Every woman deserves a positive birth experience

In fact, she believes giving birth –whether at home in the pool or in hospital via caesarean – should be an experience that women will always feel empowered by. The key to this, she believes, is in taking an active role in their birth choices, making a plan, and becoming informed about the basics of female physiology.

In the five years since the initial release of her bestselling title The Positive Birth Book: The Bestselling Guide to Pregnancy, Birth and the Early Weeks, Milli has helped transform the lives of thousands of women by showing them how to have a positive birth experience.

To mark the publication of a fully revised and expanded version of The Positive Birth Book— the must-have pregnancy and birth guide for all expectant mums—we spoke to Milli about the secret of her success and how she is proud to be challenging the received narrative on birth.

A. I started talking about the term ‘positive birth’ about 10 years ago, because I felt there was too much polarity between the idea of natural birth as this idyllic, fulfilling experience, and hospital birth/caesarean/epidural etc. as the absolute opposite. What I wanted to bring was the idea that whether or not a birth is positive is up to the woman to decide—and I came up with the following 5 criteria: 

Q. Why is a positive birth experience important, both to mother and child? 

A. Well, you could start by asking the opposite: what is the impact of a traumatic birth on both mother and child? This can be quite far reaching. When a woman comes through birth feeling like she has been through something truly awful, this can affect her mental health, both long-term and short-term, and this can impact on her attachment with her baby, and ripple out further into her other close relationships. Nobody should have to start motherhood traumatised or with PTSD. It’s really a no-brainer why this is the case! On the other hand, a positive birth can be transformative to a woman, and as women make up half the population, it can also be transformative to the world! If a woman begins mothering feeling empowered and strong then this can impact on her parenting, her relationship, her self-esteem, her mental health, her career, her identity, and sense of self. 

A. Oxytocin, for example. Women need oxytocin to give birth. If you don’t make it yourself then you get it in a drip because you can’t give birth without it. Many people are surprised when they hear this. To make oxytocin you need a certain environment: no interruptions; calm, low light; warm, cosy, loving. A romantic vibe. It’s quite simple but is often forgotten in the modern birth room where the myth pervades that nothing in particular influences how birth unfolds; that it’s all down to whether the woman’s body ‘works’ or not. 

A. That completely depends. You can’t give a blanket answer to this question which is why individualised care is so important. The evidence shows that for low-risk women with their first baby, home or birth centre birth is safer for them, but that home is slightly more risky for the baby. For second and subsequent babies to low-risk women, home or birth centre are safer for both them and the baby. This is in the NICE guidelines. However, as I said, it’s down to the individual and we can’t make blanket statements about risk. 

A. I think there are portrayals of birth in popular culture—This Is Going to Hurt being a recent one and One Born Every Minute being another—that are unhelpful to women and basically terrify them. What has led to this is complicated (I’ve written another whole book about it!) but aside from scaring women, I think it also discourages them from doing any birth preparation because they feel it’s all ‘pot luck’. It makes them lower their expectations and just, basically, hope they survive the experience when it can be so much more than this. 

A. I had three great births overall. My first I was induced for being overdue and ended up with a forceps birth in hospital, which was hard, but the labour itself was still great. My second and third births were at home in a pool and absolutely wonderful. 

A. The fact that so many women are getting a raw deal. The number of birth trauma stories I heard at baby groups and among friends and families. I felt that surely we can do better for women. It was my feminist principles that were driving me, really. 

A. Well, because I did a bloody great job of it first and foremost! It’s funny and well-written and it’s ‘woman to woman’ and very down-to-earth, not yet another ‘expert’ telling women what they should or should not do. It hopefully speaks to all women no matter what kind of birth they want and a lot of it looks at mind-set, cultural expectations etc. and helps women unpick and unlearn all of that baggage in a way that other books don’t. 

A. That it has changed people’s lives. This is the feedback I get the most—that the book spoke to them either when they were a terrified first-timer or a traumatised second-timer, and helped them reframe the entire way they were thinking about or approaching birth; helping them to have the positive experience they didn’t think was possible, and that this was transformative for them. That’s a very nice message to get and I get about one a week! 

A. The same brilliant book as before, just fully updated and with some new additions such as a section on exercise in pregnancy from Charlie Launder, the author of Bumps and Burpees, and a section on the pelvic floor from Nikki at the Belle Method. Overall, I’ve tried extra hard to make sure that the book speaks to all women no matter what kind of birth they want or end up having.