Making babies

Small, slim, with cropped bob and businesslike attire, fertility and pregnancy expert Zita West could easily intimidate as she rattles off advice in her London clinic, a light, bright room punctuated with dashes of hot pink and red. The only other colour emanates from pictures – dozens of snapshots of babies.

But West is more eager to converse than to pronounce. It's easy to imagine unburdening yourself to her about even the most personal of topics.

A youthful-looking 51-year-old who counts such luminaries as Cate Blanchett, Kate Winslet and Ulrika Jonsson among her admirers, she was raised in Coventry, the eldest of four daughters. Their father worked in a factory and their mum was a nurse and midwife. West was not an obvious star. After messing around when it came to A levels, she got a job in the china department of her local Co-op. It was her mother who applied for a nursing course in Leicester on her behalf.

After completing that, she went to Southampton to study midwifery. Later, newly married, she and her architect husband moved to Oman, where she initially worked part-time in a local hospital.

"Then we moved to Muscat and I worked as a midwife. I'd been trained with a very medical idea of midwifery – machines, scans, epidurals and equipment, equipment, equipment. Out there conditions were primitive ... I never used any painkillers. And I did more deliveries in the back of a pick-up truck in the car park than in the labour ward, because the Arab women were convinced that if they went into hospital they'd be tied down."

While in Oman she had her own daughter, now 23. "I was in a ward with 30 others, with a friend for support. My husband wasn't allowed in because it is a Muslim country. Two women whose babies I'd just delivered were in beds opposite me."

Returning to the UK meant a massive readjustment. "I was hopeless. I couldn't set up an epidural, couldn't put in a drip. I'd forgotten all those skills. And I wasn't used to how long it all took, because in Oman the women all came to the hospital in established labour. My experiences there and what I learned from the fantastic Indian midwives moulded my way of thinking."

It was her experience of post-natal depression following the birth of her son, 20 years ago, that inspired her to explore complementary therapies. "I tried a few wacky things until I discovered acupuncture," she says. "I look back and realise the problem was sleep deprivation and the shock of having two children. Acupuncture helped enormously, so I applied for a grant in Oxford, where we were living, to train as an acupuncturist and persuaded my hospital to set up an NHS clinic. I used acupuncture for all the ailments of pregnancy, as well as for labour and postnatal depression. But like everything in the NHS it became a victim of its own success. We were so oversubscribed I ended up treating 30 women a day, two days a week."

Around that time several baby magazines started up and she became the go-to woman for quotes and advice – which increasingly revolved around problems conceiving. Couples would ask, "We don't understand why it's not happening. What are we doing wrong?"

Medical problems are important to identify and treat, she says, but it's the couples suffering from unexplained infertility who prove more intriguing. "I always ask, 'Is there anything in your psyche that's stopping this from happening?' It's incredible, some of the sad stories you hear. There are a lot of previous terminations and low self-esteem. Grief is a big one, the loss of a mother, or sibling.

"But is it any wonder it's hard? This comes at a time when a woman's career is taking off – and many are breadwinners. They're working long hours and trying to get together and have sex is very hard. Intimacy goes out of a relationship so quickly. To have a sex life you need energy. At the end of the day it doesn't matter how much nutrition, acupuncture, hypnotherapy, or whatever, if you ain't having the sex, it isn't going to happen! So I'll sit here and do a biology lesson. These women are very savvy, but basic biology has evaded them. I don't think they're taught it at school.

"It's the simple things, like the fact that ovulation is a random event that can't be predicted. You need to have sex three or four times a week. Very often women are focused on that fertile time and using a lot of props – taking their temperature, peeing on sticks. Throw it away. Get so it's an unconscious thing, don't be dragging him back from work at two in the afternoon and worrying about it."

Many don't see the counter-intuitive nature of their behaviour, she says, citing those who arrive with a list of banished foods, including wheat, dairy, sugar and fat. "I say, 'What are you eating?' It's no good beating yourself up that you had a cup of coffee, or that you've eaten a non-organic pea."

West's job is to give couples the confidence that with a few tweaks they'll get there: "I hate it when women go down the IVF route too quickly. It's not a fix. You need to get your emotional life and lifestyle right first."

She encourages them to talk things through – hence a prominent box of tissues on her table. "They are amazed what comes out in a session. I know I'm going on about sex a bit, but if you aren't having sex because of resentments, you won't get pregnant. And because stress is such an issue, you need to have down time. When I ask, 'What do you do to relax?' and they say, 'I go to the gym.' Well, the gym isn't relaxing. Exercise is important but true relaxation is getting enough sleep or meditating or cutting down on drinking, or spending time with yourself – sometimes that's the hardest person to be with.

Another problem is the widely held assumption that you just need one sperm and bingo! "A lot of lifestyle factors affect the sperm. Many of the men I see are not going to tell their doctor they're doing cocaine or marijuana, but recreational drug use does affect sperm. You've got to allow the man at least four months to clean up his act. Smoking has a huge impact, along with alcohol, age, saunas ... you name it.

"Finally, some couples are not right to have a baby together. They go off with another partner and boom – pregnant. There's an awful lot we don't understand."

Infertility is such a hot topic and baby mania so rampant, does she ever flash a stop sign? "Yeah", she replies. "Some women go on and on, at the risk of their health, their relationship, at the risk of everything. If you think they're pushing the boundaries, you need to point that out. Sometimes it's not about having babies, it's about moving on, working out how your life is and what the positives are. Helping certain women reach closure is an important part of the work that I do."

She's critical of the mindset that blames women for leaving it too late. "Very many have not met the right man; they split up from a relationship; they have elderly parents, lots of issues prevent them from having babies much earlier. I don't think you can have it all. But I think we need to be thinking about younger women having a baby and then going for a career."

Couples going to West for help emerge with a programme combining medical and alternative approaches, which might include acupuncture, cognitive behavioural therapy, Qi Gong or hypnotherapy. "We call it gate-keeping: we work out the areas in their life they need to improve, and focus on somewhere they can make a difference. You can't land too many treatments on someone. It's expensive and they don't maintain it. Rapport is important. I look after a very vulnerable group and they need hand-holding."

You know, I say, women have been having babies for millions of years. Why do we need fertility consultants all of a sudden? She laughs. "Well, they were younger then and it was easier, you'd meet someone, you lived in a smaller community and didn't travel so much. Also, we lead far more stressful lives. Twenty or 30 years ago many women didn't juggle careers with child-raising. Women I see on the whole are vulnerable and desperate and badly need help, no matter what stage they're at."

West and her team will be at Edinburgh's Radisson SAS Hotel on 4 April. Tel: [phone] to make an appointment. For more information, visit www.zitawest.com