Women gave birth in different settings and were supported by a range of health or allied health professionals during labour and birth. Most mothers gave birth in hospital (public or private) where they were attended by midwives only or by both midwives and an obstetrician. Some chose midwife-led care in a birthing centres, while a couple of women had their babies at home with a homebirth midwife or doula present. A few women engaged a doula to support them during labour and birth, whether this was in hospital or a birthing centre.
Women who felt positively about their labour and birth often described feeling a sense of 'control' throughout the experience. For some, this was because they had vaginal births with minimal intervention or pharmacological pain relief (and often spent most of their labour at home), while for others it was a result of deciding to have an elective caesarean.
Lara felt 'gratitude' for support from midwives and women friends and minimal intervention in her son's birth. The only time they saw a doctor was on discharge.
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And we'd already had like a lot of discussion prior to going to hospital about what we would, how I wanted things to be, which was to birth naturally and that I wouldn't use pain medication unless it was absolutely necessary because something was going wrong and that I wouldn't just by default, accept interventions unless it was absolutely necessary so I thought, 'No thanks, I won't have your water broken strategy', I'll just go.
But we actually just booked into a motel down the road and birthed, so - oh not birthed - I laboured in this motel room - for the whole day - I think it was a hot day, it was in mid-December - and a friend of ours came and sort of helped for a while. We've got friends who have sort of alternative ways of helping a woman birth. Both of those friends actually had birthed at least one of their children at home. They've got a lot of sort of healing modalities. And so my friend assisted and another friend I spoke to on the phone because I'd been in labour, I think I was on my third day by then, I was getting really exhausted, and starting to sort of lose - you know get a little bit despairing I guess that I was going to be able to do this myself without intervention. And then the friend who wasn't actually physically present but I spoke to on the phone - there was something she said that made me just burst into tears and all this ugh, all this emotion and all this stress sort of came out.
And then the labour just kicked right back in again and a few hours later my waters broke and so we rushed off back down to the hosp - well, waddled back down to the hospital and got into the waiting area and within 10 minutes the nurse is ringing upstairs saying, "Is the bed ready yet?" Because I was having one minute apart contractions and I think she was scared I was going to have the baby in the waiting area.
So he was born like an hour and fifteen minutes after we arrived back at the hospital I think with just a little bit of gas at the end and then it was like, 'Ahh, this is not doing any good anyway, so'. They wanted me to be up on the bed. And I'm like, "Nooo, I can't," - I couldn't even get up there, I was down on the floor on my knees and birthed him splat onto a yoga mat near me. Yeah we're happy about how he was born and just heard so many stories from so many other women, even women who are very into alternative modalities, that's not - so many other women aren't so lucky.
So I feel very, I feel a lot of gratitude for being able to have that experience that at least, that aspect of things wasn't traumatic. But I do understand that that's not the case for many women and that's really sad in itself.
We were part of a pre-natal group at a private hospital in this region and I don't - I think we were the only couple in that group of eight or nine families who had a natural birth. All of the other women had obstetricians and they all had interventions which led to a cascade of interventions. So it, I guess it makes us very sad about the medical system and how it handles women who are birthing. But anyway so [son's name] had a perfect apgar score when he was born and we stayed in the hospital for a day or so and then we had to be seen by a doctor apparently to be discharged. This by the way is the first time that a doctor had had anything to do with the whole birthing process, just by accident - like it had just been midwives and women.
In late pregnancy,
Melissa was told her IVF-conceived baby was large for its gestational age. Although her obstetrician was happy for her to have a vaginal birth, she opted for an elective caesarean.
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With my daughter I was told at the first ultrasound that I had - the placenta was sitting too low. So there was a possibility we would have to have a caesarean. And I had to have a 36 week scan, or 32 week one, one of them, and at that they told me she was going to be 10 pounds.
So they told me she was going to be about 10 pound and about five, five different people came into the room at the ultrasound and they asked my husband and I whether we were large babies and neither of us were really that large. I was a tiny baby, but I was a premmie, but my husband was only six pound. So it just got us really scared of why were they asking about her being large? So I went back to the obstetrician and he was, "Nothing to worry about, don't worry about it. Lots of people have large babies". In the end because we had been trying for so long and I just didn't want any risks. I didn't want anything to go wrong so we chose to have an elective caesarean.
