have medical training.
And for families who don’t prepare, risks are even higher. In 2020 and 2022, two Iowa couples were charged in connection to the deaths of their newborns. Both babies were born at home unassisted, and both families reportedly avoided medical care because of substance use issues.
This type of unassisted birth adds to the stigma other mothers are trying to dispel.
In Nebraska, influencer Abbey Khopesh abundantly posts content about her free births to her thousands of followers. Khopesh gave birth to both of her children unassisted and did not receive prenatal care. Her most recent birth, a boy, was born last month. She posted updates leading up to the birth.
Khopesh received a lot of criticism online. Despite her content about the advantages of unassisted and out-of-hospital birth, Khopesh said in multiple posts that she does not recommend free birth for other women.
In an Aug. 19 Instagram post, she said she believes every woman is capable by design to give birth unassisted. But Khopesh said it's "not for the faint of heart."
“You’re throwing all of your cards to the gods,” Khopesh said. “I am not trying to discourage women from doing this. I love to see it. But I’m also not going to sit here and advocate that everybody can and should do it.”
Destiny’s story
Destiny Abercrombie, who lives in Kansas City, Missouri, is training to be a birth assistant with a local home birth midwife and works as a certified lactation counselor. She had an unassisted birth a couple of years ago with her son.
Abercrombie said she does not recommend free birth to her clients. “I don’t suggest it at all because I feel like if it’s not like a conviction, like if you don’t feel called to do it, just go to the hospital or call a midwife, please,” Abercrombie said. “It’s not for everybody.”
Abercrombie has four children. Her first, a boy, was born in a hospital. She said the birth was overall pretty smooth, but she was induced and felt pressured into getting an epidural — interventions she didn’t want.
“I had a birth plan that they said they would follow, but they really ignored,” Abercrombie said. “But ultimately, I would say for a hospital birth, it was a fair experience.”
For her second son, Abercrombie gave birth in a hospital birth center with the help of a certified nurse midwife. Hospital-affiliated birth centers are typically staffed by CNMs and offer a more home-like experience. The one Abercrombie gave birth in closed last year. Abercrombie said that after the birth, she felt uncomfortable because the room was very cold, and doctors and nurses kept coming in. For her third baby, a girl, she opted for a home birth with a midwife. She said it went well.
When Abercrombie became pregnant with her last child, another boy, her life was different. She was going through a divorce. Abercrombie said she couldn’t afford a midwife for a home birth, so she considered returning to the hospital birth center.
“I really felt like I was selling myself short,” she said. “I felt like I was really just relinquishing all the power that I could have.”
Abercrombie opted for a free birth. She said she researched and prepared a lot, including learning how to resuscitate a newborn. Her mom, two of her sisters and a close friend attended the birth. Abercrombie said it went smoothly until it was time to deliver the placenta. She said she couldn’t deliver it, and she started to hemorrhage. Abercrombie instructed her family to call 911 and then passed out.
After treatment and a brief hospital stay, Abercrombie made a full recovery. But she said if she would’ve listened to the advice in Facebook groups advocating for free birth, things may have been different.
“Had I not done as much research, had I never been to a birth, if I didn’t feel like I had the capacity to recognize when it’s time to transfer and things like that, it could have ended a lot worse,” Abercrombie said.
Abercrombie is a Black woman, and she said while her race didn’t play a role in her decision to free birth, it did play a role in how she approached all of her births.
“I think being Black changes the way the medical system interacts with me,” she said. “Being Black definitely played a part in how I chose all of my births.”
Abercrombie said for her free birth, she was careful to get prenatal care and document all of it, so she wasn’t flagged for being medically negligent. She said she took her youngest son to a children’s hospital shortly after birth to check out a possible infection. The hospital started administering antibiotics before test results were available, she said, and she asked a doctor why.
Abercrombie said the doctor reported her to Child Protective Services. She said she felt like her race played a role in that call.
“I absolutely had no control in that situation,” she said. “So that’s kind of where it was like, I want to avoid the hospital because I wanted to avoid that.”
Abercrombie said racial disparities are one reason she is pursuing a career as a birth worker. According to the Centers for Disease Control and Prevention, maternal mortality rates for Black women are 3.5 times higher than for white women.
“As much as birth does need to be reformed in the states, the solution is not free birth,” she said. “I think the solution would be more education.”
Tara’s story
Tara Webber gave birth unassisted in August. Webber and her partner, Kyle Baker, live in Sioux City, Iowa. Webber said she was born at home with a midwife.
“I watched my birth video and kind of looked up to that my whole life,” she said. “I really wanted to do a water birth specifically, but I also wanted the comfort of my own home and not to be rushed around a hospital and told that I have to stay at a hospital with my newborn.”
But Webber, 20, said she couldn’t find a midwife who would help with a home birth in her area. Her next plan was to go to a freestanding birth center, but the nearest one was almost an hour away. She said she ended up deciding against the birth center because of the long drive and because it was cost-prohibitive.
“I couldn’t imagine doing contractions in the car for 45 minutes when our hospital, if I really need anything, is 10 minutes away,” Webber said.
Webber said she was wary of a hospital birth because of bad experiences she had with a previous health issue. She said she wouldn’t be opposed to it if there was a medical reason she needed to deliver in a hospital, but because her pregnancy was healthy and uncomplicated, she felt comfortable giving birth at home.
