The Wellness Scoop - Changing the Birth Narrative

Episode Date: October 8, 2019

What happens in birth? Why are we so afraid of it? Do we need to be that afraid of it? Can you really have a calm, empowered experience? Does it hurt? Will I tear? What are my choices? This episode looks at the FAQ’s and the current conversation around birth, breaking down the culture of fear and dread and questioning the current dynamics through the lens of #metoo and whether birth can be a feminist issue. From the widely differing stats of different birth choices and their respective outcomes to hypnobirthing, tearing, birth plans and doulas, this episode looks to guide all women through their thinking and create a positive outlook for all of us. Milli Hill – The Positive Birth Book & Give Birth Like a Feminist Ina May Gaskin – Guide to Childbirth Emily Oster - Expecting Better See acast.com/privacy for privacy and opt-out information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

This episode is brought to you by Samsung Galaxy. Ever captured a great night video only for it to be ruined by that one noisy talker? With Audio Erase on the new Samsung Galaxy S25 Ultra, you can reduce or remove unwanted noise and relive your favorite moments without the distractions. And that's not all. New Galaxy AI features like NowBrief will give you personalized insights based on your day schedule so that you're prepared no matter what. Buy the Samsung Galaxy S25 Ultra now at Samsung.com. Welcome to the Deliciously Ella podcast. It's just me, Ella Mills today. And today we are talking

about birth. Our guest and I just recorded our whole episode and we got to the endly Ella podcast. It's just me, Ella Mills, today. And today we are talking about birth. Our guest and I just recorded our whole episode and we got to the end and I thought, do you know the thing that helped me most with birth and that I wish I'd had more of was birth stories. And what introduced me to our guest Millie on The Londoner, which is a popular blog, she wrote about her home birth experience and it really inspired me. And so here is our birth story we'll talk about it a bit more as we go through the episode but I felt it's important to share and we have had a lot of questions on it so originally I had decided to give birth in hospital

and take a very standard route and I about 20 weeks in we were seeing a doctor and I just didn't feel it was the right thing for me every time I went I'd ask questions that I didn't really get the answer to I didn't feel safe and I didn't feel empowered and I just it just didn't feel like me and so I started to look at other options and we were introduced to this amazing woman called Catherine Graves who is this hypnobirthing specialist and she completely changed everything for Matt and I and first of all she just told us everything that happened in birth and really really took away a lot of the fear and started to understand that it was a very normal event

and not something to be scared of and as that started to happen I started to relax into it I kept doing yoga and walking and things that really helped to be really active. And when the time came, I felt really ready. And I was convinced that she was going to come early. I just had this really weird sense about it. And at 38 and a half weeks, it was 38 degrees. It was a really hot day. And I kept saying to her, please don't come today. Please don't come today. But the next morning I woke up and it was raining and it was cold, you know, coldish. And I thought, you know, this would be the perfect day. And I went to yoga that morning just to the usual class I always go to. And there was a cover teacher and she was the most calming, grounding, amazing person I've ever probably done yoga with. And I left and I was like, I think she's going to come.

I think this guy is coming. I called Matt and I said, let's go out for dinner tonight. I think she's going to come tonight. And Matt was like, well, she's not coming. You're so early. But yeah, let's go for dinner. We went she's going to come tonight and Matt was like well she's not coming you're so early but yeah let's go for dinner we went for dinner and the whole dinner I was like she's coming I just know it she's definitely coming this is our last time as the two of us and then I woke up at like three in the morning and nothing had happened I was so disappointed because I was so convinced I knew and we went to go to one of our best friend's weddings the next day and then I woke up at six my first thought was the wedding and then I suddenly

thought oh my god it's so wet where I'm lying and I had no idea when your waters broke that there was actually so much water there was so much liquid it was insane and my midwife had told me what to look out for and it to be clear maybe with a little kind of blush pink of tiny bit of blood and it was all good but I was absolutely blown away by quite how much liquid there is I thought I wished I'd been warned about that and I think I would have had no idea that we were kind of starting but if that hadn't have happened so we just pot around the house I was so overexcited when it happened I was like shouting and screaming and like I was like I can't believe it I can't believe it she's coming she's coming and Matt really calmed

me down because we'd focused so much on understanding how important kind of being calm and present and like that flow of oxytocin is and stopping adrenaline in order to help birth progress quite easily. And so he was amazing on that. And Catherine, when she talked to us about hitting a birth, she said the most important thing is just kind of keep it really normal, keep it really relaxed. So we just had this kind of really strange couple of hours it was like this alternate universe where we made breakfast and then there's a farmer's market right by the

house and we thought okay should we just potter the farmer's market Matt got coffee I was like oh let's get loads of bread because I'm sure I want bread today and there's this kind of really strange moment you're like standing in line to pay for your bread and you're thinking wait I'm in labor there's a child coming into this world and no one around you knows and it's this kind of really strange moment you're like standing in line to pay for your bread and you're thinking wait I'm in labour there's a child coming into this world and no one around you knows and it's this really surreal strange feeling and we came home and we started watching a movie I was petitioning for four weddings and a funeral Matt won on Notting Hill in retrospect I'm not sure if he should have won that day but that's okay and we just kind of really tried to almost ignore it but as the film was going it just

started to build up and it started to build up and we had decided to have a doula and a midwife and for people who are not sure what a doula is our doula who was absolutely incredible she'd been attending births for 30 years and so she's just an amazing female companion who is able to support you and nurture you and guide you through something that's so new to you and also so new to your partner and she came over and she kind of helped me as it started to build up at that point I was really wanted to water birth but it was a bit early to get in the pool and so I just had so cliche my yoga mat on the floor of our room and a kind of birthing ball and I was just leaning on that and breathing through the contractions but just watching the movie in between that and really really really

trying to not focus on the fact that we were in birth basically and just kind of laughing and joking and then it started to pick up and so we got our midwife over and we got the pool and we'd set up our pool in our guest room and it's literally like the funniest thing arrived in a box and it has everything including a pooper scooper which really made us laugh like a very intense paddling pool basically and we'd set it up and we had tried it out and honestly I'm not joking when we got in there it was like taking the pain down by like 50 or 60 percent it was the most amazing feeling Matt has these pictures where I'm like lying back I look like I think I'm in a spa or something it was just so relaxing and and everyone said to me you know so much happens kind of between the contractions you really need to relax and I was finding that a little bit hard

to do out of the water because you're still supporting your body and in the water I felt like I could completely let go and we'd really focused on creating a calm environment so we turned off all the lights we had candles and then we had yoga music. I've said this a million times, we're obsessed with this amazing artist called Snatam Kaur. Surname is K-A-U-R. She's amazing, it's the most beautiful music.