It turns out the best thing I did because she didn't - her head didn't fit into the top of my pelvis so I would have had to have an emergency caesarean anyway. So the good thing was during the birth there was no - if I'd had to go and have an emergency caesarean I would have been petrified and stressed and I wouldn't have even remembered.
For other women who described their births as 'good', feelings of control resulted from respectful support from and 'connection' with the health professionals who were present during their labour and birth. Melanie who had an epidural and had positive memories of her hospital-based labour and birth said: 'all the midwives were really beautiful and I can't fault the hospital in any way' while Beth who had a water birth for her first baby in a birthing centre said: 'all the midwives started crying. And it was lovely. And my doula had been awesome'.
Josie felt very supported by her doula, midwife and obstetrician when giving birth to her first baby in a private hospital.
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Things don't go always to your plan but in fact it was a really positive birthing experience for me. And I feel like the day of the labour I was probably pampered more than during pregnancy. I was really impressed when the midwife started this - guided meditation and when my doula was able - I get emotional. You know do everything for me to feel positive.
So we were able to use things like aromatherapy with electric aromatherapy lamp in the room. And she was able to apply Shiatsu pressure points and use homeopathic remedies and that just meant so much to me. That during the time when it's difficult, people do everything for you. I remember talking about my obstetrician during my pregnancy as someone I did not emotionally connect with. It really was a professional relationship where five minute appointments were just - would check on my pregnancy progress. But it was during the birth, during the labour and even afterwards that I feel I actually established that connection with him. I felt like I got to know him through the process of how my baby was born.
And while we were staying in the hospital he still visited us a few times in the room to talk about the experience. And that was really impressive for us because we did feel the need to debrief and debriefing with your obstetrician goes to a lot more detail than with your friends. So it was a surprise that an obstetrician who might come across a little bit as a cold hearted professional had so much emotion in him. And that he enjoyed delivering the baby, that it wasn't just a job and so I look back at the day and draw so much strength from the birth because it was a really empowering moment. When you hear how labour is painful or how birth is difficult, how maybe women don't want to think about the day.
And we felt like we were with his medical expertise that we felt a little bit safer, I suppose. There was a decision during my labour where it was very close to me going for caesarean delivery. In fact they made us sign all the paperwork. They gave my husband the clothes to wear and they scheduled us in but it was perhaps thanks to us having a private obstetrician who was there, who was able to monitor us so closely that when the baby was in distress that we were able still to give a little bit more time, and be watched and monitored so closely that we could still have a natural delivery. That even to his surprise we were able to avoid the caesarean, and I think the midwives commented that if we didn't have the obstetrician highly likely in a public system they would not have questioned it and would have sent us for a C-section.
In contrast, mothers who recalled difficult births involving intervention (see Labour and birth experiences, unwanted or ineffective pharmacological pain relief, assisted instrumental delivery, or emergency caesareans described varied emotional responses.
Some felt that health professionals did not support them or 'believe' what they were trying to communicate to them. Sarah M described what happened when she went into pre-term labour in hospital with her third baby at 30 weeks: 'A student came in and asked what was wrong and I said, "I'm going to have the baby," and she said, "No you're not, you're just contracting because you're bleeding, everything's okay," and I said, "Look, I've had two children, I know how it feels and I'm definitely going to push this baby out tonight, please get an obstetrician"'.
Alice, a young mother, felt her emergency caesarean and haemorrhage could have been avoided if the midwives and doctors had taken her seriously when she tried to tell them she was worried about the size of her baby.
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But I knew I had a big baby. And the hospital kind of annoyed me because at 38 weeks I was five centimetres bigger than I should have been, and my stomach was that stretched that it was going to tear. And I asked to be induced and they said - my midwife went and spoke to the doctor, and the doctor didn't even come and look at me. And he said no. And every centimetre is a week, so my son was five weeks bigger than he should have been at 38 weeks. And so that kind of upset me.
And so from the time that I went into hospital, from the time that I had my son was 26 hours. That's not including my labour before I got into the hospital. So I kind of had a rough birth. I tried naturally, and I just couldn't. He wouldn't pass my pubic bone, so for a baby they have to like groove into place. And then they tried an episiotomy which is a cut from your vagina to your bum. Then they tried a suction cap, which is a vacuum kind of thing, to try and get him out. And that didn't work, and then they tried forceps, and that didn't work. And then I started haemorrhaging really bad and they said, I remember, code blue, "We have to rush you to theatre".
