On one one level I could describe the birth of Lydia as very straightforward, it was medically uncomplicated (with the possible exception that she was a posterior baby) and everything went smoothly. I was successful in achieving a natural birth i.e. I gave birth without any pain medication and no drugs were used at any time to induce or speed up labour. I would also describe Lydia's birth as a happy one – there were some moments of stress but there were many more moments of humour and tenderness, and Lydia arrived into my arms in a warm, dark room, welcomed with smiles and good intentions.

At the same time I realize now that my birth experiences were anything but straightforward, at least in Singapore and probably in much of the Western world. I know realize just how unusual it is to have this kind of birth in Singapore, and I believe that my experience could have been VERY different had I followed the path I initially took at the start of the pregnancy. I believe that for me this pregnancy and the birth of my daughter was just the start of a journey which I am still very much engaged in – a process of personal development and growth and the development of a totally new perspective on pregnancy and childbirth.

Lydia was my first baby. At the time of her birth my husband Neil and I had been married for 8 years and were both living and working as expatriates in Singapore. I had wanted to have a child for a long time, Neil was the more reluctant of the two of us.

To begin with I had no words for an active birth, but I knew I wanted a gentle one – the result of teenage viewings of documentaries about Leboyer's work and other things I had read and come across over the years. I also had the legacy of my mother's stories about my own birth – a fairly clinical and cold experience in which my father was not allowed to participate and where my Mum was left feeling very brutalized by the experience of labouring alone with no support. What was interesting to me was the number of horror stories women would gladly share about their own birth experiences – the pain, the blood, the tearing, the cutting. Every birth story I had ever heard seemed to involve hours of labour, often ending in a caesarian, and accompanied by terrifying complications like tearing, incontinence, cracked nipples from breastfeeding and all manner of other problems. I admit to feeling pretty intimidated about the whole thing.  

I therefore think that initially my intention in finding a doula was to have someone to help me through all this pain and fear. I wasn't looking for empowerment, I was looking for someone to help me in this alien environment, something like a guide or maybe even a mother-like figure to take care of me. 

Finding Nikki and the Parentlink doula group was a bit like finding an oasis in the desert. It amazed and thrilled me to hear women talking about their birth experiences in very positive terms – natural births, home births, drug free births – it was incredible to me to realize that there was a world in which this kind of birth was considered normal. It was like my whole reality had shifted. At the coffee mornings I felt excited and inspired. I began to think that maybe this could be my reality too. I was working at the time and so used to slip away from the office on the pretext of attending some meeting or other – so being at the coffee mornings, full of babies and doulas and new mothers was somewhat like being in a parallel universe.

The difficult bit was the reactions I got back in the "real world" when I shared my plans for an active birth (as I had learned the terminology by then). Some people smiled, some were downright dismissive but I certainly felt that what I was looking for was difficult, unusual, even a bit weird. It began to seem as if it wasn't just about the birth but about my sense of personal identity. Was I a suit-wearing professional sailing serenely through my well managed pregnancy under the guidance of a reassuringly expensive and professional ob gyn? Or was I more like the women I had seen at Nikki's place – the uber-earth mothers, all unshaven legs and lactating breasts? I used to find myself very torn between the two extremes and possibly at one level I still do.

Meanwhile the more I learned and read about the benefits of an active birth and the downsides of what I had previously thought were fairly benign interventions such as epidurals,  the more convinced I became that a "normal" i.e. highly interventionist birth, was not what I wanted. However, this realization was not instantaneous. I remember at 20 weeks still thinking about having an epidural. It was only through a gradual process of reading, talking to other women, going to Nikki's coffee mornings and so on that I gradually gained the knowledge and confidence to choose an active birth.

