It has been a couple of weeks since I have attended a birth. That has given me a much-needed rest, and has been conveniently at the same time as a winter cold.

I write from my perspective. I try to understand the woman within her own family setting, but my stories come out of my own experience. My clients all read my stories, and I believe they provide an introduction, a basis for us to understand one another. This woman, Melissa, said to me soon after her baby was snuggled to her breast "I’ll be interested to see what you write about me". The writing of this Journal has become an important part of what I offer as midwife. "I would love to read your story too" I said.

I have now had time to reflect on that woman’s personal account of her experience, written a couple of days after the birth. Melissa’s story is powerful, written with the intensity that will fade in time. The story is quite different from what I wrote (The Midwife’s Journal 98.14 Sunshine and Shadow). Melissa’s account (Erin’s Birth) can be read on my website, as can all my Journal tales.

Melissa writes of her feelings. Excited and nervous, then "later I was beside myself and near tears, those words I didn't want to hear: drip / caesarean; those apparently were my options but the decision would be left up to the consultant on duty. I was told I wouldn't be going home as my waters had broken and there was a risk of infection and the constant referral to my uterine scar was thrown in my face."

Melissa then came to the point of asserting "this is my baby, my body, and my birth, not the decision of a consultant on duty".

… then suddenly "wham", I knew this was labour. I was uncomfortable and vomited and was not prepared for the sudden intensity of the contractions. I couldn't say if I was excited or nervous at this stage, I just had to get on with the job and finally get to birth my baby myself."

Melissa’s plan was to give birth in hospital.

It was time to go to hospital. I couldn't move, or maybe I was too scared to move. 'The hospital' - this was where all the negativity was and the doctors who made me feel inferior. Well we arrived, this was it; I would be meeting my baby soon. We entered the delivery suite and I remember how sore my throat was from all the screaming. The next few hours were a blur, getting through one contraction at a time, the peak of each contraction was so painfully intense, but still the thought of any pain relief was not an option, I was doing this naturally. And I was actually doing it, I was in labour birthing my baby"

"I want to remember every little detail of the labour, every position and movement that happened along the way. I wished there wasn't a clock on the wall, I didn't want to look at it, but I couldn't help myself, it reminded me of "how much longer can this go on for?" But baby's OK and I'm OK and that's the main thing. Joy suggests changing position again; I didn't think I could, once I was in a position I just couldn't move; but each and every time I did and it helped.

Melissa describes her feelings as she accepted medical help to birth her baby.

I had been pushing for a while and the doctor came in with some suggestions. I was exhausted and baby was getting very tired too, the fetal heart rate was slowing. … The baby was the most important factor and I didn't consider the vacuum to be an intervention as such, but aided me and baby to meet one another sooner, but more importantly to have a healthy strong baby to meet. … I just wanted to feel my baby coming down and out of my body and to feel the warm bloody body next to mine. I didn't feel pressured into having the vacuum extractor but I felt it the right decision for both of us, and it was my decision.

I was delighted at Melissa’s confidence in making this decision. This woman was empowered. She prepared herself well, and maintained her authority for her own body. Melissa’s first child had been born by Caesarean, without labouring. She compares the two experiences.

"I was about to meet my baby at long last and it was vaginally. … I could actually feel the baby's head moving down, what a sensation, the most amazing feeling, this is what I longed for, this is what I missed with Nathan. … it was the most fantastic euphoric experience of my life, I was giving birth, it was happening as I had planned and dreamed of. I felt the baby's head slide out then the shoulders, what a relief, and then whoosh, no more pain, but a beautiful, black haired baby placed straight onto my chest all wet and warm and bloody. All my dreams and hopes of a vaginal birth had at that very moment just come true. (I have tears rolling down my face as I remember this beautiful single moment.)

The vacuum extraction and the episiotomy - I don't regret making the decision to have either of them. I still birthed our baby vaginally and drug free. I couldn't get over the little miracle lying on my chest, wide eyed and alert and born by me and not through an incision on my uterus. While I was being stitched I was experiencing all the things I missed last time, the little things, Damian cut the cord, photos being taken, my baby stayed with me, the instant love I felt for our miracle was amazing. We just marvelled at our little Erin for hours … the best part of the whole successful VBAC is Erin's start in life has been the best I could possibly give her. I feel so complete."

I am well known at hospital in which Erin was born. I had been a member of staff for some years prior to setting up my own practice. I have worked there recently on occasion as a clinical supervisor for midwifery students. I am well known professionally for the work I do with the College of Midwives.

Being ‘with woman’ when the woman’s wishes and my practice are at odds with the protocols of the hospital is no easy task. This woman was making the sort of noise that is usually managed with a dose of narcotic. This woman had prolongued rupture of the membranes, and a previous caesarean. Either of these ‘conditions’ was enough for her to be treated as ‘high risk’, and to be automatically strapped to a fetal heart monitor, rather than standing in the shower. The medical officers who spoke to her were obviously not used to women who were in control. "I understand your recommendation, but at this stage I do not accept it" is not the usual response of a labouring woman. It is interesting to note here that the doctor also recommended antibiotic treatment, which Melissa accepted. Yet Melissa did not even mention that in her record. It was not an important issue to her.

Similarly the acceptance of a medically assisted birth seems of little consequence to Melissa. The birth statistics and the woman’s perceptions are very different. Melissa had prepared herself to do her very best, with the wellbeing of her baby always prominent in her mind. She had employed me to work with her. There was no sense of failure in what she achieved.

Melissa’s description of the early skin-to-skin bonding that took place in that hospital room is very important to me. We have research evidence, data from controlled trials reported in reputable scientific journals, to support this practice. But what a poignant description from the mother herself. These are the memories that a mother takes away with her. While birth attendants are busy with the clean-up process, recording times and measurements, the new parents can focus on the child. I took a photo, and I have a copy of it. Baby Erin is lying quietly on her side on her mother’s chest, eyes open and alert, and looking straight at her mother’s face while her father is cutting the cord. This is insignificant to the medical record – even the fact that the baby stayed with the mother may not have been recorded. But the miracle of love which happens as a mother takes up her newborn child; and as a father accepts his special role, is of far more lasting significance than the time of birth or the mother’s pulse rate.

This mother was able to say to her baby that she gave her best. No wonder she felt complete.