The surge of interest in, and commitment to, birth centres in the
UK may be one positive way of reclaiming undisturbed birth and
allowing students, midwives and women to once again know
the beauty of a woman’s body doing what only she can do best.
The encouraging outcomes of the NPEU Birthplace Study
(Birthplace in England Collaborative Group 2011), the Serenity
Birth Centre (Gutteridge 2011) and other birth centre reports,
would suggest that there is something integral about the
birth environment, about midwives being with women and
understanding how labour is best supported. There is little
quantitative research that can demonstrate the wisdom of birth
but there is much anecdotal evidence, storytelling and women’s
talk, which can pass on the tricks and magic seen in a
Baker A, Ferguson SA, Roach GD et al (2001). Perceptions of labour pain by mothers and
their attending midwives. Journal of Advanced Nursing 35(2):171-9.
If I were to give three pointers to midwives wishing to be with
women in a sensitive, supportive manner, I would suggest they:
Be gentle and kind at every opportunity through pregnancy,
birth and afterwards
Be with women, not coaching, not doing, just offering calm
support and intuitive help
Ensure the environment is nurturing by being present
throughout a woman's labour, or when she needs you,
offering therapeutic touch if the woman wants this.
Birthplace in England Collaborative Group (2011). Perinatal and maternal outcomes by
planned place of birth for healthy women with low risk pregnancies: the Birthplace in
England national prospective cohort study. BMJ 343:d4800. http://www.bmj.com/highwire/filestream/545014/field_highwire_article_pdf/0.pdf [Accessed 2 October 2012].
Burvill S (2002). Midwifery diagnosis of labour onset. British Journal of Midwifery
Chishti GM (1988). The traditional healer: a comprehensive guide to the principles and
practice of Unani herbal medicine. Rochester, VT: Healing Arts Press.
Corli O, Grossi E, Roma G et al (1986). Correlation between subjective labour pain and
uterine contractions: a clinical study. Pain 26(1):53-60.
Green JM, Coupland VA, Kitzinger JV (1990). Expectations, experiences and psychological
outcomes of childbirth: a prospective study of 825 women. Birth 17(1):15-24.
Gutteridge KEA (2011). Serenity Birth Centre: clinical outcomes report for Sandwell & West
Birmingham Hospitals NHS Trust. [Unpublished].
Gutteridge KEA (2001). Failing women: the impact of sexual abuse on childbirth.
British Journal of Midwifery 9(5):312-5.
Hobbs L (2007). Assessing cervical dilatation without VEs: watching the purple line
revisited. Practising Midwife 10(1):26-7.
Kitzinger S (2000). Some cultural perspectives of birth. British Journal of Midwifery
Kitzinger S (2002). Rediscovering birth. New York: Pocket Books.
For a midwife to understand how a woman's labour is
progressing she must ‘be’ with the woman. If the woman
allows it, being close to her, feeling her abdomen and listening
in to the baby's heart with a Pinard stethoscope will suggest how
relaxed she is between contractions, the power of the uterine
activity, the position of the fetus and also her body temperature.
Only then will a midwife appreciate how a woman is moving
through labour and how she is coping with the process.
The three pointers above, and the physical signs discussed
earlier in this article will not guarantee anything during labour,
but they will help you to assist the woman in her journey
through birth, and she will remember you for the kind and
compassionate person that you hope to be and, whatever
the outcome, will result in a good memory of her birth.
Lemay G (2005). Angle of the body during a contraction: to push or not? Midwifery
Newton N, Foshee D, Newton M (1966). Parturient mice: effect of environment on labor.
Redshaw M, Heikkila K (2010). Delivered with care: a national survey of women's
experience of maternity care 2010. Oxford: National Perinatal Epidemiology Unit,
University of Oxford.
Shepherd A, Cheyne H, Kennedy S et al (2010). The purple line as a measure of labour
progress: a longitudinal study. BMC Pregnancy and Childbirth 10(54). http://www.
biomedcentral.com/1471-2393/10/54 [Accessed 5 October 2012].
Sutton J (2000). Occipito-posterior positioning and some ideas about how to change it!
Practising Midwife 3(6):20-2.
Sutton J (2003.) The rhombus of Michaelis: birth without active pushing and
a physiological second stage of labour. In: Wickham S ed. Midwifery best practice.
Edinburgh: Books for Midwives.
Wickham S, Roberts K, Howard J et al (2004). Body wisdom: detecting birth by smell.
Practising Midwife 7(1):30-1.
Wagner M (1994). Pursuing the birth machine: the search for appropriate birth technology.
Camperdown, NSW: ACE Graphics.
Wilson RI, du Lac S (2011). Sensory and motor systems. Current Opinion in Neurobiology
Winter C, Cameron J (2006). The 'stages' model of labour: deconstructing a myth.
British Journal of Midwifery 14(8):454-6.
SEN, RGN, RM, SoM, MSc & Dip Counselling & Psychotherapy
is an established consultant midwife who is passionate about women’s issues and particularly in relation to childbearing, with a
reputation for representing women’s psychological wellbeing. She founded Sanctum Midwives, an organisation that educates,
represents and challenges stigma around sexual abuse and its impact during motherhood, and was involved in developing the
‘Your Birth in our Home’ project at Sandwell & West Birmingham Hospitals NHS Trust, which offers intrapartum services in two
birth centres. She is currently undertaking her doctoral studies examining fear in relation to childbearing women.
Essentially MIDIRS • March 2013 • Volume 4 • Number 3