And then they ended up having to give me an emergency Caesar ... the lady that was trying to deliver my son, she knew that they did the wrong thing and she ended up - she was crying. She left. 'Cause my son was nine and a half pound, four and a half kilograms and 52 centimetres. And my midwife had the audacity to come in the next morning and go, "Oh I knew that you were having a big baby, but I just didn't want to tell you". And I'm like - which kind of upset me 'cause there was things that they could have done to - so I didn't have to go through all that, like do a scan of my pelvis.
After
Sara L's waters broke she went into hospital where she said the obstetric registrar did not perform the required test to confirm this, even though she was Group B Streptococcus positive.
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My waters broke a week beforehand, and when I went down to the hospital and said, "My waters have broken", it was all over the floor, the doctor, the registrar, at the time at the hospital, who was in charge of obstetrics, didn't believe me and he didn't do the swab stick he was supposed to do. So for a week I was leaking amniotic fluid, and I was strep B positive, which is really bad, so the baby could've been badly infected, yet no one would do the test. When I went to the midwife for the very last appointment and I showed her, she said, "Oh I think it's amniotic fluid but I can't be sure". And I said, "Look, well nobody's believed me for the last week, don't worry about it, I've got my FMAC appointment tomorrow".
Foetal Monitoring Care Unit. And they monitor the baby to make sure the baby's heartbeat's all right, it's not in distress, the size is okay and it's engaged, so you have to go to the local hospital to have that and you sit for about an hour. But on the weekend I went into labour, labour pains started, and that was on the Saturday night, and on the Sunday afternoon I said, or evening, I said, "I can't take this anymore". I went to the hospital and I said, "I believe my waters broke a week before but no one would assess me properly, wouldn't do the swab stick", and she did the swab stick and she was a bit in distress, the midwife. She goes, "It's bright purple, you should've had him a week ago". And so then I was put into the room and they said, this is 11 o'clock at night time on the Sunday, she goes, "Look, we have to induce you but we're not going to induce you 'til the morning, go stay in the birthing unit, try and have a sleep", and they gave me a sleeping table and stuff, with the pain it didn't really make any difference. And then the next morning they started the induction, and because I'd been leaking for a week they started the induction [at a] really strong level, when they broke my waters, so the pain was instant, I couldn't get off the bed.
Other women who had 'traumatic' births described feeling unsupported.
Susanne and her partner were very upset when the team midwife care program they had chosen at a public hospital fell through at the birth.
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Because we were in this program, which is a really interesting program. They match you up with a midwife, a team of three midwives and you see the same midwife every time.
And the idea is that you go home within 24 hours and the midwife comes and visits you every day. But your midwife is there for delivery, or if not her it's one of the other two that you know. We were really comfortable with all that, I was really proud to be having a baby in the public system because I really believe in it and we were really happy with all that sort of stuff.
Managed to stay at home until about 11 o'clock, by midnight we had gotten to hospital and I just, I can hardly even remember getting to hospital, it was just so hideous. When I went into labour - I won't go blow by blow - but when my water's broke, sorry, I spoke to my midwife who was a wonderful, wonderful midwife and she said to me, "I have no hours left for my - I've just come off a 12 hour shift, I can't. I really don't want you to go into labour tonight because I can't be there today. So hold off if you can". I was all - I mean there wasn't any pain yet, so it was fine.
But, so what that meant was that when we got to the hospital they couldn't call her because she was done. I don't know why but neither of the other two midwives were called either. And I've actually not looked into it. I don't think I want to but so here's me screaming. I feel like I'm that horror one on TV that you see.
My partner is beside herself, I'm in agony and our midwife's not there and the other two midwives aren't there. We were literally in the delivery suite on our own. There's no-one there with us and I'm screaming, well not screaming but I'm like you've got to do something, I can't handle this pain anymore, the TENS machine's not working. I didn't realise I was like eight or nine centimetres dilated by that point, it just went bam, straight through and there was no-one. My partner had to go into the hallway and flag someone down and when they came in to us they were like, "Oh, you're a [midwife program name], you're on [midwife program name]" or something like that and they were like, "Really you're not our problem".
