‘She was like a deer in headlights’: how unskilled radical birthkeepers took hold in Canada
When the holistic practitioner Emma Cardinal, 32, became pregnant in May 2023, she planned to have a home birth with midwives. Cardinal lives in a town in British Columbia with strong counter-cultural roots. “The community that I live in, home birth is something a lot of women prioritise,” she explains. Then Cardinal stumbled across a podcast from the Free Birth Society (FBS). One episode in particular, she says, made an impact: “Unpacking Ultrasound With Yolande Clark.” In it, the Canadian ex-doula Yolande Norris-Clark falsely links ultrasounds to autism and ADHD and states that “ultrasound damages and modifies and destroys cells”.
Norris-Clark, who was born in Vancouver, is arguably the most famous freebirth influencer in the world. She is also a key figure in FBS, a US company run by her business partner and fellow ex-doula Emilee Saldaya. FBS, which promotes an extreme version of free birth in which women abandon any form of prenatal care and give birth without doctors or midwives present, is estimated to have generated more than $13m in revenues since 2018. A recent Guardian investigation identified 48 cases of late-term stillbirths or neonatal deaths or other forms of serious harm involving mothers or birth attendants who appear to be linked to FBS. The intellectual heft behind FBS, Norris-Clark shaped the organisation’s radical position on birth, while Saldaya, its founder, runs the business. Most women find FBS through its Instagram account, which has 132,000 followers, or podcast, which has been downloaded 5m times. But Norris-Clark is a significant social media influencer in her own right, pioneering a radical version of free birth that concerns even pro-freebirth advocates.
After listening to the podcast about ultrasounds, Cardinal was alarmed. “I was petrified of miscarriage and stillbirth,” she says, explaining that her younger brother was stillborn. “There’s not a chance I’m risking that.” Cardinal came to believe ultrasounds “aren’t super safe for the baby”. At that stage, Cardinal had not yet decided to freebirth. She phoned a local midwifery practice and explained that she wanted a home birth, but did not want to have any ultrasounds during her pregnancy. But the receptionist, Cardinal recalls, said that if she wanted to give birth with them, ultrasounds were non-negotiable. Cardinal thought about it, and decided she was not comfortable proceeding. Instead, after listening to about 100 episodes of the FBS podcast, Cardinal decided to freebirth. In one journal entry, she wrote: “I know it in my bones that freebirthing is my safest and most liberated option.” She purchased FBS’s popular video course, “The Complete Guide to Freebirth”. Cardinal’s son Floyd was stillborn in March 2024. During labour Cardinal saw meconium in her waters, a possible sign of distress, but dismissed it because “I was told by FBS that meconium is totally normal”. She stayed home for three days, because “I remember hearing Emilee Saldaya’s voice in my head [from the podcasts], saying: ‘I wouldn’t be concerned for the first three days.’” After Floyd died, Cardinal was hospitalised with sepsis and placed in an induced coma. She has had a number of surgeries to repair the damage from his birth, and had to wear an ostomy bag for a time. “I didn’t think that could even be a reality that could happen after birth,” she says. “I almost had to have a hysterectomy.”
Looking back, Cardinal believes that much of the information she received from FBS was “incomplete, biased, one-sided and kind of dogmatic”. This includes the information she received on ultrasounds, which are not harmful to unborn babies when used appropriately. She adds: “You can’t just post about the good side of free birth. What happens when it goes very wrong?” Norris-Clark has not responded to repeated requests for comment about the Guardian’s investigation, which is told through The Birth Keepers podcast series. She has previously defended her partnership with Saldaya, saying FBS is “the most ethical kind of business you can run”. Critics of FBS, she has said, fail to understand the commitment to women taking “radical responsibility” for their births. And she has said it is unfair to hold her responsible for the choices of a mother who consumes her content. However the spotlight on tragedies involving mothers around the world who consumed FBS content is posing a crisis for the business. Saldaya has also not provided a substantive response to requests for comment, but told the Guardian in one email that “some of these allegations are false or defamatory”. She has previously responded to criticism by saying she does not care if women freebirth, but wants them to have the choice. In recent comments to her followers, she described the Guardian’s reporting as “propaganda” based on “lies”, and suggested her work, words and character had been misrepresented by “twisted, dark attacks”.
