In an active birth the mother is in control of her body. She moves and changes position freely -- she is the birth giver. In an actively managed birth, all the power is taken from her -- her body is controlled and she is a passive patient.

Being free to move and choose your own positions has some other advantages, too. It's easier for your uterus to do its work, so the contractions tend to be less painful than if you were lying down. Freedom of movement, free expression of sound and the natural forward tilting of the uterus help to modify the pain and are likely to reduce the need for medical pain relief.

Whatever kind of labour and delivery a woman has, and wherever she chooses to have it, with active birth principles she can be in control of the birthing process

Active birth is not new. It's a way of describing how women the world over have always behaved during labour and birth throughout history. It was only 300 years ago, in 17th century France, when forceps were first invented, that the notion of women lying down for birth first became common. This made it easier for events to be "managed" by the birth attendant and the baby to be "delivered" -- a trend that continued for the next three centuries and which still haunts us today.

This was the start of modern obstetrics and led to the sophisticated medical back-up for birth that we can be thankful for all over the developed world today. However, along the way, the birthing mother became disempowered. Birth, for the majority of women, became a medical event carried out in a clinical environment. Age-old wisdom and midwifery skills were almost lost and forgotten. By the late 19th century, most women became passive patients rather than active birth givers and the semi reclining "stranded beetle" posture for giving birth became the norm.

When I trained as an antenatal teacher in the late 1970s, the aim was to educate women for a natural birth. Hoping to manage without drugs, women were learning breathing and relaxation techniques, but were still being prepared to labour and give birth lying down or semi reclining, mostly in a medicalised environment. Despite this preparation, the majority of these women ended up with a cascade of interventions and a complicated birth. The whole atmosphere surrounding birth was one of fear and the general expectation was that women need help to have a baby.

Disappointed with these results, I decided to do some research into how women have given birth in other cultures and other environments. I very soon saw that cross-culturally, labouring and birthing women were standing, kneeling or squatting and were generally assisted by other women. It dawned on me simultaneously that the anatomy of the female pelvis is ideally designed for labour and birth in upright positions.

I coined the phrase "active birth" in the early 1980s, when the first women I taught began to use upright positions. It was a deliberate play on the words "active management of labour", used at the time to describe the medical style of managing birth with induction of labour, epidurals, electronic foetal monitoring etc. Today, we have progressed a long way from these early beginnings. Active birth has become a generic term and we are moving closer to a much better balance between nature and the benefits of science. There is growing understanding of birth physiology and a gradual transformation of the birthing environment, whether home, birth centre or hospital, to one that's more conducive to the natural processes of birth.

In an active birth the mother is in control of her body. She moves and changes position freely -- she is the birth giver. In an actively managed birth, all the power is taken from her -- her body is controlled and she is a passive patient. An active birth is one in which the first resort is the mother's own instinctual and natural resources and the last resort is medical intervention.

When they are needed, medical interventions can often be adapted for use in upright positions, so that even when a birth is difficult and needs obstetric support, the basic principles and benefits of birth physiology can often still be observed as much as possible. Obstetrics is there as back-up to serve women when there are difficulties or complications.

Change is slow and there is still a long way to go before active birth becomes a real option for all women, but amazing progress has been made in just over two decades, since the active birth movement was founded in 1981. I am often asked what and where is the active birth movement? It's not an institution or an organisation. It's simply a way of describing the tide of change arising all over the world as awareness and consciousness about the true nature of birth awaken. No one is in control of the active birth movement -- it is not a method. It is a global transformation in the culture of birth and a rediscovery of ancient wisdom, principles and common sense. The power in the Active Birth Movement belongs to the birthing mother.