But I needed pain relief and I needed help. So it took probably about an hour or two before we actually had a midwife with us and it was hugely traumatic to not have the system that we thought was going to be in place.
A few women were critical of how consent was dealt with during labour and birth and described feeling powerless or 'violated'. During advanced labour with her second child Nellie recalled being pressured to consent to 'drugs' and augmentation. A new midwife came on shift as she was 'about to cause a big problem by not consenting' and accepted her wishes. Nellie was happy with this but said: 'I just feel that uneven care makes it difficult. And I don't know how many times one has to say in labour, "No I don't want drugs. I will ask if I need drugs. But I don't need them"'.
Cecilia experienced a loss of 'self-agency and control' as a result of intervention during the second ('pushing') stage of labour.
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I wanted a natural birth and family birth centre and all that sort of stuff and it went quite differently and I sort of had to have a fair bit of intervention and I didn't like the way that I was - I felt like I was treated by the medical professionals that looked after me and I've probably - I've always had a little bit of a distrust towards hospitals and doctors.
So I found that really challenging, so it was quite different from my way of wanting to have my daughter with the support of midwives and less intervention-type approach. But I mean, I can really see that that was particularly heightened in the context of a relationship breakdown as well. Not only did I feel like I didn't have the sort of support of the systems that I wanted, I also didn't have the support of my partner at the time, you know?
So I think I was - I felt a bit thrown by things, and then I was booked into the family birth centre and when I got in there about 5:00 in the morning they actually didn't have space for me, so that was - like thrown by that, "Oh, that's not how it's supposed to go", so I had to be in the formal hospital. And then I think that labour was actually relatively quick and I think that the midwives helped sort of debrief me afterwards, that maybe that was part of the trauma as well, that things did happen quite quickly.
And in the end there was a bit of, the red button was pushed and a bit of emergency because I'm sort of pushing and she's not coming out, that sort of thing that's actually pretty common and so I guess I just have this - the image that sort of sticks with me is them making a decision that, "No, she's not coming out fast enough", pressing them - sort of pressing the red button.
And then all of a sudden all these doctors were in the room and your feet have to go up in stirrups and I was, "No, get those fucking", so trying - you're in this incredibly vulnerable and pained situation, people are coming in, making decisions about your wellbeing, which of course they have to, they're the doctors, but there's a massive tension between what you want and what they're saying is best for you and the life of your child, "How dare you even say anything against it because are you a bad - are you an evil mother?"
And men. I didn't want men. I didn't want male doctors and there was - it's got nothing to do with it, where he was from, but he was a Chinese male doctor between my legs and like, "Who are you, where - what are those scissors doing? Get those fucking scissors away", and them sort of just telling you what they're going to do and you're saying, "No", but you're having also the happy gas at the same time so you've consented because you're somehow like - you're on another planet.
Yeah, real murky situation, it's really massive tensions around feeling violated, feeling really violated and invaded and all your self-agency and control is taken away from you by these anonymous medical figures who then afterwards don't even come back to debrief with you or tell you why they made the choice that they did or even acknowledge how there was that discrepancy between how you might have been feeling and what they chose to do in the end and just, I guess, sitting - taking 10 minutes to sit down with you and sympathise with you and acknowledge your feelings and emotions.
Not everyone who had a difficult birth felt negatively about the health professionals who supported them. A few people said they experienced a variety of midwives, some 'horrible' and some 'lovely'. Michelle had a very difficult birth ending in an emergency caesarean but appreciated her midwife: 'she stayed with us the whole time and constantly said to me, "You're very brave"'.
Others were able to see things from the perspective of the health professionals who attended their labour and birth. Joanne felt quite 'traumatised' by her baby's ventouse (vacuum) delivery and the midwives' failure to give her antibiotics during labour for Group B Streptococcus. This meant antibiotics had to be given to her son, which made him unsettled and breastfeeding hard to establish. However, as Joanne reflected: 'it's a bit conflicting, I did feel the care was good, but then they forgot to give me my antibiotics - but I think I saw that as a genuine mistake because all hell did break loose, it just was a bit crazy at the end'.