It was during this early phase of the pregnancy that I also found myself switching ob gyns. Initially I was with Dr. R  and did everything  very much "by the book" – I had all the scans, I had the AFP test, and so on. In fact I actually cringe now to think that I even had a vaginal scan done at around 8 weeks – something I would not do now.  I never even thought to question it or that there was an alternative way – this was what all my friends had done, and what the books I was reading at that time recommended. I realize now that I was in a totally different place to where I am now. I can't say I was totally passive, because I did put a fair bit of effort into pursuing the doula route, changing ob gyns and so on, but the full implications of choosing the active birth route had not yet sunk in. I now feel that it comes as a package, you can't pick and choose. Once you cross the rubicon and start to question and take responsibility for what is happening, this extends to all areas of pregnancy and parenting, not just the actual birth itself.  

Soon after I met Nikki I spoke to her about which doctors she would recommend given my birth preferences and she suggested Dr. T. When I met him I liked his laid back style and also the fact that he was totally unquestioning about me wanting a doula. I remember him saying "you can give birth standing on your head if you really want to – you probably wouldn’t be able to, but if you want to try that’s fine with me!".

So by the end of my pregnancy I had firmly made up my mind that I wanted a "natural birth". Armed with Janet Balaskas and Dr Sears I wrote my birth plan (Neil read it and said it sounded okay to him!) and then relaxed to enjoy my month of maternity leave, swimming and shopping and doing prenatal yoga and all the usual expat pregnancy things. I met with Nikki a couple of times before the birth to go over the details, and also met Tania who was attending the birth as "second in command" to Nikki as part of her training. I felt very happy to have their support and so did Neil who was quite upfront in hoping that my having two doulas let him off the hook as far as supporting me at the birth!

Lydia's due date came and went. First a week, then another. During that time Neil and I spent a lot of time eating out – with a "this might be our last chance" attitude. However by the time we reached 10 days "overdue" I was starting to get anxious about the wait, and to worry about being induced (having in mind the "cascade of interventions" we had talked about on the Active Birth class). I had already had some show so knew things were moving, but no real contractions. It was Saturday and I was due to see my doctor on the Monday, by which time I would be 12 days over my due date.  

I recall now how every passing day over the magical "due date" made me feel more and more impatient and anxious and how very long each of those days seemed. I can totally understand now how many women allow their doctors, or probably even encourage them, to get things moving artificially, even if they know logically that such a route could lead to further intervention. It's very difficult (especially for a first baby) to just accept that they will come when they are ready and not before. It's difficult to imagine and understand that even before you are in active labour your body is preparing itself for labour in ways that you cannot see or feel, such as your cervix softening and starting to dilate. There is also the temptation to make the uncertain (when will I go into labour?) be more certain by accepting interventions to start the process. I can understand now how it could be very tempting to hand over the reins to the doctor, especially when you can say afterwards "well, I had to be induced" or whatever. Taking responsibility can be scary – and not everybody wants it. 

In the end I started having contractions on the Saturday night after a very convivial and relaxing evening with some very good friends of ours at home over pizzas and red wine (plus a cup or two of cumin tea during the day). I certainly think the evening at home and the glass or two of red wine I drank helped relax me, that and knowing that Neil was there if anything happened. I called Nikki that night to let her know – said to her that the baby felt like the baby was break-dancing on my cervix. I suppose she was – as a posterior baby her head would presumably have been pressing against the cervix but not quite fitting properly, which is why it felt strange. According to my birth notes, I started having contractions that night although I don’t remember the point at which the odd feelings became actual contractions.

We went to bed, but I didn't sleep. I remember getting in and out of bed lots of times during that night and pacing the flat in the darkness. I also took a couple of baths during the night and at one point even got up to make myself a heat sock using rice, spilling uncooked rice all over the kitchen floor in the process. I chose to spend most of this time alone, but by about 4am I was seeking help from Neil  – we started timing the contractions and he was rubbing my back and trying to help me breathe through them. I remember that the pain made me tense up and hold my breath, and it was so useful to have someone there to breathe me through it and help me relax.  I remember that it felt so nice to lay and cuddle in bed in the "spoon" position – I also remember feeling very grateful that he was there with me and helping me. Neil told me some time afterwards that he needed to be needed – he needed to feel that he was useful and could make a difference.

