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Some women are silent in labour, others hum, some rock backwards and forwards while others swear, sing or chant. Making a noise or swearing in labour doesn’t mean that a woman requires pain relief or that she should be silenced. In fact women’s noises are a familiar feature of labour, and every midwife will have experienced them.

The real skill is to be able to read these noises as an indication of progress in labour. But how you interpret her expressions of emotion or pain will depend on your attitudes, your understanding of what she is feeling and your willingness to allow her to express herself in whatever way she wishes.

Shhhhhhhh! you might disturb someone!

In the past, we have tended to be embarrassed by the noises women make in labour. We often justify our unease by arguing that, in a hospital setting where labouring rooms are adjacent to each other, a noisy woman may disturb others. But are other women really disturbed by labour noise? Has anyone asked them?

The influence of culture

Midwives now come into contact with women from newly arrived communities whose cultural practices vary from our own. And women from different cultures often express themselves differently during labour, although the physiological processes of birth are the same everywhere. So they may have quite different attitudes towards making a noise. But remember that no two women are the same even though they may come from a common culture, so treat each woman as an individual.

Tips and tricks

• Examine your own attitudes to noise – how do you feel when a woman is expressing her pain or emotions noisily? Why do you feel this way?

• Encourage her to make whatever noise she wants – help her to feel that noise is normal and acceptable, and to feel that she has the privacy to be noisy.

• Learn about your local population - ask women from different cultures to tell you about their birth practices.

Further reading

Moore S. Psychological support during labour. In: Henderson C, Jones K (eds) (1997) Essential Midwifery Mobsy, London

Raphael-Leff J (1991) Psychological Processes of Childbearing Chapman & Hall, London

Schott J, Henley A (1996) Culture, Religion and Childbearing in a Multi-racial Society Butterworth Heinemann, Oxford