And we listened to the Snatam radio on Spotify and it was so beautiful and calm in there. And our midwife kind of was really, really hands-off and she just was hovering and watching like a hawk but kind of allowing the two of us to do it together and Matt was the most amazing amazing support and I'm kind of endlessly grateful I don't think I could have done it without him and at every single contraction or surge as people often call it in hypnobirthing he was like right there he was sitting next to the birthing pool you can kind of be right next to each other which

is so it was so amazing I really felt like we were doing it together because lots of people say they kind of feel like their partner's useless and for me it was the polar opposite and he was able to talk me through each time and that what was happening and that you know that was the intense point and that it would slow down and I got in the pool I think around like one o'clock and our midwife thought she'd be born about four but things did slow down a little bit towards the end. And it got kind of more and more intense. And I asked our midwife for gas and air at that point. And it was really interesting because I have to say for me personally, it was the least helpful thing ever. Because I was so busy breathing in the gas that I wasn't really focusing on then starting to push down and start to kind of actually push Skye out.

We were in that phase for about just over an hour or so but um they actually confiscated the gas in there because they could see that it wasn't working but by that point I guess we didn't really I stopped caring that it was intense because you could feel how close she was and each time that happened she came that little bit closer and that little bit closer and her heart rate got a little bit high towards the end because she her head was taking a little bit of time to come out and our midwife said you know just try another position try another position so we moved around and she then came out all in one and it was the most hilarious moment because my midwife was saying okay just one more just probably just one

more just two more because I was kind of my energy was really flagging at that point I was like no no no she's out and suddenly me um the doula Matt all put our hands in the pool to like fish out the baby like she was a lost bar of soap but I caught her and she came out and she had her eyes like wide open they were like black they looked like at the time and it was just the most incredible incredible moment it was so much more than I'd expected it to be and we did everything really naturally I then got out of the pool and we waited and birthed a placenta without the injection and she just kind of got straight on and got on the boob and um it was just yeah it was the most incredible incredible experience and I could talk about it forever and we'll get into the episode now but I guess I

wanted to share it because it wasn't easy by any means it was really really difficult because it was physically and mentally such a huge challenge and I felt mentally I had to go so much into myself to stop myself from getting scared getting panicked allow myself to kind of stay calm and stay present in what we were doing but it felt always within my capabilities and I think so much that had come from learning as much as I could beforehand and I guess that's that's why I want to share this episode because had I not have been able to access all the resources and books and people that I spoke to and courses that we took I don't think there's any way it probably would have transpired the way that it did but it really was one of the most kind of empowering joyful incredible totally untraumatic moments that we've been lucky enough to ever

ever live through so i have to say this isn't probably the easiest conversation to have and i have to admit that i did actually almost shy away from the episode in fear of upsetting anyone or kind of triggering anything so before we get into anything i just really want to highlight a totally genuine belief that there is no right or wrong way to give birth and there's no judgment in this conversation whatsoever. The episode we did period power in season three was one of our most popular episodes ever and I want to do the same kind of thing here it's a conversation about education it's shining light on an incredibly important topic that so many of us actually know so little about and as our guest today writes there is not one single

birth scenario in which increasing empathy for the woman listening to her voice respecting her decisions and honoring that this is an extraordinary day in her life will not be valid and when I got pregnant I realized so quickly that I knew pretty much next to nothing about what was to come all I knew was the fear that was ingrained in us all from such an early age. We're taught next to nothing about the process of pregnancy, birth and postpartum growing up. So little is covered in school. The only thing I remember is a really traumatising video of somebody giving birth that we all kind of screamed, shouted and ran away from. That being said, I think this lack of knowledge really, really takes away a lot of our power and feeling of confidence in this area. And then too

often as a result, it takes us out of the the driving seat so I'm hoping that this podcast will start to change that for some of us. So our guest today Millie Hill wrote the positive birth book which so many of our readers and listeners recommended when we got pregnant and Millie is also a friend of our midwife and when our midwife came around to see us the other day she recommended Millie's new book which is called Give Birth Like a Feminist. I'm sure like lots of you guys the title immediately drew me in and I was very curious about it and I have subsequently become obsessed with the book. She says giving birth like a feminist doesn't mean giving birth in any certain way just as doing anything else a career relationships parenting like a feminist doesn't require one size fits all approach. You can give birth like a feminist in any setting and in any

way from an elective cesarean in a private hospital to a free birth in the ocean and everything in between. All that is required is that you have somehow moved from a passive place where you view birth as something that happens to you and over which you have no control to a place of understanding. Essentially take charge, take control and make conscious choices. So welcome Millie. Hello. I wondered if we could start with the Positive Birth book and just give us a kind of overview on I guess why you feel like it's important that we reframe our conversation around birth and also the importance of the education that you share.

Yeah I mean I think for a lot of the reasons that you were just talking about so many women have only ever heard negative information about birth and our expectations of what birth is going to be like are framed around those messages that we've got from the dreadful school video to One Born Every Minute to the kind of overheard snippets of conversation among women about how horrific things were for them. And so I think we're in danger, if we like, of staying in that kind of negative loop

where we believe that to be reality so strongly that it eventually becomes our reality and then we in turn have our dreadful story to tell. So I think the positive birth book is just about saying to people okay hang on let's all just stop let's look at what we think is true about birth and kind of unpick that and then let's try and replace some of that fear-based stuff with facts because I really believe that information is power so I think the positive birth books whole message is actually very similar to give birth like a feminist really the two books are very interrelated positive birth books kind of got more of an instruction manual feel to it's got more

solid information about all the different types of birth and your different choices but the message that underpins it is the same which is that you can influence how birth is for you. And it doesn't have to be the way that you're kind of expecting forward slash dreading. There's a title on Give Birth Like a Feminist called Am I Allowed? Which really resonated with me. And I found myself just like nodding and nodding and nodding and nodding and nodding. Because I found I went into it and everything I asked was like is it okay am I allowed I quite like the idea of this but I was so kind of nervous and scared I was sort of tiptoeing around everything and I wanted to

talk a little bit more about that kind of I'm am I allowed but also get a bit more of a sense of what are those kind of key choices and what is the information that we're so scared of that you know that we can separate from fact it's I mean it's complicated obviously it's not about going into your birth and saying you know all guns blazing like I'm I'm the expert in everything and all you obstetricians midwives etc you know away you go but I think what it is about is challenging that power dynamic that you're talking about that most women walk into when they are first pregnant. And for the 21st century woman, it's not a familiar feeling to be in a situation where you are basically the permission seeker. And for the first time, they're kind of on the back foot. Part of that is because of the fear.

