12 Things That Actually Help You Have a Normal Birth
Twelve evidence-based interventions, that genuinely shift the odds toward a normal vaginal birth.
Continuous, one-to-one support in labour
Having someone with you the whole time, uninterrupted, who isn’t moving between other patients, makes a measurable difference. Women with continuous support are more likely to have a spontaneous vaginal birth, less likely to need a caesarean or instrumental birth, less likely to need pain medication, and more likely to look back on their birth positively. No downsides have been found.¹ The World Health Organization recommends a companion of choice for every woman, throughout labour and birth.²
2. Midwifery continuity of care
Being cared for by the same known Midwife, or a small consistent team, through pregnancy, birth and afterward is linked to more spontaneous vaginal births, fewer interventions, and comparable safety with higher satisfaction.³ Women cared for this way also report feeling more in control. If continuity isn’t automatically offered where you’re booked, it’s worth asking whether it’s available.
3. Let labour start on its own
Where it’s safe to, waiting for labour to begin on its own rather than being induced without a clear medical reason keeps you out of a chain of interventions that often follows induction.⁴ If induction is raised, it’s reasonable to ask what it’s for, how urgent it is, and what would happen if you waited a little longer.
4. Stay upright and keep moving in early labour
Walking and upright positions in the first stage shorten labour by around an hour on average, reduce the chance of a caesarean, and reduce the need for an epidural, with no evidence of harm.⁵ If you’re offered continuous monitoring, ask about wireless options so you can stay mobile.
5. Choose your position for pushing
Being upright or lying on your side in the second stage, rather than flat on your back, is linked to fewer assisted births and fewer episiotomies. There’s a small trade-off, a slightly higher chance of blood loss over 500mL and of second-degree tears, so it’s worth knowing both sides and practising a few positions antenatally.⁶
6. Stay home in early labour
The slow, early part of labour often goes better at home. Being assessed and supported in early labour, rather than admitted straight away, is linked to fewer interventions, less augmentation, less epidural use, and in some studies, fewer caesareans.⁷ Arriving too early often starts a chain that’s hard to step back out of, so it’s worth having an actual plan for what early labour at home looks like.
7. Ask about intermittent listening.
Your baby’s heartbeat can be followed continuously (a CTG) or intermittently, with a handheld device at set intervals. For low-risk labour, intermittent listening supports mobility and is linked to lower rates of caesarean and instrumental birth. Continuous CTG halves the rate of newborn seizures but doesn’t reduce cerebral palsy or deaths.⁸ For most women, intermittent listening is a reasonable, evidence-supported choice worth asking about.
8. Choose your birth setting carefully
For low-risk women, planned birth in a midwife-led unit is linked to substantially fewer interventions and more normal births than an obstetric unit, with no difference in outcomes for the baby, especially for women who’ve given birth before.⁹ In Australia, low-risk women cared for privately by obstetricians have markedly higher rates of intervention than those in public or midwifery-led models.¹⁰ Where you give birth, and who leads your care, makes a measurable difference.
9. Protect a calm environment, and name your fears early
A calm, private space with people you trust supports your body’s own labour hormones. The World Health Organization frames this kind of respectful, woman-centred care as the standard for a positive birth experience.² Fear of childbirth is common, and addressing it antenatally is recommended and can reduce unnecessary caesareans.¹¹ If you’re carrying fear from a previous birth, find space to talk it through before labour starts.
10. Eat and drink as you need to
For healthy women in labour, there’s no good evidence to support routinely withholding food and fluids. The World Health Organization recommends oral fluid and food in labour for low-risk women.² Keeping your energy up supports your ability to labour actively for as long as it takes.
11. Plan how you'll cope with pain, on purpose
Movement, water, breathing, relaxation techniques, a steady support team, and medical pain relief including an epidural are all reasonable options. Relaxation techniques can reduce how much pain medication you need.¹² An epidural is safe too, current evidence doesn’t show it increases the overall caesarean rate, though it’s linked to a longer pushing stage and more instrumental births in some studies.¹³ The point isn’t to avoid any option, it’s to choose on purpose ahead of time, rather than by default mid-labour.
