My advice for anyone who worries that their wishes will not be taken seriously during and after childbirth is simple:

I wrote a VERY comprehensive birth plan, which I discussed with my midwife team before labour, and then reviewed it following their advice.

When I went into hospital (Chelsea & Westminster - hey if it's good enough for Cherie Blair, it's good enough for me!) I gave another copy to the Head Midwife, with another copy to be kept on hand should a doctor be required. I had a long labour, but was extremely lucky. My midwife team (and after 32 hours, I'd gone through four of them) all read and agreed my birth plan, and ensured that I was given all the options open to me. In fact, I feel that without this plan, the Doctors would have intervened and "forced" me to have a caesarean, something I was desperate to avoid. As it was, the Midwives kept them away, understanding that I knew I was strong enough to go the whole way.

Speaking your mind during the throws of a contraction is very difficult, but with a good birth plan, your wishes are clear in advance. I also made it clear in the plan that I reserved the right to change my mind at any time! The levels of care do vary from trust to trust - this does not mean that you should adapt to their requirements. Be insistent, be proactive, and listen to the midwives. They really know what they're doing, and given the chance, will certainly fight your corner for you.

Good luck to everyone about to go through this amazing process; it really does change your life.

Sara McKenna