Joy at Birth

An Interpretive, Hermeneutic, Phenomenological Inquiry

Susan Crowther

• Éditeur: Routledge
• Année: 2019
• ISBN:
  9780429754111
• Édition: 1
• Sujet: Medicine
• Sous-sujet: Nursing

To be at the birth of a baby is special, yet there is an increasing secularisation and reliance on technology in contemporary maternity care, particularly in the western context.

Through exploration of experiences at birth this book explores joy at birth, which is often ignored and overlooked beyond the activities that help to ensure survival. This book draws on a collection of stories of birth from mothers, birth partners, obstetricians and midwives, that demonstrate joy at birth across professional groups and in different types of births and locations with or without technological interventions. Each chapter introduces stories of joy that highlight embodied, spatial and relational meanings. Employing the Heideggerian notion of a human being, it sketches out an ontological focus that draws our gaze to the everyday taken-for-granted ways of being at birth.

Based on phenomenological experiential data and rigorous interpretive analysis underpinned by seminal philosophical writings, this book calls for readers to attend to the wholeness of birth in all situations and at all births in ways not attempted before. It will be of great interest to midwives, and those working in and studying maternity, obstetrics and neonatology, as well as social and medical anthropology, sociology, cultural, organisational and clinical psychology and spirituality.

Part I An invitation into a clearing

A clearing is more than a space. It is where something has been cleared away. A clearing offers us an opening through which new horizons of understanding and insights can bubble up into thought through hitherto previously unknown pathways of thinking. A clearing is a space where we find ourselves and others emerging out of darkness, hiddenness, and covered-up-ness where what was invisible and obscured by shadow comes into the light. In this new light, we can now see the concealed and appreciate that which remains concealed. To find oneself in such a clearing is to be transformed and illuminated so that we can glimpse possibilities on our journey ahead.

As the philosopher Martin Heidegger reminds us:

In the midst of beings as a whole an open place occurs. There is a clearing, a lighting.… Only this clearing grants and guarantees to us humans a passage to those beings that we ourselves are not, and access to the being that we ourselves are. Thanks to this clearing, beings are unconcealed … yet a being can be concealed too, only with the sphere of what is lighted.

(Heidegger, 1971/2001: 51–52)

Reference

Heidegger, M. (1971/2001). Poetry, Language, Thought. New York: HarperCollins.

1 Introduction

To be at the birth of a baby is special, an experience that often touches us in ways that are difficult to articulate. For most of us, parent, healthcare provider, or/and support person (accidental or planned), it is a precious experience like no other. However, there is an increasing secularisation and reliance on technology in contemporary maternity care, particularly in the western context. Amongst this growing dependence on technology there is a concern that something of significance at birth gets concealed and silenced. Technological birth, natural or normal birth, and holistic social models as opposed to medicalised models of care are well defined and extensively written about by their protagonists. Yet the experience of joy when a baby is born and how that is meaningful to those present has received little attention. This book turns our attention to this silence, returning our focus to experiences of being there at the moment of birth and the experience of joy.

Joy at birth is something that matters in ways not yet fully articulated or investigated. To be touched and affected by a mood (which I am naming ‘joy’ mindful of the limits of any one word) has both intrigued and invoked passion. Birth arouses the imagination. It is a mystery in which all of us have been involved (Forbes-Rogers, 1966). Birth has been seen as a rite of passage which has been identified as a re-enactment of the myth of the divine mother and child (Campanelli and Campanelli, 1998), a joyful occasion of great significance that is often experienced as a numinous occasion and “… the first act of magic” (Razak, 1990: 168).

Exactly how joy transcends the type, place, and who is present at birth remains elusive. Rhetorical debates continue in the literature and in practice. The social and medical sciences provide knowledge and expertise that assists in alleviating human suffering and minimising loss of life. Birth has a profound meaning beyond social, political, and cultural descriptions. There is something magical that inheres within the experience of being at birth that remains hidden yet embedded within the wholeness of the experience itself. In the process of a hermeneutic literature¹ review, I found little regarding the experiential and meaningful aspects of the moment when a baby is born (Crowther et al., 2014). For me, this posed unresolved and unanswered existential questions about what birth ‘is’ and how ‘it’ is experienced and meaningfully interpreted.