And part of it is because of the misconception that they do have to hand themselves over, I think, and that they can't be in charge of anything anymore. And also, you know, I mean, I go to sort of mainstream maternity events and I'm shocked when I talk to women and I talk to them about their choices in birth. And they say to me, you know, they are shocked to find that they have a choice. They are shocked to know, for example, that they don't have to have a vaginal exam every four hours when they're in labor. I'm not going around telling everybody nobody must have a vaginal exam. I'm just saying you have a choice. What that then does is it changes this power dynamic because knowing that you can say no isn't the same as saying no. So a good example that I use is that in your sexual relationship, hopefully you know that if you say no to your partner at any point,

he or she will stop. But you might have been with your partner for a decade or two decades or three decades and you might never have said no to them, but you've always known you could and it's on that unspoken basis that your relationship is built. The maternity relationship between maternity care providers and women seems to be often built on a situation where women do not know that they can say no if they want to. And that's the kind of power dynamic that I'm kind of trying to get people talking about, really.

I didn't feel that whatsoever when I started the process, so I can completely relate to anyone who who has had the same experience and it was really finding an amazing midwife that that changed it for me and it was really interesting I actually never forget crying on Oxford Street when RGP who's a kind of older man a very very kind man but he kept saying you know no you can't have your birth at home and I said but but why you know like I'm if you can give me a very kind of tangible logical rational data-led point 100% I'm all ears but but but you can't and so you're making me feel like an idiot and I'm someone that has done the research I live literally five minutes away from the hospital I've got an amazing midwife who's so experienced

I'm kind of failing to understand but you're making me feel like I'm not allowed to do something that seems very sensible and I just never and I was saying when before we went down the midwife led route because we'd switched about halfway through 20 weeks you know I said to um our doctor who again was so lovely but I said to him you know I really want to do hypnobirthing he sort sort of smiled and said, you know, we'll just see how that goes. And I thought, well, no. Like, we won't just see how that goes. We will do that.

And I will do that in a cesarean. I want to have that, like, calm, centered approach however the birth goes. And I would want you to be able to respect that, not just kind of smile at me like, oh, you think you're just going to sneeze and the baby will come out. Well, I think underneath conversations like that is a power struggle, it seems to me. You know, and we saw it played out

on the kind of global stage with Meghan Markle, who had exactly the same phrase used to her or about her. An obstetrician who was giving a talk to a room full of obstetricians mocked her by saying, oh, she's going to have a doula and a willow tree. Let's see how that goes. And everybody laughed. So yeah, there's the kind

of mockery there. And there's, it's very undermining for women. And it happens, I think it happens to most women during their pregnancy, who say that they're going to take that natural path or make those sorts of choices. There's quite often a kind of guffawing of, you know, and a mockery. And there's a huge amount of mockery of birth plans as well, which I've written about in Give Birth Like a Feminist, because I think that that really, really is a kind of crucible for all of these power struggles. A birth plan is actually a very sensible document. It's a very sensible attempt by a woman to lay out her choices. I always encourage women to make a plan B.

So I don't expect your midwife discussed with you what you might want. Say you had to transfer to hospital. Say you even ended up having a cesarean and you didn't get your home birth. You probably had it all thought through. So that's your birth plan. Fantastic. Why would anybody have a problem with that? I think it's saying don't try and take control of this love you know we've got this and doulas come under the same umbrella as

that really so in places like America on some South American countries you'll see signs saying or hospital policy saying no doulas in Ireland someone sent me a sign saying you do not need a birth plan in this hospital so there's kind of like that attempt to kind of claw back power um and I think that birth plans are women's sort of attempt to try and take some of that power for themselves and make make those conscious choices which is such a brilliant thing to do yeah so I guess I kind of sort of I guess politely want to ask you know what is going on there because one of the things that I was most struck by when I started doing my research is just where the stats and facts and figures are today. And they're a bit uncomfortable. And I know, you know, you had an interesting bit in the book from The Lancet, which is one of the leading

medical journals, for anyone who hasn't come across it, and that they'd highlighted that women in high income countries, so like the UK, like the US, are likely to experience a too much too soon approach with the over application of routine interventions. And we know that interventions like induction syncytarians continue to rise rapidly in disproportion to improvements of birth outcomes. And according to a report from the College of Midwives in 2016, only one in five births had absolutely no intervention, which is insane. But then on the other hand, there's this really amazing midwife in the US called Ina May, and she wrote this really great book called A Guide to Childbirth, which was another book that really, really helped me. And, you know, in contrast to those stats, in over 2000 births that they had between 1970 and 2000.

But in that, the home birth rate was 95% and cesarean was 1.4%. But maternal mortality was 1.4 percent but maternal mortality was zero and I know you referenced that having checked the stats for the last kind of 20 years they're exactly the same and just for comparison for the 1.4 percent of cesarean that they have there's a 32 percent across the US in total and so I guess the question is like what's going on you know why are we having more and more traumatizing experience you've got a stat in your book, which blew me away, which is that one in three women in the UK would now describe their birth as traumatic

and up to 18% of that third go on to develop PTSD. And I've certainly got friends and people I've come across who've had that exact experience. And it just seems, and this is no judgment for anyone who's been there. And I know that's what you talk about because that's how you see your first birth.

