For many women, having a baby is their first real experience with the formal health system. When it comes time to walk into the hospital to have their baby it is often an automatic response to take on the 'passive patient' persona. This is a conscious or unconscious state where the woman sees herself as a 'patient requiring treatment', giving over to the caregiver(s) who will 'now look after her'. For many women these feelings can cause them to modify or change how they feel about their labour and the pain associated with it.
When a woman enters the hospital environment, it is common for her to take on the 'passive patient' persona. Subtle actions like being asked to change into a hospital gown, being directed to lie on a hospital bed (which is usually high and narrow, often restricting the woman's choice of her labouring positions), can contribute to her feeling like she is a 'guest' on 'caregiver's territory'. Being a guest often means being polite, asking permission, not wanting to 'put anyone out' by moving from the expected routine.
One way that a woman can avoid this 'persona' is viewing the hospital as a 'service' and the 'caregiver(s)' as service providers or hired professionals, employed by the woman. Seeing the maternity system from the perspective of a consumer (rather than a patient), can help you to view the service as needing to meet your needs, rather than you fitting in with the hospitals requirements. For a few women the only way they can feel fully in control of their environment and choices is to choose options such as birth centres or home birth.
We do recognise that there are many women who would prefer to be the passive patient. It is often much easier to hand over the choices in labour to the caregiver(s). This is your choice, but think carefully about the implications of this attitude and try not to confuse this with the 'that's what I am paying them for' argument (if you have your own caregiver).