When
Nellie's first baby was overdue she resisted a caesarean but had to be induced. One midwife who attended her labour was 'officious' while the other was 'lovely'.

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I went through the hospital and I had midwife-based care. I didn't understand with the first one that midwife-based care meant you still have an obstetrician-led delivery. So everything with my son in the antenatal care was really great, really supportive until the point when I started to go post-dates and they were really pushing - I started to get very actively pushed towards caesarean. They were saying, "You're just going to have to have a caesarean, you're just going to have to have a caesarean". And I'm quite stubborn. So I really wanted to - I didn't consent to having a caesarean before I went into labour which I feel is what they were trying to push me at. And I was at a public hospital so I was surprised by that.
I had the induction so I had this nurse who was so happy to put that needle in my hand and then push the button really high for the induction and she spent the whole time there. And she just kept pushing it harder and harder so there's no gap between the contractions and it was really awful. And then the shift changed about four hours before [my son] was born. And then the midwife came in and said, "There's no need for this, we'll just turn it down; everything's progressing okay. It's alright".
So I just have this memory of this officious nurse who was just so happy to push the button. And it just made me feel - 'I hate you, I hate everything about this'. But then I had this lovely midwife later. So even though it was an instrumental birth, I had to have the ventouse and episiotomy in the end which I think is all related to that cascade of interventions. By the time he came it was fine and she was really lovely in terms of letting him stay on my tummy for a while, doing all that attachment-centred approach to meeting the baby and things so that was really good.
Most mothers described feeling better prepared for the birth of their second babies. Several who had had a difficult first birth described taking steps to try to make the second a better experience. Some employed a birth attendant or doula, others described being more assertive with hospital staff, or chose to have either a VBAC or an elective caesarean if they had had an emergency caesarean for their first birth. Elizabeth who found her first emergency caesarean 'quite traumatic' had an elective caesarean for her second baby and said: 'the second much nicer experience with the second baby did help to replace some of the bad memories from the first birth experience'.
Rumer explained why she engaged a doula to support her attempt to have a VBAC (vaginal birth after caesarean) following an emergency caesarean with her first baby.

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I was quite disappointed that an emergency caesarean had been the outcome the first time. But I really felt that whole silencing thing of - 'It doesn't matter what happened. The outcome is that the baby is OK and you are healthy, that's all that matters, so move on'. And I really resented that because it's like nobody gives you that permission to kind of - and none of healthcare providers or anything are really that interested either. Friends listened, but a lot hadn't given birth themselves. Or they'd had really different birth experiences. So it's really difficult to find someone sympathetic. And it probably wasn't really until I met a doula at the second birth who - she gave me that recognition.
I was a bit fixated on trying to have a vaginal birth. And so I read up about VBACs and I went to a different hospital the second time round. And they didn't really want you to do it. They basically explained that you can do it but you're under much stricter conditions. And then basically you have to accept that it's very likely you'll have another caesarean.
And so I was happy to go in with that view but I just thought I want someone because I understood that support was good, and the doula I went with was quite experienced, so she'd been prepped; she'd been doing this for over 10 years. She'd been to heaps and heaps and heaps of births. So she wasn't going to be freaked out by the birth environment. And she was very committed to supporting you in whatever you wanted. And acting as a kind of buffer, 'cause that was the thing I felt as well. Like the birthing centre, everyone was really lovely and supportive. But when you got to the regular ward, the staff there, some are nice. But others are very procedural and you just feel it's very impersonal. And I realised obviously after the first time, once you're in labour you're unable to negotiate or advocate or anything like that. You're just a total mess - and I just really felt for my partner, you know? It's hard for him because it's uncomfortable for him as well seeing me in that state. And so it's a big burden on him as well. Yeah, so, the doula was just the best decision ever.
A few women experienced difficulties with their second or later births. Again, health professionals' approaches made a difference. Deb experienced complications after her second child's birth including surgery for a haemorrhage and her daughter having facial bruising. She said: 'I woke up from surgery and I was really confused. I feel we probably didn't get enough support from the nurses there'.
In contrast, Melissa's second elective caesarean was more stressful than her first because her spinal block didn't work as well and she could feel 'every movement'. However, as she explained: 'the obstetrician was really good because he just kept talking to me while he stitched me up and everything so that I wasn't concentrating on that, which was great'.