Many women believe that birth is painful and something that has to be 'endured'. They tell horror stories of intervention and alienation from their own body. However, it is the medicalisation of birth that has led many women and those around them to lose confidence in women's ability to give birth without interventions, or without others telling them what to do. It has also led to many health professionals in Australia losing the skills and confidence to deal with birth as a normal part of life.
 
For these reasons we are seeing intervention rates sky rocket, and since higher levels of intervention are linked with lower levels of satisfaction for women, it is not surprising that many women have births which they are dissatisfied with. Many are no longer happy with just having a healthy baby; they also want to avoid births which could leave them with physical and mental impacts for years to come.

Understanding What Makes Birth Better
The future emotional and physical health of you and your baby often rests with the choices you make about where and how you give birth. A woman (and her partner/husband) can feel much more satisfied with their birth experience if they understand why their birth might be managed in a particular way, if they feel that their feelings and concerns are taken seriously and addressed, and they have a say in what happens. This includes knowing that any interventions are absolutely necessary, and not being left with lingering doubts that things could have been different, for example, if you'd been given more time or asked for a second opinion.

One key thing in helping yourself have a better birth is to make sure that your views of birth and your expectations match those of your main care provider and birthplace. Statistics and research show that not all care providers and birthplaces are associated with the same outcomes or experiences. For example, Australian research shows that having your baby in a private hospital reduces your chances of a normal birth and dramatically increases your chances of an unnecessary caesarean or episiotomy.

So what can you do to help yourself?
Many women are surprised to discover that bad birth experiences are often less to do with how they coped with birth and more to do with the way their birth was viewed and managed. To increase your chances of a better birth, it is important to understand that in Australia there are two different views of birth, and you need to find care providers and birthplaces whose views match your own.

The "obstetric view" is that pregnancy and birth are a medical risk and potential danger for every woman, and so need monitoring and intervention by doctors and technology. The "midwifery view" is that pregnancy and birth are healthy aspects of life that most women's bodies can cope with well, and which require only the support of a professional midwife unless complications develop.

The main differences between these views affect:

• Who is in control of your birth -  the care provider, you, or both together
• Whether you are expected to follow the usual plan preferred by the care provider or birthplace, or can discuss your care and negotiate a plan which suits your own personal needs and situation
• Whether you are only "allowed" to do what the care provider prefers or what hospital policy dictates, or whether you can do what you feel you need
• Whether you must perform according to time schedules and routines, or can follow your own body and feelings
• Whether technology and interventions are used routinely for every woman, or only when the woman and/or baby really need them
• Where you can give birth (birth centre, labour ward, home, private hospital)
• How much, and what kind of, support you will receive in caring for your baby

People with the "obstetric view" tend to err on the side of interventions, rules and time limits, often using technology to "rescue" mothers and babies from what they see as the difficult process of birth. Care providers with this view are most likely to be obstetricians because they are trained to be specialists in complications, technology and interventions. However, some obstetricians hold the midwifery view, and some midwives hold the obstetric view.

People with the "midwifery view" believe that most women can have an uncomplicated birth and tend to err on the side of intervening only when complications develop or are likely. They are more likely to encourage natural birth and natural pain relief methods in the first instance, and to allow the woman to labour in her own way and time. They will make the birth environment quiet and supportive and be with the woman through most of her labour, focussing the care on her needs rather than around hospital policy or their own preferences.

Care providers with this view are most likely to be midwives, but some obstetricians also practice in line with this view, and more so those who work only in public hospitals.

Understanding these views can help you in planning your care. For example, if you are keen to use water in labour and birth, and to have a waterbirth, you need to find a care provider and birthplace with the "midwifery view", because this is more associated with natural methods. You will also need a birthplace with the facilities and policy to support waterbirth, and care providers who have experience in safely managing waterbirth.

There are many other things women and their partners can do to help themselves have a good birth the first time round, or to have a better birth than they had previously. A well-researched and easy-to-read new Australian book written for this purpose is "Better Birth: The Definitive Guide To Childbirth".