Ultimately, Webber and Baker decided she would get prenatal care at a clinic and then hire a doula and have a home birth. Because doulas are not medical professionals, some people who chose to free birth still enlist the help of a doula.
Baker said that, at first, he was scared by the prospect of Webber having their baby at home without a midwife present.
“I’ve never had a baby myself and I haven’t really seen too many births,” he said.
After a long labor and a trip to the emergency room to see how she was progressing, Webber got the water birth at home that she wanted. Webber’s mom flew in from California, and the couple said her support and the doula’s support enabled them to have a home birth.
After the birth, Webber said, she struggled to birth the placenta and lost a lot of blood. She asked the doula to pull the placenta out.
“I can't do it myself, and I'm not going to the hospital just for this,” Webber said.
Webber said it took about two hours to deliver the placenta. Medical professionals recommend the placenta is delivered 30 minutes to an hour post-birth.
Webber said she ended up being OK and going to the hospital later to have herself and the baby evaluated.
“While it doesn’t give me a peace of mind to be surrounded by doctors and to be in a medical setting, it still gives me a peace of mind to have medical access and to have somebody that knows medicine to tell me that everything's going all right,” Webber said.
Webber said she would free birth again, but she would prefer a midwife the next time.
“A midwife would definitely ease my peace of mind, but I would do an unassisted birth with a doula again,” she said.
Baker said he sees both sides of the free birth debate.
“I think the main thing is, unassisted births are scary but they’re great. But you definitely want a support system around you,” Baker said. “I couldn’t imagine doing it without any family or without a doula or anybody.”
In Dr. Linscheid’s view, the hospital is the safest place to give birth.
Linscheid said in parts of Europe, it’s common for medically trained midwives to attend home births. But she said the U.S. doesn’t have the same access to specialized hospitals for transfers and training and support for midwives.
“So I hesitate to endorse a home birth, whether it be unassisted or assisted, just because we don’t have the infrastructure to make sure that that’s a safe option for patients,” she said. “When emergencies do happen, they happen quickly and they can be truly catastrophic.”
But Linscheid said doctors need to get better at listening to women and their birth plans.
“Because they want to feel empowered and they want to feel heard,” Linscheid said. “And I think it’s 100% possible to feel empowered, heard, autonomous and strong in a hospital setting, but that requires that we as providers show up and are committed to making that a reality.”
What the data says
Free birth is hard to track. There are no clear numbers from health officials. Unassisted birth happens accidentally sometimes, like when a person gives birth on the way to the hospital. And health officials do not track whether a home birth was intentional or attended by a medical professional.
Home births in general, however, are easier to collect data on. According to a release from the CDC, home births reached the highest level since at least 1990 in 2021, rising by 12 percentage points to 51,642.
The Midwest Newsroom is an enterprise journalism collaboration that includes Iowa Public Radio, KCUR, Nebraska Public Media, St. Louis Public Radio and NPR. There are many ways you can contact us with story ideas and leads, and you can find that information here. The Midwest Newsroom is a partner of The Trust Project. We invite you to review our ethics and practices here.
METHODOLOGY
Journalist Bek Shackelford-Nwanganga visited four Midwest mothers who chose free births for their deliveries: Natalie Krueger of Osmond, Nebraska; Chalé Turner of Topeka, Kansas; Destiny Abercrombie, of Kansas City, Missouri; and a 20-year-old woman from Sioux City, Iowa. Shackelford-Nwanganga also interviewed Dr. Caitlin Linscheid, an OB-GYN in the Kansas City area. She reviewed data about home birth and consulted other media reports about free birth.
REFERENCES
Nowhere to Go: Maternity Care Deserts Across the U.S., 2026 Report (March of Dimes | August 2026)
Three Nebraska Mothers challenge state’s restrictions on midwife-assisted home births (Nebraska Examiner | June 30, 2026)
Home Birth Blues: 49 states allow nurse midwives to deliver your baby inside your home. Not Nebraska (Nebraska Public Media/Flatwater Free Press | June 20, 2026)
Nebraska Supreme Court reverses ruling on credentialing for nurse midwives (Omaha World Herald | Updated Oct. 12, 2025)
Nuchal Cord (Cleveland Clinic | Updated Jan. 23, 2025)
The Birth Keepers: how the Free Birth Society is linked to baby deaths around the world - video (The Guardian | Dec. 11, 2025)
Home Births in the U.S. Increase to Highest Level in 30 Years (Centers for Disease Control and Prevention | Nov. 17, 2022)
National Vital Statistics Report: Changes in Home Births by Race and Hispanic Origin and State of Residence of Mother: United States, 2019-2020 and 2020-2021 (Centers for Disease Control and Prevention| Nov. 17, 2022)
What is Trauma-Informed Care? (Trauma-Informed Care Implementation Resource Center)
Maternal Mortality Rates in the United States, 2023 (Centers for Disease Control and Prevention, National Center for Health Statistics | Feb. 2025)
Placenta Delivery: What to Expect (Healthline)
Melbourne wellness influencer found short of breath and clammy after free birth hours before death (The Guardian | June 15, 2026)
Encompass Farming (Instagram profile)
Encompass Farming (Instagram post | Aug. 19, 2026)
TYPE OF ARTICLE
Enterprise — An in-depth examination of a single subject requiring extensive research and resources.
