Birth then and now.

Halfway through the 20th century, views on pain in labour encompassed almost everything from women's self-blame to blaming nurses, midwives, doctors or partners for 'bad experiences'. Soon after that, giving birth came to be seen - in some settings and by some caregivers - as a 'natural' and thus benign event which women could 'master'. In their recent systematic review of women's expectations and experiences of pain relief in labour, Joanne Lally, Madeleine Murtagh, Sheila Macphail, and Richard Thomson show that there is wide variation in women's expectations and knowledge about the first birth. This systematic review provides us with a strong basis for reflection and action.