Having a baby? Don't believe the false promises, says Emily Woof. The gulf between natural birth and the medicalised approach puts mothers in an impossible situation. And she should know

I remember being at a party when I was eight months pregnant with my first child. I got into conversation with three experienced mums. They looked at my round belly, and smiled conspiratorially as they unleashed their birth stories. They divulged everything – the baying, the blood, the fear, the chaos, the agony. They seemed to want to outdo each other's horror and as they talked they were transformed into electrified, possessed creatures. I was terrified. The adrenaline rush sent my baby into back flips inside me.

I have never talked about the births of either of my two children. There are plenty of reasons. Most of them are pragmatic. Birth pitched me into motherhood. Suddenly there was no time, certainly not for dwelling on the past. The births were behind me, the children ahead.

At least it's what I tried to tell myself. I had given birth twice. Each had produced a beautiful, healthy boy. Why linger on them? People went through far worse. It seemed churlish to brood, especially when so many women were unable to conceive. But my experience remained locked inside me, refractory and unexamined. If birth came up in conversation, I would stay mute hoping the subject would move on.

I knew that writing this article would be hard. I would have to face raw memories and all the old unanswerable questions. Above all, it would mean describing the actual births. I wondered whether the article should have a subtitle: not to be read by expectant mothers.

I asked my mother about her births and she said she never talked about them to anyone. She said the reason was obvious (my mother's second pregnancy ended with a stillbirth, and the unspoken grief still lives inside her after 50 years): birth was so dreadful that it had to be forgotten, or no one would go through it more than once. I don't believe women forget their birth experiences. I certainly haven't forgotten mine. Many women do talk about their births. Plenty of my friends recount them openly, especially if they went well, and I've noticed that even among those who had difficult births, talking about it can be a way of coping with the trauma. There are a multitude of responses, but mine, like my mother's, has been silence: not because of how dreadful the births were, but because at some level I couldn't acknowledge my feelings about them. I felt ashamed. I felt I had failed because both of them went "wrong".

It was the due date for my second child. The birth of my first had been by emergency caesarean, and I was keen to try for a natural birth. We had chosen a female obstetrician with a good reputation and discussed Vbac (vaginal birth after caesarean), which she was confident I could have. My husband and I arrived at her surgery for a cervical sweep, whereby a doctor or midwife uses a finger to stretch the cervix to stimulate labour. My consultant cheerfully inserted a finger. "Push against me," she said. I did. It hurt. It hurt a lot.

"Ah," she said, smiling, "I've broken your waters!"

She pulled out her hand. Her face went pale with shock.

My skirt was drenched in bright red blood. I couldn't understand where it had all come from.

"It's frank blood," she said. "Where's your car?"

We ran red lights all the way to the hospital. I was put in a birthing room and strapped up to various monitors. The bleeding subsided. A slow flow of clear fluid ran between my legs. It was amniotic fluid, my consultant reassured me – a good sign. She went back to her surgery to see more patients. When she returned four hours later, I had started to have mild contractions. She asked me to stand up and move around the room. As I stepped from the bed, I suffered a huge loss of blood. I had been haemorrhaging internally since the sweep. The blood had merely collected inside me. The clear fluid was not amniotic fluid but serum from still, separating blood.

I remember a blur of green gowns, a drip in my arm, the hospital corridor rushing past, my husband's terrified face, the bright coldness of the operating theatre, the mask going over my nose and mouth.

My husband waited in the corridor. After five minutes, a nurse emerged with a baby. He put it under his jumper to keep it warm and waited for three long hours. The memory still makes him cry. The doctors were too busy to tell him what was going on. He remembers someone rushing out and shouting, "We need blood!". He thought I was dying. I suppose I was. Only a massive transfusion saved me.

I have struggled with hundreds of questions about it ever since. Why did it happen like that? Looking back, I can also see that I had put myself under enormous pressure to have a normal delivery. Why? Why didn't I choose an elective caesarean? The answer is that in having one with my first child, I felt I had somehow let myself down.

On the internet, women chatter anxiously about every aspect of birth, from pain relief to whether an epidural can affect the baby's brain, from cultural differences in birth methods to whether having a caesarean can save your sex life. The voices seem uncertain: dismayed by choice, and fraught with the worry about getting it right.

The previous generation had no such choice. My mother's first birth was a lonely and scarring experience. My father was not allowed to be present. She was strapped to a bed on her back, her feet hoisted into stirrups. She was given ether for the pain and the baby was yanked out of her birth canal with metal forceps. Her vagina ripped badly, and she felt alone, ashamed and frightened. She said she was treated like an animal. Her baby was taken away to a separate room and only brought back to her when the staff deemed it necessary.

It is not surprising that after such experiences the natural childbirth movement sprang up. Women wanted control. Birth was a natural process, they said, and a joyous one. They wanted the sense of community that could surround a woman giving birth: midwives, partners, doulas. The hospitalised degradation our mothers had suffered was a thing of the past. Birth should be a positive experience.

Ten years ago and pregnant with my first baby, I found myself caught up in that idealisation of birth. My friends were the same. We practised squatting, breathing, and massaging. We were encouraged to indulge our bodies. It was a special time. Not least because we felt we were discovering a new faith; in nature, and in ourselves.

My husband and I sat on bean bags in the National Childbirth Trust (NCT) class, taking copious notes on an A4 pad. We learned that drugs could harm the baby. They could make it sluggish, and slow to feed. We heard horror stories about epidurals. We learned that the increasing rates of caesareans were due to doctors fitting them into their shifts. Birth had become over-medicalised and modern women were becoming "too posh to push".

