Why Is Having a Natural Birth So Difficult?

In this first episode, I draw on my 25 years as an NHS midwife and doula to ask why, despite most women quietly hoping for a 'natural' birth, it often ends up being quite different.

This episode unpacks how we are being quietly shaped long before we walk into a labour ward. I explore why we find it so hard to have a natural birth in 2026, and how getting even close to that starts with listening to your own voice.

00:00 Navigating Birth Expectations

02:42 Empowerment in Birth Choices

05:29 The Impact of Medicalisation on Birth

08:45 Overcoming Authority in Birth Decisions

11:26 Claiming Your Birth Experience

Transcript

By the time most women sit down with me, they are full. Full of other people's birth stories, other people's fears, and other people's version of what a good birth should look like. From Instagram to your granny, from everything that you see out there, from the podcasts and the birth stories and the groups to what you were passed down from generation to generation.

of what to expect birth to be like. And that's for both ends of the spectrum, know, whether it's like birth is really scary and you should definitely go to hospital and have all the drugs, to the Instagramable perfect birth, the free birth in the woods, you know. Somewhere in the middle of that is your own voice and what you want. I am here.

for those who want a natural slash physiological slash normal birth, for those who want to birth their babies out of their vaginas and they have a calling that is deep within them. Now, often it starts as a, as just a, a voice that is common sense of a reason that, you know, you see the midwife,

you have your booking visit, where would you like to have your baby? I think I'd quite like to have a water birth or like to be on the birth center. And that's fantastic. You know, every birth choice is fantastic. I'm not saying that there's one better than the other, but I specifically talk to those who want a vaginal birth and a vaginal birth that is not traumatic, that is not dragged out with drips and drugs and von-tos, the suction cup.

The ones who want to have a birth on their own terms and really feel it, to feel that feeling of birthing your own baby, of catching your own baby with your hands as they slip into it all slippery and wet and bloodied. You know, that's who I'm talking to. The trouble is, all of that clouds us from our own inner voice.

And that's where we start knowing our own mind, knowing our intuition and being able to hear it, being able to listen and hear that little voice that says, actually, I'd quite like just a nice berth in water and to, I'd rather not have any drugs. And it often starts like that. And it's very tentative as well, I've noticed. So I've been doing this for over 20 years.

We're about 25 years now of supporting pregnancy and birth and postnatal, but pregnancy and birth is where my focus is. I was a midwife for 20 years and the past few years I've been a doula. And that voice is usually quite tentative because it's like almost like I'm not allowed to want it. I'm not allowed to expect that I can have this.

And that is really sad that we shouldn't expect that we can do this and birth our babies in a way that is joyful, positive, physiological, it's not dramatic, and it's not using drugs and so on. And again, the caveat is if you want to have drugs and if that turns out to be what you need for your birth,

This is not saying one is better than the other. But can you see how every time I say that you should be able to want this and get it, I somehow have to caveat myself because somebody out there will say, yeah, but not everyone's like that. But not everyone gets that. Not everybody's body is made for birth. Babies die and we need to save them. I mean, it's literally, it goes from

one extreme to don't expect too much to your baby might die and they are different ends of a spectrum and so even saying that this is what you want and going out to seek it you are going against the grain of your culture of society right now medicalised birth is the norm and to be honest it has been for a long time

Medicalised birth means having intervention of some sort. It might be induction. It might be right down the end of cesarean. But what we have now in the UK in 2026 has got to be heading towards 50 % cesarean section rate. And I think the last guess was about 30, 35 % induction rate. I think

places everywhere's different and it can be up to 50 % as their induction rate as well. so induction is not physiological. It's not a birth where you've gone into labour by yourself, your body and your baby have worked together to birth your baby and for you to meet your baby in a way where you are mobile, awake, catching your own baby.

able to be really present with them and it's a whole different experience. Anyone who has had two different births and has had a medicalised birth, I am one of those people, so I did have a lying down on my back birth with my first baby, which was a long time ago, lying down on my back with straps, the monitors.

