The British maternity service is in crisis. All the evidence points that way: the Royal College of Midwives says we're short of 10,000 midwives; our caesarean rate is up again, so that one in four UK births is now surgical; there's a shortage of consultants on duty to handle serious complications; and in many areas it is difficult or impossible to have a home birth (last month a Welsh woman was forced to give birth with just her mother on hand when no midwife was available to attend, despite the fact that she had registered for a home delivery).

Anecdotally, horror stories abound: tales of tragedies, "near-misses", overcrowded maternity wards, women giving birth unattended or in waiting rooms. The system, it seems clear, needs an overhaul. But what is the view on the ground - are any women getting the birth they want? To find out, we spoke to six women across the country as they neared the end of their pregnancies, then we spoke to them after the birth to find out how expectations measured up to experience.

Maria McGuigan, 38, Cardiff

Before

The community midwives I've seen have been very encouraging (the Welsh assembly wants to increase home births to 10%). But they're seriously short-staffed and have cancelled antenatal classes till the end of April. One told me there's a chance that nobody will be able to come out to me in labour, but after writing to the chief executive of the trust I've been reassured that won't happen. I've had two scans and several blood tests and paid to have a nuchal fold scan [a screening test for Down's syndrome] privately as my hospital didn't offer this. I've hired a birthing pool and am hoping that I can manage the pain without panicking. I want the baby born at home with dimmed lights and music playing.

After

Baby Grace Isabella was born at home weighing 8lb 9oz. I used the pool and gas and air for pain relief and delivered her leaning on my sofa. I was shocked by the pain but the two midwives were fantastic. There were complications with the delivery of the placenta and I lost a lot of blood. It was a bit of a shock when the paramedics arrived and I had to go to hospital in an ambulance, but one of the midwives came with me. I couldn't fault my care in any way: the midwives truly went above and beyond. My midwife stayed way beyond her working hours and consulted me every step of the way.

Kris Parkinson, 31, teacher, Edinburgh

Before

I've seen two community midwives throughout the pregnancy but, because of the way the system is arranged, they won't be at the birth. The hospital doesn't allow mothers-to-be to look round the labour ward as they're too busy - I've seen a video, but the unknown is a bit scary. It's a big teaching hospital which we chose in case there are any complications. My friends in England all got two scans but in Scotland you don't get the 20-week scan, which I wasn't happy about. I found out about nuchal fold scans myself - they're not offered here either. I'd like the birth to be as natural as possible using water pool and gym balls, relaxation and massage. I do feel confident of the care I'll be getting and I'm sure if I need a caesarean they'll be able to make a good judgment.

After

Benjamin Elvis was born in hospital weighing 8lb 6oz. It was a long labour, and didn't go as expected, but I felt informed and empowered all the way. When we first got to hospital there were no rooms free so we had to wait in triage for a while. I was in labour all day but it wasn't progressing. Eventually, Benjamin was born by emergency caesarean after 19 hours' labour. The midwife was amazing, doing everything she could to respect my wishes. Though it was a situation I'd have preferred not to be in, my care was faultless and I've come away feeling really happy about the birth. I'm so chuffed with my little boy.

Clare Singleton, 19, hairdresser, Oxford

Before

I've had two scans and was offered a nuchal fold scan, but didn't want it as I wasn't in a high-risk group. My midwife has explained everything to me brilliantly, all about diet and the mother and baby groups, and I went to an antenatal class, about the signs of labour, which was useful. I visited the hospital and it was all very clean. I feel confident that I'll be getting good care there. My plan for the birth is to get as much pain relief as possible (an epidural, definitely). My mum and my boyfriend's mum will be with me - they can hold a leg each. I don't really care what midwife I have as long as they just get him out OK.

After

Baby Conor was born in hospital weighing 7lb 13oz. I went into labour at my boyfriend's mum's house on the Monday evening, but was sent home from the hospital. When I was finally admitted, I asked for an epidural - in fact, my boyfriend said, "Give her one please" - and it was brilliant. I went to sleep and they woke me up at 7am and told me to start pushing. Conor came out at 7.50am. The midwife was really good - her shift ended at 6am but she stayed with us till 8.15am. After he was born I got no help with breastfeeding or how to bath him (it was so painful, I only breastfed for a day). My community midwife Penny popped up to see me and showed me how to bath him. She took me under her wing and gave me all the support I needed when I went home, the day after he was born. Overall, I'd say the care I got was brilliant.