The contractions were irregular so I knew it wasn't time to go to hospital, but they felt tough and were frequent with the pain mainly in my back. Around 6am I asked Neil to call Nikki – I was starting to feel a little panicky, wondering what stage in labour I was at. I will always remember the overwhelming feeling of relief I felt as she walked through the door – someone is here who knows that to do!  I remember a sense of wanting to relinquish control – I think I wanted someone strong to take charge of the situation and guide me through it.

Tania also arrived around this time and took it in turns with Nikki to massage my back and apply sacral pressure. I remember feeling barely conscious of who was in the room with me – I didn't really care, Nikki and Tania seemed to blend seamlessly into one person, I just knew that someone was there helping me. 

By this stage it had became obvious that the baby was posterior and we had to wait for her to turn before true active labour could begin. Looking back on this, I know that I knew well before labour began that the baby was posterior. I think I had just been in denial about the implications this would have during labour. We had discussed posterior babies at the coffee mornings and also at the Active Birth classes. For some weeks Neil had been instructing me to "keep that uterus tilted forward!" and I had made some attempts, such as watching TV while sitting on my birthing ball, and trying to dive to the bottom of the swimming pool to help lift the baby out of the pelvis and therefore turn. However, I did this in a fairly half hearted way, thinking that everything would probably work out okay on the day. 

Looking back on it now and having read more about it I am sure that if I had not had a doula to help and support me through that day and to talk me through what was happening at each stage, we would have gone to hospital far too early in labour, thinking I was in active labour when I was not. I guess I would have been only a few centimetres dilated at that point so no doubt would have been subjected to a barrage of interventions.  I know now that if I have a posterior baby in a subsequent pregnancy I will be much more active in terms of trying to help it find a more favourable position prior to labour.

I realize now that you can take a pregnant woman to water but you can't make her think – I "knew" Lydia was posterior and I "knew" that this could mean a long "back" labour, but I didn't know quite how long and didn't really take this into account enough. I didn't eat and drink enough, and was very tired, so that by the time we got to the pushing stage I was surviving on adrenaline.

Anyway, later during the day we moved into the living room, and spread the quilt on the floor, with me leaning on the birth ball. This is one of my favourite memories from the whole birth – the sunlight was streaming in through the window, we had Gregorian chants playing on the stereo and Nikki was calmly but firmly massaging my belly with oils. It felt wonderful, I wasn't really in pain but I did feel a strong sense of pressure. I think I was naked or wearing only a t-shirt and was in an all fours position. I remember commenting on the fact that I had never been in a situation of having three people looking at my bottom before – I didn't feel embarrassed or really care that they were, it just felt unusual!  I think I have now got over my modesty about giving birth and could tolerate any number of people in the room so long as they were supportive and bringing good vibes to what was happening.

I then remember Nikki asking me what I wanted to do. I remember being almost surprised by this question and really not being at all sure what I wanted. She suggested either going outside for a walk to try and keep things moving or getting some rest. I seem to remember thinking that I "should" walk and keep moving but feeling so tired and sleepy. The rest option seemed so much more appealing on a number of levels. So Neil and I retired to bed and Tania and Nikki left for a while to give us some peace and quiet. Sometime around 4 in the afternoon I sat up in bed and felt a "pop" followed by a gush of water – my waters had broken! I remember feeling really surprised and also laughing. I called Nikki on my cellphone, still sitting on the bed in a pool of liquid. She said she would come back and that it was probably time to be going to hospital.

I can clearly remember getting dressed to go to hospital and even what clothes I wore. I felt very calm and serene at this point, proceeding somewhat slowly but in a sort of stately fashion, like a galleon gliding into harbour. I felt very much in control at this stage but in a very self possessed way – I was "keeping myself together". I wonder now if there was a reluctance to let go and really get into things which perhaps slowed things down. 