Cardinal is not the only Canadian woman to lose their child after an FBS-influenced free birth. Although Canada has universal healthcare, it is a sparsely populated country, with large “midwifery deserts”. Alternative communities can be sceptical of licensed professionals. As in other parts of the world, FBS messaging often resonates with women who have had traumatic experiences of maternity services or unnecessary medical interventions. The Covid pandemic also eroded many women’s trust in the medical establishment. Not all of the women who want to avoid licensed providers are ready to freebirth. Some turn to unlicensed attendants, believing they offer their best chance to avoid hospital for their birth. Canada has a community of unlicensed birth attendants, in part due to the historic status of midwifery in the nation. Unlike other countries with strong cultures of midwifery, such as the Netherlands and Denmark, Canada has lagged behind other developed nations when it comes to recognising midwifery. Midwives and their clients can sometimes encounter scepticism, or even hostility, from healthcare professionals. It is in this context that women turn to unlicensed attendants, some of whom, while unregulated, are skilled and experienced underground midwives. But others – such as those who enrolled only in a brief online FBS course – have limited or no experience of births, and no adequate skills for managing potential emergencies. ‘I actually don’t believe gravity is true’ The most popular of FBS’s schools, the Radical Birthkeeper School, has trained 850 “authentic midwives” from more than 30 countries. On its three-month Zoom course, only about half the content deals with birth, and the rest focuses on self-development and business skills. There are at least 22 FBS-accredited birth keepers in Canada, according to an online directory seen by the Guardian. FBS advises its radical birth keepers – or RBKs – to get out in the world and begin attending births. “The very best way to learn how to do midwifery is by doing midwifery,” Saldaya told her RBK students in 2025. Many have since set up their own businesses supporting women during their free births. Alexandra Smith, 29, a life coach who hired an FBS-trained RBK for her birth, is from Vancouver Island. “It’s a different way of thinking out here. People prefer to be off grid,” Smith explains. “It’s a holistic space, with lots of hippies, everyone is about free birth and Waldorf education.” Norris-Clark, she adds, is “very popular where I live”. She says women in her area see Norris-Clark as the “founding mother” of free birth, who has “brought a solution to systemic problems” in Canada. During her pregnancy, Smith says, she listened to the FBS podcast regularly, sometimes multiple episodes a day, and that she found Norris-Clark particularly captivating. Were it not for FBS, she says, she would have had a home birth with a midwife.
Many of the women who follow Norris-Clark on social media, seeking advice in their pregnancies, are unaware of her more extreme views, which she sometimes revealed to FBS students. “I actually don’t believe that gravity is true,” she told FBS students in 2024, adding: “Maybe that just makes me crazy and that’s totally OK.” In another class, she told students they could cut a baby’s umbilical cord with an “old rusty fork”. “I don’t believe in germ theory,” she said, “I don’t believe in contagion,” adding: “But even if contagion were real … there would be a pretty much 0% chance of anything happening.” Such radical beliefs are not part of FBS’s slick advertising and promotional materials. Smith says she believed, based on FBS marketing, that RBKs were “trained, unregistered midwives”. “I feel like I was falsely advertised to,” she says. (Others have made similar complaints about FBS. Earlier this year a lawyer for FBS responded to a consumer protection complaint filed in North Carolina alleging a course was mis-sold by stating that the company had always been transparent that it was offering “personal development and sovereign-birth related education” rather than certified midwifery training.) The RBK who Smith hired to attend her during her free birth was in her mid-20s. In a video testimonial she filmed for the RBK school, which had been available online until recently, she said the school “wasn’t your typical school in that it provides hard facts, information, data, and all of that stuff. It was different in that what I gained from the experience was this deep trust in birth, the deep sense of knowing that birth unfolds beautifully if we just step out of the way.” When it came to the birth, Smith alleges her RBK was woefully underprepared and “like a