I was fit and healthy. There's no reason I should have been like that. Struck to a bed, unable to move, in a lot of pain. I wasn't induced. I went into labour by myself and yet I didn't know. I trusted the people caring for me and this is in 1995. I trusted the midwives caring for me that they would know. But also I had watched countless births. I've been obsessed with this.

since I was like six years old, know, I'd watch countless births on TV where everyone sits down, they lie down to have their baby and they push their baby out on their back. So of course I thought that's how you have a baby. I never saw somebody being upright or leaning over the back of the bed or standing up or being on all fours or any of those things. And despite that being the most logical way to birth a baby,

because you're opening the pelvis and opening the sacrum, giving your baby just a little bit, it's only a tiny bit of room, but it's a little bit more room that enables them to move and manoeuvre and come down. It's the most logical thing, but still we have still research evidence coming out and data coming out now in the past couple of years that women are still lying on their backs to birth their babies, the majority. So nothing's changed in 30 years.

This is not new that it is very difficult to get to have a physiological mobile empowered, if you want to call it that, birth inside the medical system. And in the UK, that's the NHS. So what people usually do, and I've watched this for years, is to go out and get the information.

They go and get the information and they arm themselves with information so that they can make a really tight birth plan. I want this. I want to be mobile. I want to be off my back. I don't want coach pushing. I don't want an episiotomy. All of those things. And then they walk themselves into a system having never thought

how they're going to articulate that in the moment. Because in the moment, you are at your most vulnerable. We are of course at our most vulnerable when we are birthing a baby, when we are in pain, because a lot of time there is a bit of pain with it. Some people seem to get by without any at all, but generally there's some intense sensations there.

No, actually, I don't want you to do that to me. No, I don't want you to know. That's a really top art, big ask of somebody, isn't it? That at that point, they say, thank you. So, and so that's what's happened. And that's what I have seen so, so many times. Years ago, I trained as a hypnobirth teacher.

and I was working with like regular people who want to do some hypnobirthing. I know how effective hypnobirthing can be because I started suggesting people use it in 2000s, 20 years ago when I worked in Wales, just under 20 years ago. And they would just listen to a CD back then. And I was watching this, the way it impacted on people and it was amazing.

So I trained the hypnobirthing teacher and I helped people do their birth plan. And then I watched them go, cause I wasn't their doula, I watched them go into the hospital and end up with a whole list of interventions. Because nothing that we were doing was actually exploring what was going on in their head and how they are as a person. Where things might start falling apart. Because the things start falling apart when

we are thinking about. So it might be just like, is the norm. Of course this isn't the norm. So I'm going to lie down and of course they'll want to do an examination. That's okay. It's that'll be fine. I'll, I'll just have that one, you know, but that one examination may well be the one that leads to the whole cascade of intervention. If you've never said no to somebody that

in authority potentially because that is what we're talking we're talking about that and how our relationship with authority our relationship with experts with the medical establishment if you're somebody that hasn't ever challenged one of these people like your GP or whatever or even like challenged anybody at work challenged anybody that even challenged your partner

you know, or your friends and you prefer a sort of quiet life and you don't want to upset people and you don't want people not to like you or to make things difficult for you. Those are the sort of very, very, very common threads that come out of this is it's going to be even harder to be able to say no to somebody who is positioned as an expert who is telling you about the safety of your baby.

So that is the thing that we need to get somebody to, that you need to get to, to be able to make those really deep decisions that are in tune with your heart, because that's what we want. That you start tuning out the noise that's around and everything that you've grown up with and everything that you expected yourself to be as a person.

to be able to get to the point to claim that physiological birth. And of course, I could say, no, we shouldn't have to do this. We shouldn't have to do it. You should be able to be able to be supported to know that whoever is gonna be in that room caring for you, whatever midwife, whatever doctor is gonna be 100 % behind you and supporting you and the decisions and choices that you want.

But the truth is that the system is not set up for that. The system is not set up for individualized care. The system is set up on a population level that treats everybody the same. And as course we live now, we have to recognize we live in a society of litigation, of blame and so on. So everyone in the system, having been in the NHS for so long,

The majority of people want you to have a safe and good birth. But what's safe and good for somebody who is used to a medicalised process, and as medicalisation is more and more common, we are going to have less people who have even seen a natural birth. A birth without drugs, a birth where somebody's moving around, a birth without having continuous monitoring.

We're literally losing people who are skilled enough to support you without you having to stand up for yourself. Because I agree, we shouldn't have to be able to be standing up for, but that's where we are. So it's like starting to think, what is it that I want? And what is it that may prove difficult for me?

and how am I going to bring those together? So there is less difficulty for me in being able to do that. So it might be that you think about how you might phrase things, but also it's about thinking about this before the labour happens so that

In pregnancy, you start to consider deeply what you really want and how you are able to articulate that to get it.

If this resonates with you, the link in my show notes will take you to my website and you can find me on Instagram as well.