It's no judgment to anyone, but it does sort of think is this fair like what is happening to women there because could we get this down to you know 95% of people effectively being able to have a home birth and only just over 1% having to have a cesarean yeah well I think that we are getting birth wrong at the moment and it's like you said at the top of the podcast it's very difficult to have this conversation in some ways because there are many many women listening to this who have already had all their babies aren't going to have another one and you know for them it's quite painful to contemplate that it could have been different but it could have been different for many people we birth is over medicalized so we need to be able to have this conversation as

women and as feminists i think we need to be able to have a conversation about how birth is right now for women and the stats you're talking about there in regards to trauma. And also there's going to be many, many more people who aren't reporting that they're traumatized, but who might maybe feel a bit sad, a bit hollowed out, a bit upset, a bit angry or whatever about their birth. They don't feel positive about it. So we've got all these people coming through birth who feel awful. And in in contrast we have other possibilities it's not just Ina McGaskin stats that are amazing there's also you can look at other places like one-to-one midwives a place in Australia called the Lismore Birth House gave me her stats for the book there's independent midwives in the UK have got some really good stats

and they're showing all of them show the same thing that by taking a more hands-off approach it doesn't really matter whether they're working with low risk or high risk women women having twins women having subsequent pregnancies first whatever across the board by taking a woman-led approach where they're listening to the woman tuning into her and letting her work with her body those women are much much much more likely to have a positive straightforward experience than a woman currently going through the nhs so i think we need to be brave and have a conversation about that and at the same time acknowledge that that kind of birth isn't for everyone and that also we can make birth better for those people who wish to have an elective cesarean we can make birth better for those people who wish to have an epidural right from the beginning

it's not about charging ahead with a natural birth agenda but we need to be able to have a conversation about natural birth because lots of women do want that they reckon about 80% of women when they're asked about their hopes some research has shown around about 80 percent of women want a straightforward vaginal birth so a lot of those women are currently not getting the birth they want and we need to be able to ask questions why are you asking me why I am I'm looking at you right now so tell me why I mean I know from my experience fear seems to be such a big part of it and I don't say that in a judgmental way, but everything that I learned and understood and then definitely was privileged enough to

experience for myself, I think letting go of fear was everything. So fear is a big problem. The fear amongst women is a big problem. We've all become conditioned to believe that birth is going to be horrific. Do you see how we're in this loop here? So birth is horrific for a lot of people. So they're telling everyone it's horrific. So we're all terrified and then it's horrific and we go round and round in that spiral. And fear can affect how you actually are when you're in labour. People talk about the fear, tension, pain cycle. So obviously the more scared you are, the more your body tenses up, the less you're able to sort of relax and move and go into the experience and am i right in saying also oxytocin is really really important during labor and oxytocin comes from feeling kind of relaxed and safe and loved it's the kind of cuddle sort of sex hormone yeah oxytocin is the hormone we produce when we feel

safe when we're in a nice sort of cozy environment the kind of environment that you would like to have kind of romantic sex in is basically the best environment to have a baby in but if you actually got a picture of a woman's best environment for romantic sex and a woman's birth room in the UK at the moment there'd be quite a contrast between those things I think so we're not providing the right environment for women to give birth in to be successful. Why is oxytocin so important? Oxytocin is basically the hormone of labour and birth you cannot give birth without oxytocin so people quite often say to me what should I take in my birth bag and I always say it doesn't really matter what you put in your birth

bag as long as you take oxytocin because you can't it's the only thing you cannot give birth without and if you don't produce your own oxytocin they will give you oxytocin on a drip in hospital and that's another thing people quite shocked to hear sometimes when I give talks but it's just so And if you don't produce your own oxytocin, they will give you oxytocin on a drip in hospital. And that's another thing people are quite shocked to hear sometimes when I give talks, but it's just so simple. So that's what you get when you're induced, right? Yeah, that's what you get when you're induced. And it's also what you get if your labor slows down and your labor is what they call augmented. So you have a drip then to get things moving.

So it's a vital, vital part of a successful, straightforward birth. And you don't produce it if you're frightened, you don't produce it if you keep being interrupted. And you don't produce it if you're in a brightly lit environment so well. And you don't produce it if you don't feel safe. The adrenaline that comes with fear or panic or not feeling safe does stop your oxytocin production and so that's why some people who labor at home to begin with and then go to hospital they get to hospital having been cracking on at home and they get to hospital and everything stops and that's because they've changed place and they suddenly they might think they feel safe with the upper bit of their brain that does the analyzing the sort of more modern parts of the brain goes oh

yes hospitals great place to have babies but somewhere deep down another part of their brain is saying this place doesn't feel right to me and so the oxytocin is inhibited and the labor stalls so you know there are things you if you learn about oxytocin there are things you can do in that situation for example like you did calming things down trying to get back into the zone getting the lights down low maybe making out with your partner is a really good way if you obviously get rid of the midwives first those sorts of things you know little tricks that you can learn can help in that situation so just knowing about oxytocin alone starts to get you thinking about the current sort of birth environment and if you picture sort of one born every minute with the sterile wards and I know it's not all like

this on one born every minute but it is quite often people on beds on their backs which is another big problem and also being attended by people that you don't know one of the things that's key in the places I was just talking about that have their sort of 85 90 percent straightforward birth rate is that they have relationship-based care so just like you did the women who are having those straightforward vagina births have a relationship with their midwife they trust their midwife and their midwives also got to know them and the midwives got to know them medically as well so the midwives got to know what kind of blood pressure is normal for them, what kind of skin tone is normal for them, all of these other details. So a midwife will be very tuned into

that woman because she has a relationship with her, which actually makes birth safer because she'll be able to see when things are deviating from that woman's normal. And a woman who trusts that midwife will know if the midwife says, we need to go to hospital or there's a problem here they will feel less traumatized afterwards because trauma isn't necessarily about what happens but about how it happens and how it's explained to you so I know people who have had I've spoken to many people who've had a traumatic birth which on paper looks very straightforward and I've spoken to many people who've had a birth they feel very positive about which on paper sounds very straightforward. And I've spoken to many people who've had a birth they feel very positive about, which on paper sounds very traumatic.

