Let’s get one things straight here: there’s absolutely no right or wrong way to give birth.

BUT everyone has things they’d rather avoid and if induction, instruments and caesareans are on yours, these five things may really help…

In the years 2022-23, NHS England recorded 537,125 births and when we look at what, how and where these happened there are some definite trends to be aware of. Mode of delivery is all about how babies enter the world; according to the maternity dashboard, in 2022-23, this is what birth looked like:

• 50% spontaneous vaginal deliveries

• 16% elective caesareans 

• 21% emergency or unplanned caesareans 

• 10% instrumental deliveries 

When we look at the data for how labour actually began, we see a trend continuing … 

• 41% started spontaneously.

• 6% started with surgical induction.

• 16% started with medical induction.

• 7% started with surgical and medical induction.

• 24% were caesarean birth, with no labour before hand. 

Now, it’s important to remember that there are always stories behind the numbers, always things to dig into and understand more deeply, the trends are really quite obvious. 

• 53% of labours start with some form of medical intervention. 

• 47% of babies’ births feature some form of medical intervention. 

While these numbers do not feature the interventions which may happen during labour (eg: augmentation, rupturing of membranes, episiotomies…) they show the trend: medical intervention is a common feature of modern birth experiences, and according to the latest research, it’s a trend that continues to rise. 

The problem is that interventions aren’t just used in response to issues; many times, they are recommended or used to avoid a problem arising: to keep things safe. Humans equate safety with control, but this creates a problem within the birth space because there are different definitions of safety and control.

For medical professionals - midwives, doctors, obstetricians etc - interventions allow control to be established. It’s the mentality of “I am doing, therefore I am controlling what’s going on.” Therefore, when an issue (or potential issue) peeps up from behind the parapet, it’s likely that an intervention will be recommended, so that greater sense of control and therefore safety can be built around your pregnancy, labour or birth.

BUT it’s absolutely key to remember that this is a medical definition of safety which is very much built on the short-term definition of a positive outcome: aka ‘everyone is healthy’. Of course, we want everyone to be healthy, but it is not the only thing that matters. There’s the longer term to consider too.

How we feel during pregnancy, labour and birth is incredible important: the emotional memories we carry will stay with us forever and has a significant influence over the people and parents we become. When we have a positive experience, where we feel safe, respected and controlled, it is far more likely that we’ll begin our parenting journey with confidence, resilience and self-belief. In the long term, this is excellent news.

However, should our birth experiences feature anxiety, fear, a lack of control or a sense of helplessness, then the positive qualities listed above are harder to come by and this can create longer term issues.

Episiotomies, inductions and caesareans may well offer a ‘safe’ route for certain circumstances, and when you’ve weighed up the risks and benefits, you may well choose to accept one that has been offered to you. But equally you can choose to delay, discuss or decline an offer.

Yet in reality, in the throws of labour, how many of us will really have the brain space to stop and negotiate and discuss rationally and logically. Very few. And this is probably why the rates of intervention are going up too - just as the rates of ‘offering’ are increasing, so are the rates of acceptance.

That’s why it’s better to act in advance…

1. Plan a homebirth: medical interventions are less likely to happen in a non-medical space. Add on to that the fact that you’re likely to be more mobile, instinctive and intuitive in your own space, and it all adds up to a space that promotes physiological (non-medicalised) birth.  

2. Identify your non–negotiables: doing your research into the different forms of interventions - not just the risks and benefits, but the long and short term consequences of them -  will help you to know exactly what you want to avoid. This will help to taper your birth plan and your conversations around it.   

3. Practise using BRAIN in conversations: it’s all very well knowing to ask for explanations benefits, risks and alternatives etc but actually doing it, in the emotional and physical heat of the moment, is really challenging. Practising it, finding phrases you’re comfortable with using when you’re doing it, helping it to become ‘rote’ will help these discussions to feature strongly, without issue, during your birth experience.      

4. Learn about your birth rights: websites like AIMS and Birth Rights are excellent starting points for understanding exactly what you CAN do (spoiler alert: it’s anything).     

5. Hire a doula: all of those things are easier to do when you have someone on your side who already knows all of this, already knows how to do it, and will do it all unwaveringly to support you whenever and however you need it.    

There is no such thing as a ‘universally perfect’ birth, only a birth experience that’s perfect for you.

Achieving that is all about balance: physical vs emotional, short term vs long term, benefits vs risks… Getting this balance is rarely straightforward, but with the right support it’s so much easier to achieve. That’s why I offer services like my doula power hour, which gives you the chance to talk through this balance, navigate the obstacles and find the right way forward for you, whatever that looks like for you. 

Fancy it? Get in touch and we’ll book you in for an hour.