deer in headlights”. The RBK, Smith says, missed signs her labour was unfolding abnormally. When Smith’s son Aksel was born on 7 May 2023, his umbilical cord was white, and he was floppy and unresponsive. The RBK, she says, did not attempt to resuscitate the baby, and Smith had to tell her to call 911. Aksel was rushed to hospital, and diagnosed with severe hypoxic-ischaemic encephalopathy due to oxygen deprivation caused by a placental abruption at his birth. The RBK has not responded to requests for comment. Legal cases and public warnings As unlicensed attendants, including those trained by FBS, proliferate across Canada, the authorities are seeking to clamp down on the practice. On Vancouver Island, Canada’s most famous unlicensed birth attendant, Gloria Lemay, 78, is awaiting trial for manslaughter after a girl died 10 days after her birth, which Lemay attended, in January 2024. It is her latest legal battle in a near five-decade long career. In 1986, Lemay was convicted of criminal negligence causing death after a baby was born dead at a birth she attended, although she was later acquitted, with the supreme court upholding a lower court’s judgment that a child that is not yet born cannot be considered a person. Four years later, after a baby boy died of an infection three days after a birth attended by Lemay, she was fined $1,000 for refusing to answer questions at the inquest. In 2002, Lemay was found in contempt of an order prohibiting her from acting as a midwife. She was arrested in relation to the most recent case in January 2025. A case management conference is scheduled for January 2026. Lemay declined to comment on her upcoming trial, but it is understood she plans to contest the charges and plead not guilty.
Norris-Clark always credits Lemay with inspiring her lifelong passion for birth. Lemay attended Norris-Clark’s first two births, and trained her as a doula. However those familiar with both women’s careers say Norris-Clark’s views on birth are more extreme than those of her one-time mentor. Lemay remains a highly divisive figure. Viewed by some in the medical establishment as a dangerous charlatan, she is equally beloved by many in the birth world, who regard her as a folk hero comparable to the legendary US midwife Ina May Gaskin. The Birth Care Alliance, a campaign to counter what it says is the “systemic overreach into birth sovereignty and midwifery”, is fundraising for her defence. (So too is Norris-Clark, who has described Lemay’s trial as “the attempted martyrdom of a cherished elder”.) Lemay’s supporters say she wished to retire years ago, but was repeatedly asked to attend births by women who wanted to give birth outside the system. They say she is highly skilled, supports medical transfer when necessary, and has attended thousands of births in her career, of which only very few ended in tragedy. To her detractors, Lemay is a thorn in the side of the medical establishment, and the authorities have repeatedly targeted her. But Canadian health authorities are also warning about less famous, and considerably less skilled, attendants, some of whom are FBS-affiliated. In 2023 the British Columbia College of Nurses and Midwives put out an advisory notice warning the public about the RBK hired by Smith, saying she was not entitled to practise as a midwife, and that she could be offering midwifery services without being permitted to do so. (The Guardian has seen no evidence that she continued to attend births after Smith’s in May 2023.) The following year, a different FBS-linked birth attendant was banned from hospitals across Alberta unless she was seeking medical care for herself or her family. The woman, who marketed herself as a “traditional midwife”, had been a member of the FBS membership community and appeared as a guest on its podcast. A number of complaints were filed against her by concerned staff at two Calgary hospitals after she was linked to two stillbirths in 2021. (Her lawyer told the Guardian that her birth services have been limited to non-medical support.) Smith’s son Aksel spent five weeks in hospital before being discharged in June 2023. Deprived of oxygen during birth, he had severe disabilities and was fed through a tube. Smith was his full-time carer. “You’re just trying to wrap your head around what happened,” she recalls of that time, “and my mental state was: how do we find a cure, how do we fix this?” She goes on: “It’s very lonely having a medically complex child in a holistic community. When things go awry, it’s like it’s your fault.” Aksel lived for six and a half months, before he died. “In my grief,” says Smith, “it’s hard to think about how things could have been different.”