So it's not about the events that happen to women, it's about how those events are held and contained by their care providers, how they're spoken to, how they're listened to, and how they're made to feel. And the best way to prevent trauma is relationship-based care, and the best way to increase this sort of normal straightforward birth rate is relationship-based care I remember someone said that to me when I started to look at the way that I wanted to give birth and someone said well just imagine kind of going into hospital and then having to have sex in front of you know seven different people that you've never met who are then like prodding you and poking you with all the lights on and all the

rest of it like you probably wouldn't be that successful would it no it's so true and it's such an easy way for us all to think about it and it was really interesting to then obviously do the polar opposite which we were fortunate enough to do in a home birth and and I never for one second felt like anything was slowing down and I think that was because we were just kind of allowed to sort of get on with it effectively which was really really interesting and I remember our midwife said to me kind of shortly before we gave birth maybe a couple of weeks before she said you know you'll just you'll see I won't really do anything and I remember thinking okay interesting um I trust you so so let's say this is a good idea and And she didn't really, if that makes sense.

She watched like a hawk. And, you know, she showed me afterwards everything she's got. She's got everything there to take amazing care of you. You know, but other than checking the heart rate with the Doppler every half an hour or so, she really didn't do anything. She didn't do any vaginal examination. She didn't do those hands on thing because she said and having kind of looking back at it completely see that she knows that the birth is progressing she can see that the birth is progressing she can see that I'm evidently more dilated and going further towards a kind of active labor because the noise that I'm making the way that I'm dealing with each kind of contraction or surge and you know you can see very very easily that they're happening stronger and more quickly

and it was really really interesting that and I was kind of unsure about how that would play out and then the only part where I really wanted something hands-on was this guy's head was just a bit slow and I said you know we'll feel it on the next contraction and see because I was in the water you know see how far it's coming out, you know, feel that. And I wanted her to do that because I wanted her to give me some more information. And it felt like we were doing it together. I never, ever felt like, you know, it's a very kind of vulnerable position as a woman. You're kind of naked doing something you've never, ever, ever done before in front of other people.

And so, you know, having that sense of kind of teamwork and collaboration felt so powerful. Yeah, it's just such a beautiful thing what you're talking about and I wish that more women could have a birth like that I've had two birth experiences like that out of three and it's so empowering to feel that you are in charge of what's happening and you're the person who's doing it you're giving birth and lovely to know that you can you can call in that help when you need it and I can remember doing that with my midwives in my second labor in particular when I was feeling really frightened. It was probably transition,

which you probably now know is a moment where you panic and you think, and it's when you're fully dilated. But for whatever reason, I was feeling really frightened and they really comforted me, you know, and sort of mothered me and talked me through it.

But they also had a lovely skill at knowing when to hold back and to stay back you know to be on the other side of the room and just to let me get on with it and then of course the knock-on effect of that is that after you've had the baby you know for some women they even catch their own baby yeah and you know to have your baby born into your own hands and to lift your own baby up yourself if that's what you want and actually I have to be honest say I didn't do that because I actually didn't want to I was like they were like do you want to catch my baby and I was like I'm too busy so but you know to have that feeling of having done it yourself basically and having only had

the help that you asked for is so rare yeah it's so rare and I think that's what that's what I've found so interesting and it's it's again it's not coming at it with it anyone else has done it wrong I've done it right that's definitely not how I feel but I feel so lucky I thought the only way to give birth was to go to hospital to lie on your back maybe have your legs in stirrups and have someone looking up and actually I didn't want to do that and I think for me it was powerful to know that there were other ways of doing it if you want to do that that is amazing and you should feel empowered and educated in that but even in that I didn't know anything about it I didn't really know what an epidural was for example I had no idea that it would therefore like take away some of the sensation so it's harder to know when to push sometimes the whole

idea of freedom of choice and free choice is a really interesting discussion because you know people might say well if somebody wants to have a baby go to hospital and have their baby in hospital on a bed on their back then that's their free choice but actually it's not 100% free choice if all you've ever seen is the school video and one born every minute or Rachel from Friends giving birth on their back screaming on a bed and then you turn up at hospital and there's a room with a great big bed in the middle of it and the midwife says hop up on the bed and on you hop and then you end up having your baby on on a bed on your back then how much of that was a free choice a lot of it is a cultural conditioning and what happened to you is fantastic and that's what my mission has always been is to get information about different

options to people it's not to say if that's the kind of birth you end up having or you want, that's wrong. But it is to say, and also, did you know that birth can be like this? For the same thing, induction happens on the dot if you're not, you know, 41 plus four or whatever your local trust's policy is. But for me, if I hadn't done some learning around that, I would have had three inductions because all my babies were born at 42 weeks which is past the sort of NHS deadline so many women are told we are going to induce you next Tuesday before you leave we're going to write your name in the diary for induction next week or whatever they're not told these are your options you can wait you can do nothing you can be coming in and be monitored you can be induced

or you know you can whatever it's not presented to them as a choice it's presented to them as what is going to happen to them and for me that's the issue I think the research around when is the safe exact safe time to have a baby is obviously fascinating but it's ongoing there don't seem to me to be any absolutely rock solid clear conclusions either way. I think it's down to an individual woman to see how she feels. For me, I knew going into my second pregnancy that I'd already gone to sort of over 42 weeks with my first baby and then I went in to be induced. So I kind of felt like I'm okay to go to 42 weeks, you know, that is considered to be still within the bounds of normal.

So I'm going to go to 42 weeks, and if I go past that, then I'll have another think. And I didn't go past that. I had my baby on the dot. So I think it's just down to individual people to make that decision about what feels right for them. And, yes, there is evidence to look at. But ultimately what my passion is is not so much about the evidence but about women being right for them. And yes, there is evidence to look at, but ultimately what my passion is, is not so much about the evidence, but about women being presented with choices properly

and not being infantilized and talked to like they don't have any control over the situation because that is what happens a lot. So obviously, you know, you're very passionate about sort of birth and empowering women, but you've written your more recent book in light of the Me Too movement

and the wave of, you know, which is only a brilliant thing, but the kind written your more recent book in light of the Me Too movement and the wave of, which is only a brilliant thing, but the kind of wave of more feminist power that's happening and on the basis that that's not happening in birth and that there's a very long history of that. And I found the history really interesting, kind of going back to Louis XVI and things like that. And I wondered if you could give us a bit of an overview of that.

