Spirituality and Childbirth

Meaning and Care at the Start of Life

Susan Crowther, Jenny Hall, Susan Crowther, Jenny Hall

• Publisher: Routledge
• Year: 2017
• Print ISBN:
  9781138229402
• eBook ISBN:
  9781315389622
• Topic: Social Sciences
• Subtopic: Health Care Delivery
• Index: Social Sciences

Highlighting aspects of birth often taken for granted, ignored or left silenced, this book questions the art and meaning of childbirth. Addressing spirituality in and around the start of life from a variety of thought-provoking perspectives, it examines the apparent paradox of impersonal biomedical-technocratic systems operating alongside the meaningful experiences encountered by those involved. Themes covered include:

• Notions of holism and spirituality, culture, religion and spirituality
• Childbirth significance at societal level
• Spiritual care in maternity care provision
• Birth environment, mood, space and place
• Spiritual experience of all those involved, including health professionals
• Spiritual experience when birth is complex and challenging
• When birth and death are juxtaposed.

Although there is considerable literature on spirituality at the end of life, this is the only book that draws together a global and multidisciplinary selection of academic researchers and practitioners to reflect on spirituality at the start of life. Each chapter explores the relevant theoretical background and makes links to practice, using case studies from research and practice. The chapters conclude by discussing: how spiritual care is, and should be, provided in this context; what practice approaches are beneficial; cross-cultural perspectives; and future directions for research. It is an important read for all those interested in childbirth, maternity care, social science perspectives on health and illness, and spirituality.

PART I
Setting the context?

1
INTRODUCTION

Susan Crowther and Jenny Hall

Human civilisation has witnessed changes in the social and cultural context of childbirth. These changes involve continuing modification in symbolism, behaviour, organisation of care and emergence of new value and belief systems. Birth is a unique social and cultural occasion holding meaning for society as a whole and each of us individually. Childbirth practices thus reflect significant cultural conditions and values (Crouch and Manderson 1993). The subsequent influences of these conditions and values on birth experience are dynamic and changeable and reflect social, religious, spiritual and emotional meanings. Birth ideologies, medical or natural, foreground cultural and political discourses revealing the effective dominant beliefs and ideas of a time and place. Over time such values and beliefs form images of the prevailing culture and contribute to the social, emotional and spiritual interpretations of birth. What is unclear is how spirituality in the context of childbirth continues to unfold as part of the human experience of childbirth in the 21st century and whether this needs addressing.

This book focuses on spirituality in and around childbirth. Drawing on a body of published work, unpublished research and our unique perspectives as co-editors along with our chapter authors, this book addresses spirituality at the start of life from a variety of thought-provoking perspectives about how 21st century childbirth is considered. Childbirth in this context refers to an undividable continuum of pregnancy-birth-postnatal; we believe that it is nonsensical to introduce arbitrary divisions between so-called ‘trimesters and parts’ of the childbirth year.

The topic of spirituality and childbirth has beckoned us both for a long time through personal and professional experiences. As we sought ways of reconciling our inner knowing something meaningful about childbirth and how this can and does influence childbirth practices began to call for us to take action – the result of which was the genesis of this book. But why does spirituality at the start of life need addressing in the 21st century context? Surely we now live in a secular technological society with advances in biomedical research and scientific techniques that have made childbirth, at least in the middle to high income regions, as safe as it has ever been in human history? Of course, that in itself is questionable with the increasing array of iatrogenic consequences emerging due to over-zealous usage of contemporary birth technologies (e.g. Downe 2004, Kitzinger 2012, Gaskin 2011, McAra-Couper, Jones, and Smythe 2010, Stone 2009, Davis-Floyd and Cheyney 2009, Fahy, Foureur, and Hastie 2008, Brodsky 2008, Davis-Floyd 2001). However, in our pursuit of safe childbirth have we lost or perhaps hidden something of experiential significance?

Technological birth, natural or normal birth, and holistic social models as opposed to medicalised models of care are well defined by their protagonists and written about extensively elsewhere. However, dichotomous thinking is unhelpful and only serves to occlude the very phenomenon we are seeking to reveal. We are not setting out to prove one understanding is noble and another approach suboptimal, but suggest that there is an approach now so dominant that it threatens to negate and ignore other understandings about childbirth. We contend that childbirth, especially in the western technological context, has become progressively technocratic leaving the felt experiential aspects hidden and unspoken. Examination of spirituality at the start of life reveals another depth of understanding to childbirth not commonly acknowledged. Our concern is that perhaps we are losing something of existential significance in our technolust¹ orientated human world? Can we really afford to ignore spirituality as human beings in all our activities and experiences? Nicola Slee (2004) suggests that spirituality is unique and deeply personal to each of us and is implicit within humanity. Would this not have implications as we bring our attention to childbirth?

There is emergent evidence that spirituality in and around childbirth is experienced as a personal sense of opening and unfolding of self-awareness and self-knowledge which brings inner strength. Pregnancy and birth appears to draw women into proximity with the divine (sense of ‘other’) and be transformative (Moloney 2007). Nicola Slee (2004) concurs and found that spirituality in and around childbirth is an opportunity to open to ‘divinity’ (whatever that may mean for you) in ways that are not possible in other ways. She describes how for many women spirituality is a ‘vibrant and manifestly obvious fact’ (2004, 2) and found that birth holds potential for women to become realised, liberated and spiritual awakened. Other researchers have found the same suggesting that birth for women can bring deeper awareness of connectedness between self, others and divinity and be a time to become more aware and reflect upon spiritual connection (Jesse, Schoneboom, and Blanchard 2007). Given this emergent evidence revealing the experience of spirituality in and around childbirth the implications for health care professionals working in maternity care are significant.

