TRANSITIONS TO ESTABLISHMENT First im pressions o f the world Birth is a formative drama which can potentiate some of our deepest personality patterns. Whether birth is also a trauma or not will largely depend on the conditions prevailing at the time, and the attitudes of the participants. During a normal birth the baby comes head-first into the world; it is its earliest grounding. Any understanding of later character dynamics rests on this first engagement with the outside world.When the foetus is ready it induces labour. This seems to be primed also by a biological clock, linked to the age of the placenta, which ensures that, somewhere around forty weeks after ovulation, contractions proper will begin in the uterus. Thus the first stage of labour begins. Lamaze has compared the uterine contractions to the tides; the waxing of contraction is the rising tide, the apogee is slack water and the waning of contraction is like the ebbing of the tide - again, another pulsation.Grantley Dick Read,1 one of the earliest modern pioneers of natural childbirth, has argued strongly that it would be surprising if childbirth was the one natural function which had an organic connection with pain. There is no reason to assume, as Rank suggested,2 that birth for the baby is necessarily a traumatic experience. ‘Only traumatic birth is traumatic’, Janov3 reminds us. As a birth that is painful for the mother is likely to be stressful for the baby, it is worth recalling the dynamics of pain in the first stages of labour.