It's hard to look at the history of birth without seeing it as a power struggle. Ever since midwives were being burnt at the stake in the 15th century or 16th century there has been this ongoing desire for men and doctors to come into the birth room and to take charge and quite a lot of that has been financially driven and some of it maybe has been driven just through the fact that birth is such a powerful event, I think. And it's a bit of kind of like, what do they call it?

Basking in the reflected glory. You know, you do see photos of the doctor holding the baby up, you know, the Lion King moment, they call it, don't they? Yeah. And I think there is an element of that, of taking some of the power away

and wanting to be near and around that powerful moment and to lay claim to it in some way you don't have to go back very far into history like even my birth my mum was completely out of the picture in terms of choice I was born in 1975 and she was shaved. She had all the pubes shaved off. She was given an enema. I've said to her, did you consent to those things? I have no idea. She just says, I don't know. I don't think so.

That's just what they did. Then just before I was born, she was given an injection of pathogen, but she didn't ask for it. She just got it. And actually that's the worst time to have pathogen if you didn't ask for it she just got it and actually that's the worst time to have pathogen if you're going to have it because that's when it can cross more easily to the baby apparently so it's not brilliant plan to have it right at the end and then after she'd held me for a little while I was taken away to the nursery and she woke up in the night having had this pathogen and

and thought oh my god where's my baby and? And kind of went looking for me down the hospital corridors and the matron found her and kind of ushered her back to bed. She was still kind of out of it on the pathogen and didn't really know what was going on, but she felt very, you know, upset because she knew that she wasn't pregnant anymore and she didn't know where her baby was. And I'm not blaming my mum at all for that,

but I mean, if you think that it's not like I'm completely ancient, it's not like we're talking about, you know, several hundred years ago here, we're just talking about 40 odd years ago. That was the backdrop then. So we can't assume that we've come past that now. And that, you know, we're now in a much more kind of like a where place where women aren't getting a raw deal anymore in birth. And I think Me Too, in many ways, has paved the way for so many different conversations in such a fantastic way. People have been talking about birth as a feminist issue and about women's rights and childbirth for a long time. And I'm by no means the only person who's raised these issues. In the birth world, amongst midwives and doulas and birth workers, everybody kind of had a handle on these issues and the power struggles in the birth room. But I didn't think that a mainstream publisher

would be interested in publishing a book about it. But they were. And I think that Me Too partly paved the way for that because there are so many overlaps in the conversation about Me Too and Me Too in the birth room. Just in the same way that Me Too itself kind of woke us all up and made us go, oh my God, yes, that did happen, that happened to me.

And there was that kind of snowball effect of being able to say, well, at the time, I just thought it was just one of those things. But actually now that all these other women are saying how outraged they were about it, actually I was pretty outraged, you know. And I think that's happening too with women's birth stories.

Women are coming back to their births and saying, well, actually that didn't feel okay to me and I think that's happening too with women's birth stories women are coming back to their births and saying well actually that didn't feel okay to me and I have kept quiet about it because I just kind of thought it was just another part of being a woman and I just had to suck it up but there's also the challenge of the fact that undoubtedly obviously the kind of the doctor the midwife obstetrician whoever it is you know obviously you know your body better than anybody they know the profession better than you undoubtedly yeah and especially because we're so uneducated about it we we literally learn nothing about it at school it's it's really sad also I think the thing that I found most interesting and my brother said this the other

day he said you know everyone's you know guys say to him because his wife's pregnant at the moment you know you'll never feel more useless than when your wife's giving birth and I said you know I was opposite I said for us I literally could not have done it without Matt and what was so interesting about that was that we did a hypnobirthing course and in the hypnobirthing course learn the whole kind of process of birth like what's happening in my body at every single stage how that might feel how people might react to it all the different decisions and so Matt literally was able to kind of he was like a coach you know kind of like talking me through every single thing being so involved in it being right there in every moment because he knew exactly what was happening and was so educated and so part of the process rather than

turning up quite blind and it's not anyone's fault that they turn up quite blind they never received the information to know how to be useful but I guess my question is like how do you change it because having been lucky enough to have a you know positive experience like and I'm not saying it didn't hurt like it's a very intense experience giving birth a hundred percent like but I never ever felt I couldn't do it and I never felt that it existed apart from me I felt like I could do it and I wasn't scared to do it it was just harder than anything that I've ever done or probably ever will do and I guess you know how how do more people have an experience like that because that it seems I feel really guilty saying that I had

that experience and and I don't think that people should feel that way because it should be the norm well can I just say that you've said quite a few times in our conversation how lucky you were to have that birth and I think that's really interesting because I don't think that you were just lucky I think that you took an active role in your choices you've described in quite a lot of detail how you you well you were lucky that in the role that you're in, a lot of information came your way that might not have otherwise come your way. But when you got that information, you acted on it. You realized that you were not getting what you wanted from your initial care provider.

And you did your homework and you learned about things like the birthplace study, which shows that home birth is actually better and safer for women, especially low risk women. You learned that continuity of care and relationship based care was made it much more likely that you'd have a straightforward experience. Your partner took an active role. He got himself informed. You set yourself up. You got to know your midwife. You chose the midwife that you wanted and you made a plan, I bet.

And then there's an element of luck. That is privilege. And that is luck in action but not all of it is and you and I both did our homework and researched what would maximize our chances not guarantee maximize our chances of having the best possible experience whether we had straightforward birth or not because like I said even if your birth hadn't been straightforward maybe your baby had been in a difficult position or you know something that had prevented the birth from being straightforward and you ended up in hospital or even ended up in cesarean you probably would still feel positive about it although you might feel some disappointment that didn't go exactly the way you wanted and that's another thing I'm really passionate about is saying it's okay to say that you are disappointed about your birth if you didn't get the birth you wanted.

