I had met Jane, my midwife, at a conference for home birth near Cambridge in the Spring 2001. I was desperately disillusioned with caring for women and babies in a hospital setting and had begun a search - there must be another way.

Jane practiced independently and I felt keen to know more. We had sat next to one another during the lunch break, she had given me her telephone number telling me she was running a workshop about independent practice and invited me along. I attended the workshop, learned and was reminded a little of the way midwives can work and began to feel passion and hope returning. Little did I know I was shortly to begin a different learning experience of pregnancy and childbirth.

A month or two later, on fathers day, my husband Simon and I discovered with excitement I was pregnant. I telephoned Jane soon afterwards as I knew she can sometimes turn away six women in a week and I knew I wanted, if all was well, a homebirth with a midwife I knew and resonated with. I also knew I was unlikely to receive this care on the NHS where midwives are stretched to their limits and homebirths relatively uncommon. Also, from experience I knew midwives working in the NHS are usually obliged to comply with obstetric protocols that, in my view, leave little room for intuitive practice and can interfere with a woman's labour - robbing her of her right of passage into motherhood and truly experiencing her power as a woman.

I must state at this point I do not condemn all hospital births or obstetricians, they have an important part to play and save many lives, and some places are very forward-thinking. I do, however, feel it is only a small percentage of women who really need to be in hospital and that with increasing medicalisation and the up rise of litigation and therefore defensive practice we have lost, in our culture, the authenticity of birth.

Had I been in hospital I would have been one of those women labeled with "failure to progress" with a 17 hour labour. Had I complied with obstetric protocols a syntocinon drip would have been infused as I was only having one contraction every four to five minutes for most of my labour. My baby's heart rate was erratic for the last fifteen minutes before birth so I probably would have had a forceps or ventouse delivery, or even an emergency caesarean, as if a syntocinon infusion had been used fetal distress may have been brought on a lot earlier with more frequent contractions. (Maybe less frequent contractions was nature's way of protecting my baby?) All of this would have probably have gone hand in hand with strong pain relief such as an epidural. As it was I found the pain horrendous and I yelled my way through labour and I think I would have given in to temptation to have an epidural had it been offered and readily available, the pain was nauseating and I became exhausted with repetitive vomiting.

As it turned out I still had the energy to give birth (on mothers day!). I had had no pharmacological pain relief, I did not tear and my daughter cried immediately after she was born (apgar scores 9 at 1 and 10 at 5mins). I had been taught an actively managed third stage of labour with an oxytocic drug should be advised after a long labour as there is an increased risk of a post -partum haemorrhage yet I did not haemorrhage with a physiological third stage (300ml blood loss) despite being at the end of a long labour and exhausted. My baby was therefore able to separate from me naturally rather than our connection being severed with her cord cut before it had stopped pulsating. I have heard so many newborns gasp just at this point and have often wondered if and how much of a shock to their system this is - the changes to be made in their circulation after birth forced upon them and their oxygen supply (if they are not yet ready to breathe) cut off which does not seem a sensible action. I was the first person to pick up my baby and we had skin to skin contact and she breast-fed. There was no being hurried to a post-natal ward - I was soon into my own bed cuddled up with my husband and our baby.

I had had the best possible outcome I could have hoped for - one as a midwife I would have felt a great sense of fulfillment about when caring for a woman and her baby, yet I rarely had this experience working in hospital. I believe the environment has a tremendous effect on a woman in labour.

At the end of pregnancy, and accentuated in labour, I had a feeling of wanting privacy and to shut out the world in a way I had never felt before, and in hospital I know I would have felt anxious and exposed. It is known that anxiety interferes with the hormones of labour - and what perfect sense this makes. In nature if a woman is anxious it may not be safe for her to birth - safety is obviously paramount in birth and this feeling of withdrawing is natural to ensure a woman finds a safe place. We have indoctrinated women that hospital is the place of safety so no wonder this is where most women choose. Also it follows why many women go to hospital very early in labour - they wish to settle into their chosen place of birth. I would have chosen a hospital had I not had an insight into the general lack of privacy and interference with normal labour by well-meaning obstetric staff that create emergency situations left right and center. The need for childbirth to be in hospital may then be reinforced by new parents leaving thinking :

"thank goodness we were in hospital as we needed an emergency caesarian", or
"thank goodness we were in hospital as our baby needed resuscitating".

