The Woman’s Voice in Positive Birth

The Positive Birth Book: A new approach to pregnancy, birth and the early weeks, is the coming together of everything author Milli Hill experienced in her years of listening to mothers talk about birth, and writing about it. It is a result of insight gained in her quest to challenge the negativity surrounding birth and her aim to empower women in the process.

Milli Hill speaks to Daniela from Dreaming of Baby on her book and the importance of listening to women, countering negative perceptions on birth, and how to stay positive in the run-up and during this powerful experience.


Daniela: Hello Milli, and welcome to Dreaming of Baby! We’re looking forward to discussing your book ‘The Positive Birth Book: A new approach to pregnancy, birth, and the early weeks’, as well as getting to know the story behind the book and how it’s helping women worldwide.

Milli Hill: Thanks so much for asking me to talk to you.

Daniela: To start with, what is the story behind The Positive Birth Book?

Milli Hill: It’s quite a long one! After the birth of my first two children (I now have 3), I had become increasingly interested in birth and the experience of birth for women. I was also writing a blog at the time. I started a small birth discussion group in my own home and then I wondered whether other people might start similar groups and how it would be if we linked them all up via social media. I called it the Positive Birth Movement – a grassroots initiative to improve childbirth and help women share information about their choices and rights. This really took off! As I was also a writer, I found myself increasingly being called upon to write articles about birth in the mainstream media. With running the Positive Birth Movement, and with writing so much about birth…it started to become obvious that I needed to bring this all together into a book! So that’s what I did – it’s literally the coming together of everything I know about birth, from having had 3 babies myself, and from talking to and listening to women in the PBM for several years, and from writing and learning about birth as a journalist.

Daniela: Wow, what a journey! You emphasize on experience, and talking and listening to other women, how important is this when talking – and writing – about birth?

Milli Hill: I think it’s vital. For some reason, women’s voices around birth have become lost. We have the problem with the media, for starters, where birth is represented in a very polarized way, usually as something utterly terrifying or even unnatural. Then we have a problem in the birth room itself, where women’s voices about what they actually want seem to have been lost too – how often do you hear a birth story that includes the phrase, ‘they did not let me’, or ‘I was not allowed’ – when in fact women have every right to say what they want and need in birth and to be key decision makers.

Worse still is the phrase, ‘a healthy baby is all that matters’. Women are told this repeatedly, often after they have had a difficult or even traumatic birth, and are made to feel that they should not talk about how they feel about the birth, in case they are perceived as somehow selfish or ungrateful for their baby – it’s really wrong that this is happening! So what we really need is to actually LISTEN to women. Funnily enough, when women DO have difficult births, this is one of the key issues they report struggling with – not the events of the birth itself – but that feeling of not being LISTENED to.  We need to listen to women and what they have to say about birth, before, during and after! We also need to make space for all kinds of birth narratives, not just the horror stories that the press love so much.

I’ve really tried to do this in my book – to give a space not just for my own voice, but for the voices of a huge variety of women, actually telling the real story of what birth is like. In our culture, I think this kind of wisdom is literally gold dust!

‘Positive Birth is defined by the woman herself’

Daniela: Is this the reason behind the name of the book then? Why do you think that negative perceptions of birth have become so widespread?

Milli Hill: Yes, the book just had to be the Positive Birth Book as the Positive Birth Movement has become so popular (we have around 250 groups in the UK and another 200 or more in the rest of the world!). Positive Birth is a great term, I think, because it cuts through the polarity of ‘natural’ versus ‘epidural’, ‘home’ versus ‘hospital’, ‘vaginal’ versus ‘caesarean’ etc.

Positive Birth is defined by the woman herself. If she says it was a positive experience, then it was. End of story. So yes, the book had to have that title I think! To answer your question about negative perceptions becoming widespread – I’m not sure! I think it might be quite complicated. For a start, one of the reasons is that many women have been having pretty unpleasant experiences in the past few decades! I’m thinking about the ‘doctor knows best’ decades of the 60’s and 70’s, where getting a pubic shave or an enema wasn’t even negotiable! And then your baby was often taken away to the nursery, which must have been very traumatic for women. We’ve moved on from that, but I’m afraid to say that a lot of women are still not being ‘celebrated’ in birth and coming out of it feeling on top of the world and triumphant. So it’s partly because birth really has been a negative experience for a lot of women, but also because it’s become somehow popular for the media and people in general to tell birth horror stories? Often women who had fantastic births tell me they are afraid to talk about them because they will either be mocked or they fear they will upset people who didn’t have good experiences.

How can I have a positive birth?

Daniela: In connection with this, and if I understood well, you emphasized earlier that a healthy baby isn’t all that matters and that this does not necessarily mean positive birth. How would you define a positive birth?

Milli Hill: Well the definition of a positive birth that we use at the Positive Birth Movement is this:

  • Women are where they want to be
  • Choices are informed by reality not fear
  • Women are listened to and treated with respect and dignity
  • Mothers are empowered and enriched
  • Memories are warm and proud

This definition also underpins my book!

Daniela: That is indeed very positive and empowering. For moms-to-be, how can they prepare for a positive birth?