But yeah, you know, you did take an active role in your choices. So your question was, what can we do about all this? I think it's complicated. Part of it is women taking an active role in their choices. Part of it is women having that penny drop that says, I am allowed to ask for what I want. know another person I was talking to recently was shocked when I told her that if she didn't like the midwife who was attending her in her hospital birth she could ask for a different midwife it's like what you can really do that and I was like yes this is one of the most important experiences of your life why should you have it in the presence of somebody who's making you feel uncomfortable of course you can ask for a different midwife and we are living

in a time now where there's so much opportunity to look at positive birth images look at positive birth films unlearning some of that stuff that we've kind of the baggage we've got about birth and replacing it with some idea of the possibilities of it being a more positive experience is all really helpful you might find that you know by asking questions and knocking on doors you can get moved you know to a different scenario so getting that message to women that they can take an active role in their choices and that they and that birth doesn't have to be a horror show and it can be better and it can be different all of those things help but it's not a magic wand first of

all women are still giving birth in a system that can be isn't always but can be unsupportive of straightforward birth we've talked about you know the oxytocin and the room and the lack of continuity of care etc and secondly women's bodies do not always give birth in a straightforward way without the need for any help or intervention so in that case it's about being in it hopefully being in a situation where even though you don't get the birth you want you feel you still remain retain some elements of the birth you wanted for example you know skin to skin for example after your birth can be really really healing moment for women being the first hands to touch your baby so we have a lot of readers questions on this so I'm going to pick out

a couple of the kind of key ones how can you be more present and not be so caught up in the pain the nervousness and the anxiety I mean I think for me coming from a kind of yoga background really did help because I feel like I'd had a lot of hours spent being quite internal and being able to go into myself and for me I almost do not sorry you can hear Austin's tail wagging against the table he's like I want to talk about birth do not get me wrong I thought birth was physically unbelievably intense but I found it more challenging mentally to stay so much in your own head to not be distracted and to like have all your focus on kind of for me it was surrendering into the experience and just saying like my body knows what it's doing let it do it

stop getting in the way of the body and so trying to be calm trying to be present and I think hours and hours and days and weeks and months spent on my yoga mat and doing practices like meditation really helped because I had kind of inadvertently unknowingly trained myself to be able to do that someone had said it to me before like think of each contraction as a wave you know it starts it gets to the top and then it does come down so for me every time I was literally was picturing it thinking about it and it was almost like I say a meditation I don't want anyone to think I was like sitting there cross-legged, like humming, you know, in a kind of that sort of state. I wasn't, I was, you know, sweating and sounding like an Amazonian woman,

but I was really, really able to go internally. So I would say for me, the most helpful thing was that. And if you can kind of pick up the practices of things like meditation, it may be really helpful. Yeah, I think that's really good advice. visualization hypnobirthing any of those tricks and ways of harnessing the power of mind over body are a really good idea but also like you say to remember that women who are pregnant for the first time have a vision of birth being like it is on a soap opera or you know on TV where it's very

fast paced and there's no let up and it's like wall to wall pain. And then you hear these stories of people saying, oh, I was in labor for three days. And it sounds like, oh my God, you know, it just sounds so terrifying, doesn't it? To think that you're going to be in labor and in absolute agony constantly for this whole time. It just sounds absolutely impossible. So, you know, it's really important to learn that it isn't like that and that it builds up very very slowly and those people who are in labor for three days the intense part is probably only about the last sort of five to eight hours of that laborer and the rest of the time you know they maybe made a cake or they took their child to the swings or you know and i'm talking about straightforward labor here

i don't want to upset anyone who's listening to this going oh well I actually did have one of those labors because if a baby is in a really difficult position or there's some other complication then you can have a very painful and difficult labor where there's no let up but that is unusual and it's not normal so it means that something isn't right so in a labor where everything is going right and it's progressing in a straightforward way you will have these peaks and troughs and in between the contractions you actually feel quite fantastic yeah i felt amazing i mean the water really helped i when i got in the water i felt it took everything down by like 50 60 percent i mean it was magic okay another question um what

is hypnobirthing because people keep talking about it and I think a lot of people are a bit confused about what is it so we did hypnobirthing because it was the first thing we were pointed to by readers and I think the hypnobirthing course that we did was for Catherine Graves and it did two things the first thing we did the education piece like it just taught us both through a kind of normal birth what to expect what is active labor what is this what is transition what is crowning and I think my sister-in-law who's actually a hypnobirthing teacher said to me which I thought was so interesting and she was like you know lots of things are very normal to happen so like when the head is actually coming out it can feel like a sting because everything's

kind of being you know stretched and she said if you don't know that that's the feeling that you might get it might throw you because you're like, what is that feeling? So it's partly just knowing what's going to happen because in knowing what's going to happen, you're not suddenly like, oh my goodness, oh my goodness, oh my goodness. It kind of negates that, that sense of kind of fear as you go through, which I thought was really powerful. So that was the first thing. But then it was just, it was honestly, it was like birth meditation is the best way I can explain it. It was like visualizations and meditations just to get you in a calm space. So we're getting a lot of questions about tearing. I think that's something

that women are really scared about. Yeah, I think it is obviously a terrifying thought to think that that part of you, which is so intimate and delicate, and that many of us kind of have a funny relationship with as well, that that part of us is going to be damaged um by birth it does top the list i think of women's fears and i think it's interesting when i wrote the positive birth book i wrote that 90 of women will actually tear and that's just kind of how it is but don't worry because when people say tearing there are there are different degrees of tearing. So most people will have a very, very small tear. Most of that 90% will have such a small injury, if you like, that it won't need stitches and it will heal very easily. And it's only a very, very small percentage of people who have third and fourth degree tears, which are the serious tears that require serious repair however in writing the next book

I then spoke to lots of these wonderful midwives around the world I was talking to you about and discovered that a lot of them have much lower rates of perineal damage than that sort of everybody almost everybody will get some kind of damage so I think it's another interesting question to ask is there something that we're doing or not doing that could prevent or cause tears I want to kind of ask you whether you at all no I didn't and I was really scared of it as well I think like most other women and I asked my midwife about it and interestingly she said that um she almost never has her now this is so anecdotal I know that she's been doing it 15 years and she said it's very very rare and she's never had anything more than second degree

yeah ever and I think to me I found that thought provoking I don't know enough about it but I did find it interesting and again one of the things that I found interesting this guy's heart rate got a little bit high towards the end. And our midwife said, you know, she wants to come out now. Let's try a new position. And, you know, it was very calm. And she said, you know, you've got to really, really put everything into this next one. And I kind of pulled off from it. She said, why are you pulling off from it?