Nicola Jackson, 36, writer, south London

Before

It took us a long time to get pregnant. I had four cycles of IVF, privately at the Lister Clinic, which didn't work, then conceived naturally. If I'd had fertility treatment through the NHS I'd still be on the waiting list now. I've seen five midwives in the pregnancy and you definitely feel you are a number. But the hospital has been amazing: I was given three scans, including an extra test (for sign of pre-eclampsia). I want the birth to be as natural as possible, using water, ideally. I feel confident about the quality of medical care I will get in labour, although I am worried I'll be left alone. I had a false alarm a few weeks ago and waited for two hours in the waiting room with two other women - both of them in labour.

After

Clara Grace was born weighing 8lb 6oz. I can't praise St George's enough, particularly Anneka, the Swedish midwife we had for the whole birth (her shift started as we arrived). She wasn't qualified to do water births and I instinctively felt I had bonded with her, so chose to go without the pool. The birth progressed well (I had gas and air for the pain) until I was ready to push, when Clara was stuck. Anneka calmly explained everything and helped me avoid a caesarean by getting me an epidural and waiting until the baby had turned. We got so much more than we expected from the NHS. Postnatally it was another story: they were so understaffed I was gobsmacked (and felt very alone). But at the birth itself, our care just could not have been better.

Rebecca Davie-Thornhill, 38, mother of two, Suffolk

Before

I live in Suffolk but I'm choosing to give birth in Cambridge, where I had my last two babies. I had a traumatic experience with my daughter's birth: a registrar who told me to push and left the room for an hour and a half, dropped the forceps and, when he finally opened me up for a caesarean, found my baby was stuck. Florence was in special care for a week and there was an investigation. I chose to go back to Cambridge this time because I want the consultant who did my second caesarean to do this one: I want the comfort of knowing a familiar face, someone we trust. I wasn't offered a nuchal fold scan, but I've paid to have four scans done privately (cost about £500) in Cambridge by the consultant I know.

After

Baby Arthur weighed 7lb 10oz when he arrived three weeks early. My consultant wasn't on duty when I went into labour, and I had to persuade the doctors who were to give me a caesarean and not to leave me in labour until they had more staff on duty. I wasn't feeling confident when I met the registrar, but the consultant knew my history and agreed to stay on duty until it was done. It was nice to know he'd be there if anything went wrong. I paid £150 a night for a private room but I had to ask to be moved, as the room I got was dirty and I was worried about MRSA. The nurses were all very friendly, even though it usually took them an hour to answer my buzzer, but I do feel the caesarean itself was handled well.

Majda Farid, 26, telemarketing adviser, Bradford

Before

The midwife was brilliant throughout the pregnancy. She did as much for me as a mother would for her child: she came out to me at home because it was hard for me to get up the stairs at the doctor's surgery, she listened to me, and would come straight round if I rang, even if it was just to reassure me. I had one scan - I wasn't offered a nuchal fold scan. My third baby was breech, born by caesarean, and this one was too, at 36 weeks, so I was given another scan at 38 weeks and the baby had turned head down. I thought at first that I'd have to have another caesarean but the consultant explained everything, and I felt very supported. I want to have a natural birth if possible.

After

Baby Faizaan was born weighing 7lb 4oz after a labour of just over two hours. If I'd spent 10 more minutes at home before leaving for hospital, he'd have been born in the car park! I had a postpartum haemorrhage and was in shock but they handled it calmly, and they gave me a side room so I didn't have to be on a ward. I have huge respect for every midwife I met. They were even supportive that I wanted to bottle-feed, not breastfeed like the doctor suggested. My postnatal care has been superb. I think they listen to the mother much more now than they did eight years ago when Armaan was born. I felt much more in control of the whole thing.

· Lucy Atkins is co-author of Blooming Birth: How to Get the Pregnancy and Birth You Want (HarperCollins).