Arrival at the hospital was smooth. I vividly remember the sunshine and the heat as we got out of the car in the hospital car-park – it seemed so strange to be outside in the daylight after all those hours in our apartment. It was a Sunday so the car-park and hospital were deserted and we just seemed to glide through to the room.  

Once in the room, the nurse asked me to get onto the bed for an exam and for the monitor to be put on. I was aware that this was standard practice in this hospital and so didn't protest. I remember thinking that I could ask for this to be done standing up but I have to say it felt SO good to lay on that bed and sink into the cool pillows! Looking back I am struck by how, once in the hospital, I acquiesced whenever the medical staff asked me to do anything. Thankfully there were no complications and no-one asked me to do anything I really didn't want to. But it reminds me that not all hospitals are like that and for many women the things they outline in their birth plan such as no episiotomy, are often ignored and that in the heat of the moment they may give in easily to pressure, especially if they do not have a doula there to remind them and support them.

Anyway, I was delighted to be told I was 8 cm dilated (less delighted to be told that Dr. T didn’t want me to get in the birth pool because my waters had already broken). Again, I didn't argue, although I seem to remember that I already knew this was hospital policy and would not be allowed. We had "Sacred Spirit" playing on the CD, the lights were low and I was off the bed. I knew I could start to push.

I always thought this bit would be the easy bit but I found it extremely hard. I remember feeling (and resisting) the feelings of pressure in my bottom. I became obsessed with this as I felt like I was about to produce a bowel movement rather than a baby and went off to the bathroom to sort myself out. I can remember coming out of the bathroom and whispering triumphantly to Nikki that I had just done a poo! 

We tried several positions for pushing. The only one that really seemed to help, probably due to the force of gravity, was sitting on the birthing stool. I guess it is a little bit like sitting on the toilet, which encourages you to relax the muscles around your bottom, but I did still find that "letting go" sensation so difficult.

I have to say that Neil really came into his own at this time. I described him later as my hero and I really felt that he was an amazing source of strength and support, helping me breathe, supporting me while standing and just being there for me. I found myself getting frustrated and discouraged during this stage and really valued Neil's constant, quiet support.  I remember pushing and then starting to panic at the burning sensation and standing up, saying that I couldn't do it. I really felt that I would be split in two.

I remember that the feeling of letting myself open up was so strange, almost counter-intuitive. I did get an urge to push which was strong, but would wear off quite quickly. In order to bring back the urge I kept wanting to stand up again. This was obviously fairly tiring, not only for me but for Neil, Nikki and Tania.

I remember experiencing the strong burning/tearing feeling as Lydia crowned, which I resisted by standing up and stopping pushing each time I felt it. I guess at this stage I was still very much resisting the physical sensations of what was happening and not really going with it. I also remember that there was a mirror, and being encouraged to look to see the baby's head coming down. I had previously thought I would in fact like to look and see this but in the event I found I couldn't look, I just found it too scary.

On reflection I think I am very much the kind of person who lives more in their head than their body. I do tend to think about things a lot and often over intellectualise things, always wanting to read, read, read and have more and more information. This was very much evident in the way I approached pregnancy. Giving birth however requires a much more "earthy" approach – you can't give birth in your head, you have to sort of move your consciousness down into your body and just surrender to what is happening. I think perhaps I was trying to detach myself from the moment, resisting what was happening to me, instead of really sinking into the moment and going with it. As a doula I know that I will not be effective if I stay "in my head" and detached from the experience of what is happening – I will have to be much more in the here and now, and much more tuned into the physical world. 

During this stage, Dr. T gave me "instructions" in pushing, telling me to hold my breath in rather than "waste energy" making a lot of noise. Again, it seemed okay to comply – another example of me looking outside for guidance rather than really turning inwards and listening to my body.

