'I was in tears as the anaesthetist punctured my skin and administered the epidural injection into my lower spine. My tears were not from the pain of the injection. Nor were they from fear of the potential risks of such a local anaesthetic. There were tears of disappointment, because in my birth plan, I had written that if at all possible, I didn't want an epidural injection."
This comment by a first-time mother about an episode in her labour sums up the perhaps naive expectations of many first-time mothers. Instead of realising that labour and childbirth are more about giving way to primeval forces - or, indeed, to the 'guiding' force of the hospital team - many want to plan their labour and know in advance what kind of pain relief they will require.
For many women, their first pregnancy is as much about themselves as it is about the growing foetus inside them. It is a life-transforming experience during which they read about their changing bodies, their sometimes volatile emotions and the developmental milestones of the baby within them. Writing a birth plan can be a way of focusing on labour, just as buying baby clothes is a physical symbol of the imminent arrival.
But are we setting ourselves up for failure by believing we can control labour? Have childbirth gurus such as Sheila Kitzinger given us unrealistic expectations? How many women do you know who had an orgasmic experience when giving birth?
"Giving birth is not a competitive thing, but there can be the feeling nowadays of getting it right among women who are only having one or two babies," says Linda Doherty, an antenatal teacher with Cuidi·, the Irish Childbirth Trust.
First-time mothers-to-be tend to fall into two broad categories. There are those who read all the books, become familiar with the terminology, then go on to discuss with consultants and midwives how they envisage the labour.
They are often very well informed about how epidurals slow down labour and often require the administration of oxytocin to speed up the process again. They know the painkiller pethidine can make the newborn baby drowsy. They may do yoga to learn deep-breathing techniques for labour, write a birth plan and take arnica, the homeopathic remedy, for wound-healing. They want to have a good labour experience, yet they still have to discover their pain tolerance and how they will cope with the excruciating, unrelenting nature of labour pain.
Then there are those who don't want to know the gory details and are keen to have the maximum pain relief available and have their baby delivered on - or if possible before - its due date. They may even opt for a Caesarean section.
SO which approach is best? Doherty doesn't give pregnant women advice in her classes. "I do say, however, that a Caesarean section is not an easy option as a way of avoiding a vaginal birth, because it is a major abdominal operation. Also, as I think women can get confused with too much information from Internet sites and books, I say that it's best to find one book or one person you trust, and go with that line."
Doherty says birth plans can be useful as a way of finding out which aspects of hospital practice women are keen on and which they aren't. "Some people say that doctors and midwives don't like birth plans, and if you go into it saying, 'this is exactly what I want,' you might get somebody's back up. But if you use a birth plan as a discussion document, you can create an opportunity beforehand to talk about how you would like things to go and even find out that some of things you didn't want are no longer standard practice."
But are we are forgetting about the baby? And if you spend your first post-natal weeks mulling over the ideal birth you never had, will you be less able to bond with your baby and enjoy these fragile and beautiful early days?
"I think what we most want is a well baby and a well mother," says Dr Siobhβn Barry, a visiting consultant psychiatrist at the Coombe Women's Hospital and an expert in post-natal depression. "I would caution the use of birth plans, because they often convey the sense that you can plan labour and that it will follow a certain course."
Barry adds that a lot of the women she sees have had detailed birth plans that haven't gone as they expected. "Post-natal depression is not caused by one factor alone, but the experience of birth can be a part of it for some women. In the past, women didn't have any control over how their labour went, which wasn't a great thing, but they didn't have any expectations of how to control it, either."
