04/18/2026
Trigger warning.
I am not a doula who will work with a person planning a free birth. Not even women in the 1800s did this primal act alone and it's simply misguided at best (negligent at worst) to choose to birth unattended. I say this as someone who very much wanted a birth center birth, but who had an unattended car birth in my driveway.
I would be remiss if I didn't comment on the fact that the reason the free birth society exists is because of the trauma, violence, and harm that exists in obstetrics- in birthing within the system. Indeed, when women feel like they've run out of options, they do desperate things.
The Pitt gets a lot of things right (and misses some things too), and I'm grateful as a show, that it is bringing more attention to diagnoses like HELLP syndrome and preeclampsia.
I remember one of the first things I watched after I supported a stillbirth delivery was an episode of Mad Man with a throw away line about having to present an ad campaign knowing they didn't get the job ("we have to deliver a stillborn baby.") I'm positive whoever wrote that line thought it was provocative. But it was disturbing to hear it said so flipplantly and I doubt very much who wrote it ever went through a stillbirth. Maybe it is fate that I watched The Pitt episode today (4/18) because that falls on the anniversary of a loved baby lost in 2024, so I'm hypersensitive to it.
Media gets so many things wrong about loss and birth trauma. I'm glad The Pitt has opened up discussion about these important issues & exposes the free birth society for the harm it has (and continues to) cause(d).
Last night, as I got excited to finish up this season on the Pitt, I also had a knot in my stomach because there was a pregnant woman in the episode trailer.
I knew it could go poorly, but I had no idea I would be watching one of the closest scenes to my birth experience.
Perimortem csection/resusitative hysterotomy, baby is born blue but able to be quickly resuscitated.
It all happened to quickly, but it was like I was watching the choas of the birth I never got to see, unfold in front of me.
If you had a strong reaction to this episode, I promise you are not alone in that. If you had to turn it off or are choosing to skip this episode after hearing about it, those are all valid choices to protect your well-being.
I have such mixed feelings about it as I often do with birth trauma in the media. I understand the activation it can cause, and I also love to see the representation. I appreciate our experiences being out in the world and raising awareness for things like HELLP and maternal cardiac arrest, and I also know there is a cost to that. The cost often falls at our feet as birth trauma survivors. Our favorite shows feel difficult or impossible to watch at times. We end our night tossing and turning through nightmares. It’s so hard, and yet, I want the world to see it. I want awareness of these rare conditions and complications to continue to be raised so that teams are as well prepared as possible.
I’ve heard from L&D friends about the medical inaccuracies, and while that’s disappointing for a show that usually gets it right, I also want to highlight what it got right. As a maternal cardiac arrest survivor, two things: the 4-minute rule and the term “resuscitative hysterotomy.” The 4-minute rule means if a pregnant patient is in cardiac arrest and not resuscitated, delivery should happen within 4 minutes, not just for the baby, but for the patient. That’s exactly why the terminology has shifted to “resuscitative hysterotomy,” to better reflect its purpose.
There’s a lot more to discuss, like the nuance around why a patient might choose no medical care and how the team handled the free birth conversation, but that will be for another post!
