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WHEN ADAM BOYLE got a phone call from his father to say that his sister Naomi had been taken to hospital following complications during her home birth, he somehow knew that the worst was going to happen.
Adam was in Atlanta, USA, where he and his parents now live, but his sister was back in Co Louth, where they had both grown up, and where she lived with her husband and their three kids.
Atlanta is five hours behind. Adam and his older sister are just 15 months apart in age, and he was used to speaking to her early in the morning. Despite the time difference and being on other sides of the world, they stayed incredibly close.
On that morning when he got the first call from his father, he tried to reassure his dad that it would be OK, but inside, he believed it wasn’t going to be.
“That was the worst day. I hope we never experience a worse day than that,”Adam said.
“I remember it was a Sunday morning, and I had the kids. I had told my wife, ‘Hey, you get a little bit of extra sleep’. Initially when I hung up the phone, on the outside I was calm because I was with my children, but it felt like all the blood was draining from my body.
“I did not want myself to believe the worst, I remember telling myself ‘I’m just going to sit this out.’
“As time went on my dad called a second time and told me things had not gotten better. I woke my wife up, and then it was just an awful hour until we got the news, and every moment after that has been truly horrendous.”
Naomi James died at the age of 38 following a ‘free birth’ at home, with no healthcare professional present. The nature of her death was reported on by The Journal at the time.
She had been advised by local hospital staff that it would not be safe for her to have her baby at home, but she wanted to ensure that she could have a vaginal birth after undergoing c-sections with her first daughter, and her twins.
Her first birth had been particularly traumatic for her, her brother says, as she had questioned decisions made around her being induced, and the labour she went through following the induction.
Naomi had engaged with home birth services while pregnant, and been advised that the risk of a home birth was too high for her due to her previous caesareans.
It’s understood that she was offered a safe trial of labour, which is when a woman who has previously had a caesarean and who wants to have a vaginal birth is allowed to go through labour in a controlled and monitored hospital environment.
During the course of her third pregnancy, Adam got some sense that Naomi was engaged in online discourse about giving birth in a non-traditional way, and that she was following influencers who advocated for birthing somewhat outside of the medical system.
Still, when she went into labour, he was under the impression that she’d have a midwife with her.
Later, when he learned more about the online free birth community, he learned that keeping your birthing plan and the choice to go without medical support private is part of the teachings that self-appointed experts give to women like Naomi, who have had difficult in-hospital birthing experiences.
He also discovered that many of those people, including the ones that Naomi interacted with, profited off selling those ideas to women.
“As far back as 2020 it was clear to me that Naomi’s thinking on healthcare provision had started to shift in what I thought was a dangerous direction. Naomi and I had multiple debates on the phone, like a lot of siblings with differing views would, but the thing is, Naomi and I never fell out,” he said.
The Journal has reported on the rise of free births in Ireland, and how online influencers are making a profit from the movement.
Adam added that in his view, his sister’s difficult birthing experience made her susceptible to online misinformation.
“I think her experience in the hospital of birth made her open to information online and that ultimately became confirmation bias.
“She wanted to be able to go in that direction, she wanted to be able to give birth according to her preference. She was more open to people who agreed with her or who presented, and even manipulated facts in a way that confirmed the views she already held,” he said.
Last year The Journal traced some of Naomi’s online activity in the free birth world, and spoke to the Northern Ireland-based doula who assisted Naomi during her pregnancy, led a retreat for expecting mothers that Naomi attended, and who was present when Naomi gave birth to her little boy last summer.
Her son survived, but despite the best efforts of staff in the hospital, Naomi died of Post-partum Haemorrhage in the hospital.
In October of 2023, she had written in a Facebook group: “Trigger warning; controversial topic. Hi, just wondering if anyone has experienced a freebirth or doula only assisted vbac? If so, what was your experience like?”.
Someone replied and told her that free-birthing is increasingly common in Ireland but mostly underground, and that it’s hard to find people who will talk openly about it.
“Are you in any of the Freebirth Facebook groups?”, the person said. Naomi replied that she wasn’t, and in turn she was given directions on how to join.
The doula who was present for Naomi’s birth also played a role in connecting her with the work of key influencers in the freebirthing movement.
This includes those who espouse views about the “medical system” that are plainly incorrect, including the view that Post-partum Haemorrhage, the condition that led to Naomi’s death, is largely a hospital-created phenomenon, and unlikely to happen if you give birth at home, the “natural” way.
