At this time of year every primary school across the UK puts on a nativity performance, with Mary giving birth in a stable, surrounded by animals. The stable is usually imagined as a wooden structure, but that's not quite how it happened. There’s even some evidence that Jesus was born in a cave. The Church of the Nativity, in Bethlehem, marking Jesus’ birth place, is built over a cave. In that area, at that time, caves were used as pens for animals, to keep them safe.
It wasn't even unusual for women to give birth in the caves. Caves are safe but also private, quiet, cool, and dark. Nicola Goodall, experienced doula and mentor, is collecting evidence of birth caves. One woman she met in Greece told the handed down story of her great, great grandmother’s first birth:
“She left the village for the cave when she knew it was time. It was just her and her mother-in-law to help. Once the baby was born they covered the baby with sheep’s wool. They stayed there afterwards too. I’m not sure for how long but long enough to allow for her milk to come through and to rest and eat soup made for her.”
In ancient societies across the globe there is evidence women would go to a private place to give birth, away from others, except a few trusted people (mostly women, but not always).
It makes sense when you understand the hormones. Biologically, labour is controlled by the most primitive part of our brain, which releases the labour cocktail of oxytocin, endorphins and melatonin. If we are in danger the body releases adrenaline which stops or slows labour till we get somewhere safe. This is true for all mammals, including us. Did you see melatonin in there? Melatonin aids the release of oxytocin, which is the hormone that makes the muscles of the uterus contract. Melatonin is released more at night, or when it is dark. My neighbour’s cat knew it. Instinctively. Women know it too.
Years ago, at a birth conference, an Italian architect, commissioned to design a birth centre, described her findings after watching births. Women giving birth at hospital, she said, gave birth on things, usually a bed; women giving birth at home gave birth between things. Just like me. With baby number two I gave birth in the narrowest bit of the bedroom, between the bed and the chest of drawers. The architect’s final design incorporated curved walls, giving women small spaces to go into, and walls to hide behind.
Midwives will attest to this too. Women at home will give birth in the most awkward corner, or the smallest room, often the bathroom, in an unconscious desire for privacy and safety. Contractions can feel more comfortable sat on the loo, and you can be on your own and so less observed. In our homes our bathrooms are like a cave: private, safe, quiet.
Home birth does make it easier to create your own cave, your own sanctuary. We feel safe at home. It is one of the reasons that home births have such great outcomes, such low levels of intervention, leading the national NHS guideline body, NICE, to recommend home birth, not just as safe, but as the default option for low risk women, especially those having their second baby, rather than the traditional delivery suite.
Hospitals are bright, noisy, and have their own smell which can trigger our fight or flight response, releasing adrenaline, even if our logical brain is saying we’re safe. Perhaps you’ve heard stories of women whose labour slowed down when they got to hospital? It will start up again when you’ve settled in to your room. Even a change of shift and new midwives can cause a pause in birth as you get used to a different person.
So how can you create your own birth cave at home or at hospital? Here are some tips. Remember, even if you are going in to a hospital or midwife led unit, you will still be doing a large chunk of your labour at home so you can still create a cave at home and then take some of those elements in with you.
Turn off the lights. Even in hospital this is possible. It happens at every birth I’m at. Use mood lighting with fairy lights or candles (battery operated).
[Doula tip for partners: i) some hospital bathrooms have automatic lights. Tape tights or a sock over the sensor.ii) Black bin liners can be taped on windows where there are no curtains or blinds. I carry a portable black out blind.]
Music: to boogie to in early labour and then relaxing or sensual music later on. Barry White is great for setting the mood, but sometimes women want music with no words in late labour. Tibetan singing bowls are fab.
Your own pillow/cushions. Important in hospitals and birth centres to have things that smell of home, to stop that irrational fight/flight response. One client had her partner’s pillow; his smell made her feel safe and loved.
Make a tent with wall hangings or sheets. Recreate the cosiness of childhood dens. You can use a large scarf to just put your head under to block everything out, or to cover the hospital bed or piece of unused equipment. Don’t be afraid to move the room around in hospital. It is your birth. Midwives know about this sort of stuff. In my experience they’ll help you with the tape.
Stick up pictures, affirmations, prayer flags. Some women create a mood board, or shrine which they use as part of their mental preparation in pregnancy, and in labour.
Choose carefully who you let in to your cave. Don’t be afraid to ask people to stop talking or to leave. I have seen it done. Midwives and doctors respect this. One partner just asked everyone to leave them for ten minutes, they just wanted time alone. It had got very busy, and whilst not an emergency, things were not going as planned, and it was emotional. Without fuss the midwives and the doctor left immediately.
Hire a doula. Their job is to ‘hold your space’, to help you feel safe. Plus they are very good a moving things around and asking for another chair/pillow, and will turn out the lights, after each time the obstetrician comes in and wonders why the lights are off again.
Use a birth pool, even if just to labour in.
For Vanessa, being in a birth pool gave her her own space: safe and warm. The blue plastic walls like a fortress; the mottled effect of the water giving her a little privacy and a sense of being a little less observed. So when the midwives where exhorting her to push, push, she felt enough in her own world to turn in and let her body do its own thing, in its own time, giving birth to a beautiful 11lb baby without a scratch.
Nicola Goodall has found some common themes when talking to women about metaphorical birth caves: dark, quiet, a bubble, safe arms of partner, no one interrupting you or telling you what to do, time stands still, privacy, guarded, infused with love and support are phrases they use. Partners can play a big role in helping a woman feel safe, guarded. They can be her rock to cling on to, her wall to hide behind, her buffer between her primal self and the modern maternity set up. Doulas and other supporters can help your partner, and take turns to rest, get food, if it is a long birth.
When the environment is right, where she feels safe, a woman is able to follow her instincts as a birthing mammal, just as my neighbour’s cat did. Giving birth, after all, is a bodily function. Michel Odent, famous obstetrician, says ‘One cannot actively help a woman give birth. The goal is to not disturb her unnecessarily.”
I hope you will message me with your birth cave ideas and stories.
I am a doula and antenatal teacher in Bedfordshire, UK.