This book contains the principal findings of my PhD hermeneutic phenomenology study as well as continuing research, writings, thinking, and ongoing interpretations of the phenomenon ‘joy at birth’. In the PhD, stories of being at birth were collected from mothers, birth partners, obstetricians, and midwives in face-to-face interviews. These are the stories presented in this book. Joy at birth was experienced across professional groups and in different types of births and locations, with or without technological interventions. Through exploration of these experiences something extraordinary was revealed which is often ignored and overlooked beyond the activities that help ensure survival. In exploring this phenomenon through the words of those present at the time of birth, I sought to reveal some of the felt aspects that constitute the phenomenon of joy at birth. Thus, I began to question what was going on, I kept asking: What is the experience of ‘joy’ at the birth of a baby and how is this joy significant and meaningful? At the same time, I acknowledged that there was never going to be any fixed and complete answers to any phenomenon – what I have attempted to do in this work was gesture a direction of thinking and ongoing inquiry.

The key aims of this book are:

• Provide in-depth insights into the experience of joy at birth

• Invite thinking about ‘how’ we are and ‘what’ we do at birth

This introductory chapter poses the question: What is meant by and what is the meaning of joy and how does it affect childbirth? Whilst birth satisfaction is important, this chapter orientates the reader to experience(s) in, and around, birth. Same or different, meaningful experiences are not always happy or satisfactory experiences, and, in the same way, joyful experiences are not necessarily exuberant in their manifestation. Each chapter introduces stories of joy that reveal multiple meanings. In addition, each chapter links with previous and subsequent chapters, highlighting embodied, spatial, and relational meaning. As the chapters unfold, a coalescence of experiential qualities at birth reveal insights of a timeless moment – named Kairos at birth – involving numinous encounters and connections across generations and revealing an overwhelming joy at birth. Joy is revealed as a felt sudden awakening that gestures to what it means to be human. This is not to say that all births are straightforward. Even when such joy is seemingly hidden and covered over – such as, when there are poor outcomes – joy shows itself in the experience of being at birth through our care and concern.

How language itself can ‘speak us’ and how texts interact with me, the investigator, and you, the reader, through a ‘fusion of horizons’² is central to hermeneutic writing which uses language to convey what is meant (Gadamer, 1960/1975). Words have different meanings for different people, at different times and in different places. Gadamer tells us that language is a way of being in the world because words describe experience. It is therefore important that the words ‘mood’ and ‘joy’ which are specific to this study have their meanings clarified from the beginning.

The word ‘mood’ was discovered prior to the word ‘joy’ during the research proposal stage. In conversations with my supervisors at the time, coupled with ongoing reading, I explored words such as ‘presence’, ‘sacred’ and ‘spiritual’ to see how close they came to the feeling of the phenomenon of interest. Eventually, the word ‘mood’ arose as the most suitable way of moving the study towards something tangible. The Heideggerian interpretation of attunement or mood was the closest to what I was ‘feeling’ and experiencing about the phenomenon. Heidegger interprets mood as a state-of-mind or our way of being disposed to the world. He states: “A mood assails us” implying it befalls us suddenly as we are “thrown into situations” (Heidegger, 1927/1962: 175). Discovering and learning about this Heideggerian notion of attunement or mood was a eureka moment and provided a way forward into my inquiry. More about this notion will be explored in the following chapter.

Joy is a word that conjures many unique interpretations: great delight or happiness caused by something exceptionally good or satisfying; it can be a keen pleasure; elation, delight, something greatly valued or appreciated, an expression or display of glad feeling, a state of happiness, felicity, and cherished contentment (Harrison, 2010; Parse, 1997). One can feel joy; be glad and rejoice. A father expresses strong feelings at the birth of his daughter in an online blog: “… looking at her, I felt nothing but pure excitement and love for her, an explosion of joy; caused by a little girl in a bundle of blankets. Clearly anyone could have figured out why they call babies ‘bundles of joy’ ” (Joe, 2011). This father’s joy is experienced as a powerful and elevated emotion; a feeling that is something more than peace, more than delight; something akin to ecstasy.

