Finding pleasure in pain of birth

Hero women, romantics, and the functional ... the three categories who enjoy the most, or suffer the most, from having a baby

There are three kinds of women when it comes to giving birth: they are Romantic Princesses, Hero Women and plain Functional Women, says Dr Marianne Morris, a health psychologist, who also claims that attitudes to giving birth can determine the psychological response afterwards.

Where Romantic Princesses seek to make the birth as perfect as possible, Hero Women see it as an "adventure" and Functionals just want it all to be over as soon as possible.

Speaking at the British Psychological Society's Women and Psychology conference, Dr Morris said that before the birth all 16 women she interviewed had agreed that the severity of the pain could not be predicted. How they dealt with labour - "the most painful experience in a woman's lifetime" - varied according to the category they fell into.

Contrary to popular belief, those requesting pain relief rather than going for a "natural" experience spoke more positively about their labour.Princesses, who worried most about loss of dignity, had the most negative reaction.

The Hero Woman wanted to remain in control. Several women spoke of "interacting with the pain", and questioned even the term itself: "Is pain the right word?"

"The romantic Hero says things like, 'I'm in control of my life', said Dr Morris. "She sees everything as an adventure and a challenge. She wants this experience ... I see her flying through the jungle like a female Rambo. One of my interviewees of this type was still cycling 24 hours before the birth, and three weeks later she was ready to cycle again."

In comparison, the Functionals wanted to "get through it as easily as possible" but some felt guilty about their attitude. One woman commented: "She [the midwife] was saying you couldn't be a real woman if you haven't wanted to give birth and had the whole thing, pain and everything ... I kept very quiet, and thought she would think I was terrible."

The Functional passed control over to others. Typical comments were: "as soon as it gets painful they can take over", and "it will only be what I want if I'm knocked out cold before anything happens." But Dr Morris said that because Functionals had a "more realistic attitude" to birth, they had fewer negative feelings afterwards.

It was the Romantic Princess who came off worst. "She is someone who wants to be the good girl and to remain in control," said Dr Morris. "She talks about having to turn away and pretend things are not happening - things going on 'down below'. She conforms to the stereotype of the feminine."

A typical comment was: "You are so exposed ... We were watching a video and the woman was laid there and from her boobs upwards was all that was covered. I would want to pull a sheet up over myself."

The reality of birth was often distressing, and Dr Morris said many Princesses tried to block it off, or said they would never go through it again. Attempting to maintain composure, some blamed their negative experiences on fate, chance or God.

Despite the Department of Health's commitment to allowing people to choose the sort of birth they want, Dr Morris reported that all those in her survey gave birth in hospital, despite some of them having expressed a preference for home births. Others talked of being on a "conveyor belt ... the doctor came in to do me, and then in the next five minutes went next door." She concluded: "There is still not enough personalisation to the care."

As for Dr Morris herself, mother of a five-year-old child delivered by emergency Caesarean: "I put myself in the Functional category."

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'I felt I was achieving something amazing'

HERO WOMAN

Ann Batanero, 34, a solicitor, gave birth to Gabriel 14 months ago.

Before I was pregnant I thought birth would be horrendous; they could throw every drug in the book at me. But I moved from a position of ignorance to being well informed, and eventually decided that being in hospital was not the best way to deal with birth, which is not an illness. I opted for a home birth with no drugs.

I had a fantastic labour and came out of it with a grin from ear to ear, thinking 'Wow!' It hurt like mad but it was hugely exciting; I felt I was achieving something amazing. I had a water pool at home and I used a Tens machine, which is supposed to stimulate your endorphins. I certainly felt high: my husband says I was really funny and everybody around me was in hysterics.

The first stage lasted 10 hours, followed by two and a half hours of pushing, at which point they said I had to go into hospital. Gabriel was born 10 minutes later and I was home again two hours after that, so they wrote it down as a home birth.

While I was at home it was my show and I was running it, but once I was in hospital it was completely not my show. They put me on a table and attached a ventouse machine to the baby. I felt totally processed; it was a loss of self, of my authority.