The NCT offered an attractive alternative. Birth was not just a matter of having a baby, it was about remaining in control. I made my birth plan. No pain relief, it said. The teacher took my husband to one side. "Make sure she sticks to her plan," she told him. "When she's screaming for drugs, it's not what she really wants, it's what they want." He dutifully made a note of it.

We were both suggestible. I was hormonal. We became so convinced of the evils of hospital we decided to side-step them altogether and opted for a home birth. We paid for an independent midwife. She came to the house and showed me a video of a Brazilian woman giving birth. The woman got down on her haunches by a tree and pushed. The head of the baby crowned between her legs and it slipped out, easy as a pea from a pod. I am relatively small in stature and my bump was enormous. "I'm worried my baby is too big," I said. "You must trust in nature. Babies cannot be too big," the midwife retorted, as though I had dared question the faith.

We had candles, mood music, a birthing pool. We knew how to breathe. We had massage oils. We were ready. My waters broke at night and I went into labour. My contractions were fierce. I was soon 10cm dilated. The contractions came every 30 seconds, pain grinding down my lower back. I felt I would crack open. My baby did not slip out like the Brazilian woman's. I laboured for 36 hours. There is no describing the agony. The midwife put her hand inside me to turn the head, but still the baby did not come. I didn't want candles or massage or music. I just lay on the bathroom floor and wanted to die.

My husband told me that the midwife had stood in the kitchen at a loss. By midnight on the second night, he insisted we went to hospital. Within three minutes of arriving, I had been given an epidural. Fifteen minutes later, the duty doctor told me that the birth was not progressing and I was exhausted. He would deliver the baby by emergency caesarean.

The independent midwife didn't stay. This would not be a natural birth. Following standard procedure, the surgeon cut my skin through to the layer of fat until he reached the fascia, the shining inner skin that supports the abdomen. He made a small incision and widened the cut. He parted my muscles underneath and pushed through a sheet of tissue using his finger. He stretched the hole open and cut carefully into my womb, just enough to allow the baby's head through.

The sight of my baby suddenly lifting above the curtain and screaming loudly with flailing limbs, is scored into my memory like a sunrise. I reached for him, despite the surgeon telling me to lie still. The nurse laid him on to my breast, and the instant he touched my skin he was quiet and still.

Lying in the hospital ward afterwards, my body swollen with fluids, and the pain in my abdomen severe, I became deeply depressed. I was in a busy ward. My husband was not allowed to stay. I remember staring at my baby in the clear plastic tub next to me. I wanted to lift him but I couldn't move. A nurse reprimanded me. Why had I not bothered to put a nappy on baby? I was disoriented and could barely understand her. She stormed off and got a nappy and wipes. She dumped them on the bed beside me and passed me my son, streaked with meconium. I cleaned the molasses-like excreta from his perfect skin and cried through the night.

Perhaps with birth experiences like these it's not surprising that I wrestle with the idea that birth is one of the most natural things we do. I was told afterwards that my first son had the umbilical cord wrapped tightly around his neck. If he had come out normally, he would have been strangled. He would have died or suffered severe brain damage. I had always prided myself on being in tune with my body, fit and strong, and this felt like a dire failure.

I'm not sure whether birth is comparable to other "natural" things that we do. Unlike other mammals, our babies do not have a straight trajectory into the world. Evolution dictated that our pelvises became narrow in order for us to walk upright, but at the same time our craniums were growing larger to accommodate our burgeoning brains. For a baby to be born, it must turn as much as 40 degrees so that its large head can squeeze through the birth canal. It is a difficult manoeuvre. I recently read a book about the Piraha people in the Amazon. There was a description of a woman going into the forest alone to give birth. The baby got stuck and she cried out in agony all night long. No one went to help her. She was found lying dead by the river, the next day, her baby still inside her. The book says that no one mourned her. I'm not sure I can believe that, but it certainly seems true that for the Piraha, death in childbirth is simply an unavoidable fact of life.

Death has always shadowed birth. In the 1600s, if the baby didn't emerge, doctors drilled into their heads to make their bodies easier to extract, piece by piece. In the 19th century, women preparing for birth were routinely told to pray and beg forgiveness in readiness for death; 19th-century novels are littered with mothers dying in childbirth.

I am deeply grateful that I live now, when medical intervention has kept me and my children alive. I also know how important it is that the NCT and similar organisations exist to support and empower women. But in my experience, the division between health practitioners who advocate the natural way, and those who encourage a more medicalised route presents its own danger. It carries with it a sense of good and bad, a gulf in which women can get caught. It is part of our culture to want choice and to be in control, but with birth, this is probably impossible.

My friend Georgia, who was pregnant at the same time as me, was induced three weeks early because of pre-eclampsia. Her cervix did not dilate and she was forced to have an emergency caesarean. I asked how she felt about the whole experience. She said she was fine, just happy to have a healthy baby. From the start she had never expected the birth to be anything but a nightmare. Sceptical by nature, she had stopped going to her antenatal classes because she disliked all the false promises about perfect births. She chose not to make any kind of plan. As a result, when things went wrong she did not feel any disappointment. It made me realise that, in some way, my silence was about mourning the birth experience I had wanted so much but was unable to have.

No doctor can predict how a birth will turn out. It's hard to know how best to prepare. To misquote another novelist, there are as many different birth experiences as there are babies. It has taken a long time for me to understand that it was not that my births that were wrong, but my expectations.

My birth stories are extreme but they are part of who I am. It is good to acknowledge them but I still feel drawn to silence. I don't know why, exactly. It is not about shame or feelings of failure any more but perhaps because ultimately birth, like death, is so intimate, so ordinary and yet so epic that it is beyond our expression.

Emily Woof's first novel, The Whole Wide Beauty, is published by Faber at £12.99. To order a copy for £11.99 including free UK mainland p&p, go to theguardian.com/bookshop or call 0330 333 68467