Milli Hill: I think the main thing I always say is, don’t let fear make you an ostrich! Women are often told, don’t bother preparing, just go with the flow, it’s pointless preparing because birth is unpredictable etc, and then this, coupled with the fear most women feel, can mean that they just decide to do no preparation at all. It’s a shame to take this approach because, whilst you might get lucky on the day, you can also unfortunately get sucked into the vortex of an overstretched maternity system and find yourself swept along down pathways you never even thought about or considered. So yes, preparation is key. There are so many choices that you can make. Learning about these choices is such a great thing to spend time on during pregnancy. You can then build a plan for your wishes, a Plan A – for your ideal birth, but also plans B, C, D etc if things deviate from how you had hoped. Doing this will allow you to feel strong and in control no matter how your birth unfolds.

Daniela: So a birth plan is a must in this regard?

Milli Hill: Absolutely! I love birth plans! And I love calling them PLANS as well, not ‘preferences’ or any other namby pamby title! There is no greater force on earth than a woman with a plan.

In my book there is also the idea of the Visual Birth Plan (VBP). We worked with leading artist Kate Evans to make ‘icons’ to represent the many birth choices. Use them to build your own bespoke plan. A VBP is a quick and easy way of conveying your choices to your care providers. But it’s also a great process to go through, maybe also with your partner too, to think about and focus on your choices.

Daniela: Great, thanks! And I definitely agree with the power a plan gives! You mention partners. How important is support, from partners or otherwise, during birth?

Milli Hill: I think it’s so important. I would really love all partners to read my book too, actually! But I’ve put some special ‘quick look’ sections in in case they don’t have time to. If partners just learn some simple stuff, for example about oxytocin (the main hormone of labour), and how to help promote its production, they can feel they really have a role to play in the labour room. It’s also really important for partners to know that they don’t have to ‘fix’ their partner during birth. I suggest that women and their partners make a pact that if she feels she isn’t coping and needs help, she will ask. They may even want to develop a special signal or code word for this. If the signal is not given, partners must assume she is coping and ok, even if from the outside she looks as if she isn’t. Because birth is very different from the inside than it is from the outside, if that makes sense?!

‘For any woman feeling fear, hearing positive stories or watching positive birth films can be really helpful. However, if you’ve had a previous traumatic birth, you have to be in the right space to do this, and getting to this space usually involves processing your previous birth first.

Daniela: It does; not all women express what they’re actually feeling in the same way. For second time moms who have experienced a traumatic birth first time round, how can they make this experience a more positive one? More importantly, how can they overcome fear?

Milli Hill: I think this is a really tough scenario for women. It depends of course, on the level of trauma, and it’s different for everyone. For some women, it’s important to go back a bit and process the previous birth and kind of make sense of that and lay any ghosts to rest before they can move forward to the next birth. There are various ways to do this – going over your notes with a midwife and finding out what actually happened and why can be very helpful for some people, and others benefit from specialist counselling. Once you feel clearer about your previous birth, then it’s a good idea – as I’ve said with all women – to put thought into preparing for the next birth and not let fear prevent you from considering your options carefully. Many women have a very positive experience with their second birth and find this really helps them heal from the first birth.

For any woman feeling fear, hearing positive stories or watching positive birth films can be really helpful. However, if you’ve had a previous traumatic birth, you have to be in the right space to do this, and getting to this space usually involves processing your previous birth first.

Daniela: When it comes to women who have experienced infertility and all that it brings with it, as well as those who have had to deal with pregnancy loss, are there any practices they can employ to stay positive about birth?

Milli Hill: That’s a tough question. I’m not sure I would advise anyone to ‘stay positive’ because that could sound a bit glib? If you have had a tough journey to motherhood, then you may not be able to feel positive about your forthcoming birth. It may be very upsetting and terrifying for you, and I think it’s really important as people to acknowledge and accept all of our emotions, not just the ones we think we ‘should’ be feeling!

Daniela: In such cases too then, being listened to remains imperative?

Milli Hill: Absolutely. Yes, being listened to is absolutely vital for a positive birth experience. Unfortunately, this is slightly out of women’s hands, as we cannot always control the kind of care we get in birth. Midwives, also, are usually doing their best. However, what women can do is head towards birth with a sense of what they want, and yes, a sense of entitlement! A knowledge that they are ‘allowed’ to ask for what they want in birth, to govern what happens to their bodies, and that their care providers are obliged to listen! I really hope I am not having to talk about this side of birth and these issues in a few years’ time by the way!

Daniela: True, here’s to hoping – and working – towards positive birth becoming the norm. As a final question, what’s that one message that you always impart to moms-to-be as they approach birth?

Milli Hill: Well in the book I call that the ‘two steel beams’ – Steel beam #1 – you have a choice, and Steel beam #2, you have human rights in childbirth. Knowing this changes everything.

Daniela: Thank you Milli, I’m sure our readers will find the insight you’ve shared with us today very helpful. It’s been a pleasure discussing this subject with you. Thank you for your time!

The Visual Birth Plan icons can be downloaded for free at

Read more on Giving Birth, here.

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