“Definitely one to listen to,” Naomi’s doula commented under a post from self-styled ‘radical birthkeeper’ Emiliee Saldaya, the founder of the US-based Free Birth Society.
In that post, Saldaya wrote that after 20 years of ‘birth work’ she wanted to make women “unafraid” of haemorrhage, that it is “completely normal” and that it can be “resolved from home”.
No medical professional working in maternal care would ever give a woman that advice.
When The Journal contacted the doula who assisted Naomi last summer, she gave a statement that said:
“This is a very distressing time for all involved. Naomi was an absolutely sensational woman and birthed her baby boy with incredible power. I won’t be making any comment or confirming any details that Naomi’s family haven’t made public,” she said.
Adam does not blame any one influencer, or individual, for what happened to his sister. By speaking about her experience, and his family’s experience of losing her, he has two chief hopes.
Firstly, he wants to make women who have been advised against homebirth to think twice about going it alone.
Secondly, he wants the healthcare system to engage further with women who have had difficult births – to make efforts to reassure them that their next birth in hospital can be different.
It’s not just that the freebirth movement and those who profit off it need to be challenged, Adam argues: mainstream birth services need to be improved, to make sure women aren’t vulnerable to these other influences.
After Naomi’s death, the doula she worked with and the online influencers who engaged with her and were aware of the outcome for her did not post online about her.
In freebirth circles, generally, you will not find obituary posts for those who don’t make it past birth.
“I think it’s tragic that people only want to share what they believe are affirming success stories of their way of thinking and their way of working, ones that benefit them,” Adam said.
“I wish there was more transparency with sharing the negative outcomes. They don’t share them unless they have to.
“For example, Saldaya shared the news of her stillbirth, which is very sad, online after she’d shared her pregnancy journey, but how many other women have had stillbirths because they’ve opted out of any and all medical assistance during pregnancy on foot of her advice? Do we ever hear about those women?” he said.
Saldaya wasn’t involved in Naomi’s birth plan and did not have any interaction with her directly.
Adam is all too aware that he’s trying to spread this message at a time when world governments have taken positions that are anti-expert medical advice, including the Trump administration.
“There are some women in these influencer positions who have a large audience, and they are profiting from vulnerable mothers.
“The more convinced you sound, the more people will believe you. We’ve seen that in multiple spheres of influence, and it is no different in the anti-medical world,” he said.
A year and a half on from his sister’s death, Adam is focused on supporting his parents, and his brother-in-law, who he says has been an unbelievable father to his and Naomi’s four children in what is the darkest of times.
“The way he has stepped in to provide double the care that his kids need is absolutely remarkable. In the midst of an incredible tragedy, the family could be doing so much worse than it is currently doing, because those kids really, truly, have an incredible dad,” Adam said.
He often feels the absence of his sister. He misses their frequent phonecalls from other sides of the world; he still copies links from articles or posts online that he sees, thinking she’ll be interested.
When he goes to send them to her, he realises all over again, “She’s gone”.
“I think that’s a normal part of grief. I think everyone must experience that. But sometimes, I’m driving, and for no reason at all – nothing triggers it – it strikes me. Boom, it hits you. And it’s like a shock that I feel in my entire body, for like maybe, ten seconds.
“Those moments are hard. And it’s not thinking about the memories, because the memories are good, right? It’s thinking about all the future moments I thought would happen. I think my birthday was difficult because I turned 39, and for the first time, I reached an age that my older sister never got to.
“It’s that kind of thing. It’s that we always thought eventually, we’d live close and our children would live next to each other, it’s those things,” Adam said.
Most of all, it’s the fact that Naomi’s children, who she loved so much, and his own children, won’t have her presence, her love and her affirmation going forward.
Naomi was a keen photographer, she was amazing at organising events, and she was good at seeing people for who they were.
“She loved concerts, we have a really large extended family, and she took many of our cousins to their first big concerts, she’d pay for everything, she loved doing special things for people.
“It was that ability to connect that made her a really talented photographer too,” he said.
“We don’t know that her death was totally avoidable. But we know that if she had been in hospital when she gave birth, the chances of her dying as a result of haemorrhage would have been dramatically reduced. And that’s something that other people should know too.”
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