And I said, because I know that if I go too hard here like it's too much and she said well then you're you're in control you're in charge she said if it's if it feels like you're pushing it too far let's just do another one let's just do another one and it was really interesting and I knew if I had gone harder on that one I would have 100% torn 100% like I'm absolutely certain of it and so it was really interesting again of her really supporting me encouraging me helping me but letting me say when to go and when not to and I did think that was very interesting it is interesting and she's not alone and it would be so interesting if if this was looked into more why do people like her in their practice have such low rates of tearing and it often is the hands-off births

the water births and where women are allowed to tune in themselves and again be in control this is what we're talking about when we mean women being in control we don't mean women administering the epidurals or anything we just mean women being in control of what's happening to their bodies in those sorts of situations so being in control of how the baby emerges and being encouraged that they have the knowledge they can tune into themselves and the knowledge will be there rather than the sort of classic sort of image that you see in the sort of of the midwife standing around the bed shouting push push push that comes that whole idea of push push push comes from epidural use because when you have an epidural you do need somebody to help you push because you don't you can't feel when you're having a contraction that's the whole

point of it so you do need your sort of cheerleaders around the bed if you've had an epidural and that's great but I think unfortunately that idea that women have to be coached about pushing has crept into the whole culture whether you've had an epidural or not you may find that it's there's a sense of panic around the moment of birth and that the midwives kind of come in and sort of start telling you what to do and there's also other things happening now this thing called the oasi care bundle which i find very worrying where they're trying to prevent tears by doing a sort of maneuvers on women during the moment of birth. And I mean, it's called the Finnish grip, this thing that they do, and it involves sort of putting hands and hands on the baby's head and fingers in a V shape on

the perineum, and really controlling that moment of birth they're doing that because they're worried about the number of women who are having severe tearing in birth quite rightly but i think it's the typical for me it's the typical obstetric approach of let's um there's a problem here let's do more let's do more let's fix this problem let's get our tools out and see what we can do to fix this problem which is kind of like a pretty patriarchal kind of way of going about things rather than saying why is this a why is this problem here in the first place and in many cases is it because the women women are giving birth on their back is it because women are giving birth

with their feet in stirrups is it because women are being discouraged from tuning into their bodies? Is it because of overuse of epidural? Is it something that we are doing that's causing this problem? And maybe can we just look around at the people who are not having this problem, like your midwife's practice, and there are people who've got some good stats on this, and ask what are they doing? and the answer is they're doing less yeah and I want to finish with the last question which kept coming up did it hurt as much as everyone said it would and honest answer is no it's not that it wasn't intense like I can't stress that enough but I think when people say to me pain I think about someone like cutting off my arm it being a kind of unnatural pain and I don don't say natural, like a kind of, you know, you might be listening to something like, oh, she's a total

hippie, very alternative. And I don't mean it like that. But to me, it started off as a period pain and it became a period pain on crack, on steroids, on whatever you want to call it. It wasn't the most intense period pain that could ever happen. But it was a very normal seeming pain. There was never a moment where I thought oh my god is my body falling apart you know the last bit when she was really coming out was was a bit different but the 10 hours up till that felt totally normal and kind of natural for want of a better word and and I think that was one of the things that also struck me was that it wasn't a pain like someone cutting off your arm or like setting fire to you that you're like, what is that?

It starts small and it builds and it builds slowly and gradually and it doesn't catch you off guard in that sense. Yeah, I mean, it is intelligent design. And that's another sort of feminist issue around birth really, isn't it? Is are we made to do this? Are we built for this this are our bodies fit for purpose or do we actually need um to have you know to have this taken away from us to have stuff done to us for this for this birth to happen because our bodies don't really work that well and what you're describing there is a really good example of intelligent design of how the body is slowly helping you to build up to that feeling and then becoming more and more intense as you go through and yes also we've got to stop thinking about it you know people say well you wouldn't have a tooth out without you know pain relief would you kind of thing but it's a totally different sensation and i think that's what i

mean and a tooth out or an arm being amputated or whatever is because something's going wrong with your body whereas birth is an example of the body at its absolute peak of health and vitality and life so it's it's not a fair comparison to talk about you know surgery or whatever or tooth surgery in terms of birth birth is is what you were built to do I absolutely love that it's such an amazing way to end it and so if people want more information you've obviously got your book the positive birth book give birth, Give Birth Like a Feminist, but you've also got the Positive Birth Movement, which is an amazing website and a kind of support group and people getting together. Yeah, well, the Positive Birth Movement, if I could just talk about it for a moment, because I'm so passionate about it, is an organization that I started seven years ago. And it's actually a network of free to attend antenatal groups. And a lot of people still don't know that it exists or are vaguely suspicious of it.

Like, are they going to make me try and have a home birth? But it isn't like that. It embodies a lot of the ethos we've been talking about, which is that, yes, women can give birth in a more straightforward way. But also there is lots of information that will help them to do that. And also other women make different choices and they can also have much better birth experiences so it is a place for women to come together and talk about birth it's kind of like peer-to-peer sharing in the groups we have different topics so like this month the topic is induction next month the topic is human rights and childbirth and there's about 200 of the groups

around the uk and then there's another 100 of them all around the rest of the world in, I think, 36 or 37 countries. I always lose track because it changes all the time. So this is a free resource where women can go and make new friends and find out more information from other women. The idea is that women have the knowledge and they tell birth stories. They talk to each other and share information together. And I really, really wish that more people would know about the positive birth movement because it's such a great resource. Amazing. Well, thank you so much, Millie. Honestly, I can't thank you enough. And I hope you guys all enjoyed this. We are talking about something completely different next week. We're talking about digital detoxes and the amount of

time we spent online and how that is affecting us physically and mentally. So I will see you guys next Tuesday. Have a lovely week. Bye. Canada, reach great Canadian listeners like yourself with podcast advertising from Libsyn Ads. Choose from hundreds of top podcasts offering host endorsements or run a pre-produced ad like this one across thousands of shows to reach your target audience with Libsyn Ads. Email bob at libsyn.com to learn more. That's b-o-b at l-i-b-s-y-n dot com.