Pain in childbirth must be linked to how you expect it to be. My mother had told me I was born between lunch and tea, which was good because she didn't miss any meals. To me the labour felt like a bad stomach upset.

There were only two or three times when I lost it, which was when they made me lie on my back to be examined. In hospital they gave me a thing for gas and air, but I didn't bother with it; I was too busy breathing, which was brilliant for pain relief.

After the birth I felt that it was an amazing achievement. I felt so important, as if I could do anything. It put everything else that I've ever done in the shade. I was on a cloud after the birth; maybe I still am."

'It seemed so embarrassing'

ROMANTIC PRINCESS

Deborah Veale, 28, a youth worker, gave birth to Ryan 11 months ago.

I didn't know what to expect. It was quite frightening; you hear stories about women shouting out in God knows how much pain. And while I was expecting Ryan, my sister lost a baby at 28 weeks and a friend had a scan showing her baby was spina bifida. It made me nervous.

I planned to go to hospital and go with the flow. Some women say, "I'm not having an epidural", but at the end of the day doctors and midwives, they know best. My husband was with me throughout.

Beforehand I was worried about what he'd see, from that end. He saw more of me that day than he ever has. I thought it was going to be degrading, being laid on a table with my legs in the air. .It was the embarrassment of it all.

But during the birth I was totally out of it. I had pethidine, gas and air, then an epidural followed by two epidural top-ups. I had a gown on, which they kept lifting up to monitor me, which bothered me, so I kept pulling it down. It was my top half I was concerned about.

The first pains woke me up on the Sunday morning and he was born at 3.30pm on the Wednesday. I hadn't slept in between. I didn't know it at the time but I had an episiotomy, and it was a ventouse delivery because he went into foetal distress after they broke my waters. They lost Ryan's heart-beat and that panicked me. When he came out, the first thing I asked was "Is he okay?''

I was so numb I couldn't feel my contractions. It was like I was in slow motion. It was okay, but the only regret I have was that I wasn't in control.

'The pain just went from nothing to absolute agony'

FUNCTIONAL WOMAN

Clare Brophy, 34, a health service personnel manager, gave birth to Hoppa 14 months ago.

I avoided thinking about the actual birth; it was too horrifying. I don't know where I got that attitude from, but I've never even been able to watch birth on TV.

I was very sick during most of my pregnancy and couldn't leave the house for much of the time. I hated pregnancy and birth, as I've always been very fit and healthy. Birth is debilitating; I expected it to be a draining experience.

I wanted the safety of a hospital birth in case anything went wrong, but not high tech. I wanted my labour - but not the birth - in water, with entonox maybe, but I didn't want epidurals or pethidine. I did yoga during the pregnancy and we learned shiatsu massage for pain relief.

My waters broke three weeks early and I was induced. Hoppa was born within two-and-a- half hours. It was just awful. I really hated it. I was very frightened and it was the worst experience I've ever had in my life.

Yes, I expected pain, but I expected it to build up. Instead, it went from nothing to absolute agony. I couldn't even breathe or stand up between the contractions. I was almost crippled. I couldn't move because of the pain; I felt paralysed.

The hospital staff were brilliant; they did run me a bath, but there was no time to get in it. I wanted an epidural, a Caesarean, anything to get me through - but it was too quick for any of that, except entonox. I tore badly, had loads of stitches, internal and external. For me it was really terrifying.

It was all such a shock. I've never been into having a lovely cosy home birth round a log fire. Look at the third world: if we all had nice, natural childbirth, half of us wouldn't have survived.

I took the realistic view, but it was all such a shock. My birth plan might as well have been torn up, although the midwives tried to follow what I wanted. The shiatsu was brilliant though, it really helped.

I'm going to my GP about having counselling before I face doing it again. I was in shock after the birth, but I was thrilled with the baby; he's marvellous. I will do it again, but I wish I didn't have to. I wish I could have another child, but that it would somehow miraculously materialise.

That it felt so awful was partly because I was out of control, partly the fear of something going wrong. I've had a detached retina and when someone said, "I wonder if she's supposed to push?" it entered my head that my other retina might detach if I pushed. I was also worried about the baby, because everything was happening so fast.