12. Ask for a warm compress in the second stage
A small thing with a meaningful effect: a warm compress held against the perineum while you’re pushing roughly halves the chance of a severe tear.¹⁴ It’s less about whether you have a vaginal birth and more about how your body recovers afterward, but it’s easy to ask for and the evidence is clear. Worth mentioning antenatally so it’s part of your plan.
None of this is a guarantee, and that's the point
A prepared woman isn’t one who’s been promised an outcome. She’s one who walks in informed, and walks out proud of herself, whatever the day brought. These twelve things won’t decide your birth for you, but they’re the parts that are actually yours to think about, talk through with whoever cares for you, and choose on purpose.
If you’d like to talk any of this through properly, an Initial Antenatal Consultation is a 60-minute, unrushed appointment to go through your pregnancy, your history, and your options. Most women start there.
Have it before you need it.
Labour rarely follows the script, and day three catches most people off guard. Move, Rest, Feed is my free field guide to labour and the first week, written for you and the person beside you. GET THE FREE GUIDE
Jennifer Hazi is a Registered and Endorsed Midwife in private practice in Paddington, Sydney, and available Australia-wide via telehealth. This article is general information, not personal clinical advice. Always discuss your own situation with your midwife or doctor.
Bohren, MA, Hofmeyr, GJ, Sakala, C, Fukuzawa, RK & Cuthbert, A 2017, ‘Continuous support for women during childbirth’, Cochrane Database of Systematic Reviews, no. 7, art. no. CD003766.
World Health Organization 2018, WHO recommendations: intrapartum care for a positive childbirth experience, WHO, Geneva.
Sandall, J, Soltani, H, Gates, S, Shennan, A & Devane, D 2016, ‘Midwife-led continuity models versus other models of care for childbearing women’, Cochrane Database of Systematic Reviews, no. 4, art. no. CD004667.
Royal Australian and New Zealand College of Obstetricians and Gynaecologists 2025, Birth after caesarean (C-Obs 38), version 4.1, RANZCOG, Melbourne.
Lawrence, A, Lewis, L, Hofmeyr, GJ & Styles, C 2013, ‘Maternal positions and mobility during first stage labour’, Cochrane Database of Systematic Reviews, no. 10, art. no. CD003934.
Gupta, JK, Sood, A, Hofmeyr, GJ & Vogel, JP 2017, ‘Position in the second stage of labour for women without epidural anaesthesia’, Cochrane Database of Systematic Reviews, no. 5, art. no. CD002006.
Kobayashi, S, Hanada, N, Matsuzaki, M, Takehara, K, Ota, E, Sasaki, H, Nagata, C & Mori, R 2017, ‘Assessment and support during early labour for improving birth outcomes’, Cochrane Database of Systematic Reviews, no. 4, art. no. CD011516.
Alfirevic, Z, Devane, D, Gyte, GML & Cuthbert, A 2017, ‘Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour’, Cochrane Database of Systematic Reviews, no. 2, art. no. CD006066.
Brocklehurst, P, Hardy, P, Hollowell, J, Linsell, L, Macfarlane, A, McCourt, C et al. (Birthplace in England Collaborative Group) 2011, ‘Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study’, BMJ, vol. 343, d7400.
Dahlen, HG, Tracy, S, Tracy, M, Bisits, A, Brown, C & Thornton, C 2014, ‘Rates of obstetric intervention and associated perinatal mortality and morbidity among low-risk women giving birth in private and public hospitals in NSW (2000–2008): a linked data population-based cohort study’, BMJ Open, vol. 4, no. 5, e004551.
World Health Organization 2018, WHO recommendations: non-clinical interventions to reduce unnecessary caesarean sections, WHO, Geneva.
Smith, CA, Levett, KM, Collins, CT, Armour, M, Dahlen, HG & Suganuma, M 2018, ‘Relaxation techniques for pain management in labour’, Cochrane Database of Systematic Reviews, no. 3, art. no. CD009514.
Anim-Somuah, M, Smyth, RMD, Cyna, AM & Cuthbert, A 2018, ‘Epidural versus non-epidural or no analgesia for pain management in labour’, Cochrane Database of Systematic Reviews, no. 5, art. no. CD000331.
Aasheim, V, Nilsen, ABV, Reinar, LM & Lukasse, M 2017, ‘Perineal techniques during the second stage of labour for reducing perineal trauma’, Cochrane Database of Systematic Reviews, no. 6, art. no. CD006672.