Health care professionals nationally and internationally are charged with providing holistic and spiritual care. This gestures to the need to explore and highlight the meaningfulness of childbirth and how these meanings inform (or not) contemporary childbirth practices, both for professional and lay persons. Through the following chapters the spiritual significance of childbirth is drawn out so that you are confronted with the apparent paradox of biomedical-technocratic systems and the lived experiences of meaningful encounters that often stir all of us involved with childbirth, both professionally and personally.

Several books have focused on spirituality in health care (e.g. Wright 2005, de Souza, Bone, and Watson 2016) and several book chapters and articles are dedicated to health and spirituality (e.g. Pesut, Fowler, Taylor, Reimer-Kirkham et al. 2008, Paley 2008, Gilliat-Ray 2003, Tanyi 2002, Cawley 1997). Yet little on childbirth and spirituality. Jenny has previously published ‘Midwifery, mind and spirit: emerging issues of care’ in 2000, which is now out of print and out of date. Surprisingly we found no other book dedicated to this topic (at least in English up to early 2017). Although there is considerable literature on spirituality at the end of life (i.e. hospice care, palliative care, chaplaincy for the dying) there are no books that draw together global academic researchers and practitioners who have an interest in spirituality at the start of life. We have therefore drawn upon a variety of disciplines to gather a variety of perspectives from midwifery, anthropology, psychology, social sciences, hermeneutics and contemporary religious studies. Each chapter brings a style that is innovative, engaging and invokes reflection on aspects of birth normally taken for granted, ignored or left silenced.

In this collection of edited chapters the art and meaning of childbirth is highlighted and contributes to deeper understandings and appreciation of this significant human experience. Through the chapters we draw attention to the beginning of life; a poignant human journey that holds meaning and significance within and beyond current maternity care systems. The overriding themes that inform this book have evolved over time in dialogue with our chapter authors:

• recognition of spirituality at the start of life (mother, baby, family, community)

• exploration of the notions of holism and spirituality

• spiritual experience and childbirth (health care and non-health care professionals)

• spiritual care in maternity care provision

• childbirth as significant bringing meaning and purpose to life at individual and societal level

• spiritual experience when birth is complex and challenging

• childbirth when there is the juxtaposition of birth and death.

What is evident is that something of significance was happening in and around birth and that to appreciate this required multiple perspectives.

Thinking about spirituality

Given that bounded definitions are not feasible we provide here a starting place for our thinking together about spirituality. As Swinton and Pattison (2010) contend definitions of spirituality are always fluid, various and imprecise. The following is not to be taken as universally agreed interpretations of spirituality but an opportunity to ignite our dialogue with you. We begin by suggesting that spirituality is the quality in our lives that gifts meaning and purpose helping us interpret life’s experiences. Spirituality is thus a shared human quality that establishes who we are. In other words, we can no more be alive without physical bodies and minds than without our spirituality. These constituents of our existence are non-hierarchical and mutually inclusive; in other words we would cease to ‘be’ without spirituality.

If we start with the notion as Ammerman (2013) suggests that spirituality may or may not be connected to religion we are confronted by a possible conundrum. If spirituality can stand alone from religion as now commonly espoused, what is spirituality? The problem with this question is it implies that spirituality is an objective entity, reality or notion. We would say all people are spiritual, physical and psychic beings and aver that spirituality and spiritual experience are part of being human and our everyday human experience manifesting in a multitude of ways in relation to time, place and person. While reviewing the literature for this chapter, key qualities of spirituality and spiritual experience continually addressed us:

• transformative (Paul 2014, Lahood 2007)

• relational presence (Pembroke and Pembroke 2008, Heron 1992, Dyson, Cobb, and Forman 1997)

• wholeness, unity, connection (Wilber 2007)

• relationships, connectedness and relatedness to self, others and divinity (Dyson, Cobb, and Forman 1997)

• integral to our wellbeing (Pesut, Fowler, Taylor, Reimer‐Kirkham et al. 2008, Swinton 2001)

• meaning and purpose (Hall 2012, Dyson, Cobb, and Forman 1997)

• creativity, mysticism, imminence and transcendence (de Souza, Bone, and Watson 2016)

• religious and secular (de Souza, Bone, and Watson 2016)

• intuition and non-rational (Parratt and Fahy 2008)

• coming home (O’Donohue 2012)

• sacred opening (Moore 1992)

• faith (Smith 1979).

This list of qualities and those who wrote about them is in no way presented as exhaustive; it serves only to draw our focus into the need for an open attitude to the notion. What is striking in the above list is the relational interconnected wholeness that nurtures wellbeing and promotes meaning and purpose in our lives. For some of you reading this book spirituality may be strongly connected to faith. Yet faith and religiosity are not necessarily connected. Faith has been described as

an orientation of the personality, to oneself, to ones neighbours, to the universe; a total response; a way of seeing whatever one sees, and of handling whatever one handles; a capacity to live a more than a mundane level; to see, to feel, to act i...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• List of figures and tables
• Notes on contributors
• Foreword
• Acknowledgements
• Part I Setting the context
• Part II Spirituality and the childbirth year
• Part III Pulling the threads together
• Index