Joy can be mixed with other powerful feelings (Harrison, 2010; Parse, 1997; Pilkington, 2006). For example, in Thompson’s (2010) hermeneutic study, mothers’ lived-experience following traumatic birth moments of expanded consciousness or apotheosis were revealed as transformative. These elevated divine states provided feelings and a sense of knowing about wholeness and connectedness. Joy does not have to be a state of effusive excitement, yet it brings a sense of peace and hope that is connecting, all-consuming, and holds potential for new understandings.

An ontological inquiry

Hermeneutic phenomenology is an ontological inquiry. It does not seek to construct labels of the phenomenon – thus contributing to a discourse – but rather reveal the ‘Being’³ of phenomenon surfacing hidden and unnoticed layers of meaning. In addition, ontological differs from an ontical focus. An ontological focused inquiry is about the Being of entities (beings) as opposed to the attributes of a being. In identifying attributes, we are speaking of entities and not the Being of those entities. In other words, ontological inquiry relates to the Being of objects, the existential meanings of objects. Let me illustrate further to clarify. If I take a professional midwife as an object in my world of research, I can determine what the attributes and qualities of that role are and arrive at some kind of fixed essential descriptive parts that make up the professional midwife. This is an ontic research exercise. Now, if I focus on what it is to Be a professional midwife, with its essential descriptive parts, my inquiry turns to an ontological inquiry drawing attention to the meaning, collective understanding, and interconnected relationship to the world in which this object (professional midwife) exists.

Introduction of these complex notions early on in this book allows you to become aware that the focus is not on measurable, material or physical phenomena, such as the physiology of joy and hormonal changes, the science of oxytocin or emotional psychometric scores. Rather, this book draws us towards an ontological focus. By employing the Heideggerian notion of a human being (Dasein), an ontological focus is sketched out that draws our focus to the everyday taken-for-granted ways of being at birth. This focus illuminates shared themes within our humanness at birth that unite us in our experiences of Being-there-at-birth rather than a focus on specific cultural, traditional, and medical practices.

It has been argued that this approach is suited to examination of experiences in and around childbirth and midwifery due to the contextual relational quality of childbirth phenomena (Bergum and Van Der Zalm, 2007; Miles et al., 2013; Thomson et al., 2011). Comprehensive understanding of childbirth requires a phenomenological view of health care that is not solely based on a Cartesian metaphysical approach that objectifies and reduces experiences to merely ontic concerns leaving existential meanings hidden.

The examination of joy at birth uncovers profound existential meanings that will provoke the reader to think beyond their own horizons of understanding and how contemporary maternity care is organised opening the possibility to think anew about birth and remind us that we are not only mortal beings but are primarily natal beings. This shared natality – a term used by Hannah Arendt – gestures to our creative possibilities that inhere at each birth beckoning us to (re)examine what and how we act, think, and care at each birth.

What do I bring?

My pre-understandings (what I bring) are an essential part of this inquiry. It is therefore important to highlight when I am speaking, therefore, the pronouns ‘I’ and ‘my’ are used to achieve this clarity. ‘I’ am part of the interpretative process and hence work in a dialectical⁴ way with the data, my professional discourses, and the world of research throughout this inquiry.

I have practised in health care for 30 years; the majority of these within midwifery (practice, education, leadership, and research roles). With a keen interest in self-development, spirituality, and concepts related to holism that incorporate mind-body-spirit interconnectedness, I am intrigued by the emotional, feeling, and spiritual dimensions of human experience. I am not the person I was before becoming a midwife. Frequent exposure to this intense ‘specialness’ is a catalyst for inward change that appears to generate a passion in me.

The possibility of every birth being significant and joyous inspires me in ways that I am unable to articulate. I maintain that birthing practices have become increasingly secular and practical, particularly within the western medical reductionist paradigm that currently informs maternity care. The mention of mood of joy at birth is conspicuously absent in daily maternity practice. I argue that it is experienced but frequently passed by. Busy modern maternity care can be likened to walking with a friend in a flower garden talking through myriad concerns. We reach the end of the walk and have not turned to the roses and taken in their simp...