During this stage I wasn't really aware of who was where – Tania and Nikki swapped places a few times, and all I really knew was that someone, anyone, was helping me. I do remember some specific moments – one when Neil held me in his arms between contractions and I was almost dropping with exhaustion and frustration. I remember panting and hardly being able to get my breath and being held by Neil felt wonderful. I also recall Nikki saying "let's give those legs a rub" as my legs were very swollen from all the standing I had done throughout the day.  I remember the fact that someone was caring enough to kneel down on the floor and massage my aching legs in such a tender way almost made we want to cry.

Anyway, things progressed and even though everyone was very calm and relaxed I felt pressure to produce the baby mounting as time ticked by. I remember a stage at which I had Nikki, Tania, Paul, Neil and a nurse all watching me and encouraging me, saying "she's almost here" and "just one more". I think in the end I just thought "it's now or never" and finally gave in to the urge and then whoosh, she was out. The overwhelming feeling was one of relief (presumably for everyone, not just me).  

Lydia was immediately placed in my arms, still attached to the cord. Neil was right alongside me, with his arms around me as I had my arms around her. I remember her feeling hot and slippery and surprisingly heavy. I also remember that she weed on me! I can't remember if she cried but Neil tells me she didn't immediately, although she was very alert and looking around intently. I don't think anyone can ever describe the feeling of finally meeting your baby. It was the most amazing feeling. I couldn't believe she was really here at last.

I stayed on the birth stool for a while and was vaguely aware of the doctor and the midwife fiddling around with the placenta, but was so caught up in looking at Lydia that I didn't really care what was happening. I had asked for a natural third stage but I have to be honest and say I really can't remember it, anyway I do know it was quick. I have to say that I was not really well informed about the third stage. Really it seemed almost unimportant after the birth of a the baby. I also don't remember when the cord was cut – I had asked for them to wait until it finished pulsing, but in the heat of the moment I am not sure if he did or not. I do remember him asking Neil if he wanted to do it and him declining! Now I have more knowledge about what happens during this stage I believe I would pay more attention to it.  

Then I was moved to the bed while I was stitched up. I remember being  worried about this and asking for an anesthetic, this was after 16 hours of drug free labour! It was only afterwards, back in the hospital room, that I realized I had given birth without the help of pain relief. I honestly never, at any point during labour, wanted to ask for them, it's like the thought just never occurred to me. I am sure that the presence of a doula was the key element in this, plus a hospital who supported my birth plan and never offered or pushed drugs as I know some do.  When I remembered this, and realized it, I felt incredibly proud of myself.

I remember Nikki coming over to the bed at this point and looking at my face, telling me I had done well and had very few broken veins around my nose or eyes from the pushing. I remember just feeling a bit drunk, it must have been the endorphin high, and I thinking that I wouldn't have cared if my nose had dropped off, at least the baby was out. I had a kind of euphoria that took over and lasted for around 24 hours – I kept phoning people and telling them about the birth and how amazing it was. I also was feeling totally psyched – I couldn't eat or sleep or come back down to earth for quite a while. I had a baby! I had given birth. My life had totally changed.

I have said to many people about Lydia's birth that we couldn't have done it without a doula. I think this is a reflection of where I was at that time and what I believed was possible. I did have great support but at the same time I also know I drew on my inner strength and resources to get me through a very long day. Although I know that I was very lucky not to have had to make any really tough decisions, I do still feel proud that I came so far from where I started out. I felt very empowered and powerful because I knew I had done it naturally, no drugs, no interventions to get things started or speed things along. And with a posterior baby too.

Physically I know of course I could have given birth without a doula– however I don't believe it would have been the birth that it was. Having been through this experience though I do now have a lot more confidence about birth and I am sure that now I could do it without a doula. However I do know that I would still choose to have one -  and indeed I did choose to have Nikki and Tania there again for the homebirth of my second daughter in 2004. But that's another story!