Little do they know that to go into hospital to have a baby the chances of needing a caesarian or the baby needing resuscitation are increased. What a trauma to begin life with - how is this impacting on lives - our future generations?

I was able to labour naturally and had a normal birth and a healthy baby. My baby's heart rate was closely monitored every fifteen minutes in the first stage of labour and after every contraction in the second stage with a hand held sonic aid, I was observed but there was no being wired to a CTG monitor, or my blood pressure taken every hour, or a midwife not focusing on me to attend to another woman, answer the phone or to write ridiculously detailed notes then enter them into a computer (yes I do feel writing detailed notes is important but not so it deprives the woman of care). The only vaginal examination I had I asked for and there was no partogram to show if I was "on target" - setting me up for failure. There was also no-one telling me to push (apart from near the end when Jane knew my baby needed to come out) or not to shout or feeling sorry for me in pain offering pain relief undermining my ability to cope or implying I was behaving unacceptably. I was aware of feeling very vulnerable and a heightened sensitivity to what my midwife thought of me - the slightest indication that she was irritated with me or thought I was not managing I felt I might have lost belief in myself. Jane was tough with me at times but I did not feel criticized or abandoned. I remember when I reached breaking point, I felt I just could not go on and she said:

"we can go to hospital if you like but you just need to get on with it".

I had got to know Jane well in the antenatal period and had built up trust and it worked that she didn't feel sorry for me - she brought me back into focus as I realized she really believed I could do it, I believed her, and my strength returned. This was a turning point for me - instead of dreading each contraction I began to welcome them and soon my baby's head was in sight.

I was grateful I was able to be in pain without anyone trying to take it away or "make it better" because they themselves felt uncomfortable with it. No-one tried to talk me through the contractions or touched me or comforted me unnecessarily - this was not what I wanted, I needed support but not help. I think it is so important a midwife or any other birth supporters do not deny a woman of experiencing her ability to cope and therefore her strength if she chooses not to have pain relief. I felt a boost in confidence having given birth using my own reserves and for this reason I feel a sense of completeness about my birth experience. At the time the pain shocked me beyond all preconceptions but there is such a sense of achievement having been stretched to what you felt were your limits and then finding out you are more than who you thought you were and can still go further. You expand as a person, you are more open-minded as your previous idea of what you were capable of has been challenged and your self-respect grows. Perhaps you are ready to nurture a child as a bigger person with greater depth and understanding. Maybe this is a purpose of the pain - to journey into motherhood, and to begin with this sense of pride and wonder, not trauma and depression.

True support for women is so important - for me this was to be at home in safe surroundings and with caring people who would enable me to go through whatever I needed to go through to give birth, without judgment. One of the first lectures we had as student midwives was entitled :

"Is midwifery an art or science?".

I now feel I have a greater understanding of what the art is - enabling a woman to feel in touch with her strength and power to give birth. It is a great skill to be able to hold a safe environment without being afraid - trusting in yourself and above all the normal process of birth. I feel Jane is a midwife who embodies this skill and I do not believe it is a coincidence that 96% of the women she cares for have normal births, and this includes twin births and breech births and so on. I believe if more midwives were empowered themselves to become skilled in the art of midwifery without the constraints of the hospital setting (where it is rare to be able to practice autonomously) more women would get the true support they need in giving birth.

Midwives are professionals trained to care for women having a normal pregnancy and birth and trained to detect abnormalities. I am asking as a woman of childbearing age that our maternity care be revolutionized in this country - that midwives work in small teams caring for and supporting women in the community, booking no-one for a hospital birth (unless there are indications) and attending all women at home in labour. Then it is left open - if the women choose to transfer to hospital they can. This leaves a small group of obstetric staff working in hospital who specialize in emergency care and are not desperately busy and can concentrate on caring for the women who need to be there. I believe then midwives would flood back into the profession, be fulfilled at work and the women would receive the care and support they deserve.