This lecture was given on July 31, 2006.

"SPIRITUAL BIRTHING - How a Doula Can Help" by Teilya Kiely

Oh dear, am I actually going to be able to give birth to this baby? Will I be a good mom? What’s going to happen in the hospital? What will I do if there’s an emergency? Will I be able to handle the pain? Will I need to take drugs? Will I be harming my baby if I take drugs? Which drugs should I take?...
Oh my goodness, is all this worrying affecting the baby? I want to have my husband, my friend and my mom there, but I‘m only allowed to have 2 people – who’s feelings should I hurt? Will they be able to forgive me? Have I been getting enough exercise? Have I been eating enough healthy food? Will that ice cream I ate give my baby diabetes? Am I a bad mother before I’m even a mother? That walk I had yesterday was really long, am I exercising too much? Oh...... I ‘m....... so........ tired....... Uh oh, I sleep on my right side all the time. I’m supposed to sleep on the left! Am I hurting my baby? Uh, will my baby hurt me? Will I be able to handle the pain? Will I tear? Will my baby be healthy? What if my baby’s too big for my hips? Maybe I should just have a c-section and be done with it? (pant pant)

These and many other questions are what are on a woman’s mind during the pre-natal period. And with good reason. In this day and age, who hasn’t seen a horrifying experience on television or in a movie, where a pregnant labouring woman is freaking out, screaming in terror as all sorts of horrible things seem to be happening to her? Who hasn’t heard first hand a story of someone’s less than pleasant birth? Birth is viewed by the majority of people as overwhelming and frightening. And it can be. But it doesn’t have to be.

If you are a woman having a natural birth, as in drug free, according to one anesthetist I spoke with, you are among only 5% of the population. If you ask what the risks of medication are to your baby, according to most nurses I’ve witnessed answer this question, almost none. When someone enquires if they may squat to push out the baby, the answer is yes, until you are actually delivering your baby at which point you may be told: “Here, come up on to the bed, it’s easier up here and you can still be in a semi-squat.” If your water breaks, you have 24 hours to have your baby and probably only 18 hours before suggestions are made to augment your labour. If you are having your baby in the hospital, there is a good chance that your doctor that you’ve seen for 9 months won’t be there. If you’re giving birth in a teaching hospital, you may have many students present at your birth and doing many of your examinations. If you are making noise during a contraction as a way of coping, you may be offered pain medication.

I have witnessed doctors get angry, be rude and make sarcastic comments to a delivering mother. I think, how dare you! When a kind word or keeping your mouth shut is just as easy. For one woman, the obstetrician, neo-natalogist and the nurse thought that appropriate conversation during delivery was what food they were serving in the cafeteria that day. One woman was berated for eating: “No food means no food!” One mother was crying that she hadn’t even seen her baby a half an hour after he was born.

Right now, Alberta obstetricians are being criticized internationally about having the highest ceasarean rate in Canada. Approximately one in three births is ceasarean. The World Health Organization states that no region in the world is justified in having a cesarean rate higher than 10 to 15 per cent. And here’s something to think about; A new report by the World Health Organization identifies complications from cesarean surgery and anesthesia as the leading causes of maternal death in developed countries.

Maternal and infant mortality rates have decreased dramatically in the last 100 years as a result of technology. However, although the necessity of these medical practices are regularly questioned, the numbers of episiotomys, electronic fetal monitorings, routine intravenouses, epidurals on demand, elective inductions and early discharges from hospital continue to rise. As a result we have inflated medical costs, women fearful and less likely to consider labour without medication, fewer women willing to attempt vaginal delivery after ceasarean, and more women experiencing post-partum depression. What message is the medical system sending out to pregnant women? What message is it sending out to the rest of society? Why do we see pain as only a bad thing without value or purpose? If not for our child, for what would we be willing to feel pain? In this instant -gratification, I- want – it - yesterday,- numb – me - out - please society, no wonder we see people turning to alcohol, gambling and drugs, food as comfort, depressed and smoking. Are we surprised that women don’t want to feel pain? We are encouraged by the media and our friends that at the slightest sign of a headache we should take a pill. Rarely do I hear anyone say: gee I wonder why I have this headache? Maybe I haven’t been looking after myself? Perhaps I’m dehydrated or hungry? Nurses and doctors are bringing life by providing life saving measures. This is invaluable. Now that they have perfected that, we need to find the balance. The hospital staff need to realize they’re not the most important people in the room.

I quite like the way Lakshmi Bertram sums it up: “Hospitals expect babies to be born on time, following the averages and according to a predetermined schedule… By having to cater to the hospital set-up and the birthing personnel – doctors, nurses, anesthesiologists- this most natural, private and intimate of moments would become a pubic affair. Like many women, with so many people around, watching and scrutinizing me, I knew I would feel an incredible pressure to perform, to be “good” at this birthing thing, as if there were a wrong way for me to birth my baby… When viewed as a whole, a hospital birth seemed to offer so little. In exchange for “safety” I would be sacrificing consideration and respect. In exchange for a doctor’s knowledge, I would be giving up my own inner guidance. In exchange for pain-reduction, I would be giving up freedom and power.”

I couldn’t agree more with Ms. Bertram’s opinions. Well, now that I’ve ranted and scared everyone, including me, let me just repeat: Birth is viewed by the majority of people as overwhelming and frightening. And it can be, but it doesn’t have to be. Dr. Kieran O’Driscoll said: “If you look after (first time) mothers properly, they will deliver themselves the next time.” Birth must preserve a woman’s dignity and must remain a joyous event with a woman feeling in command of herself. Empowering women to take the time to listen to their bodies and figure out what they may want or need during labour is crucial for their self-esteem and future births.

Let me share my story with you. There were no blips of machines, no bright lights glaring, no whrrrr of an arm pressure cuff inflating. No strangers walked in and out of the room, there was no hospital smell. No one was counting down from 10 or preparing a needle with medication.

What there was, was a darkened room. The family chalice and the lamp shining through water that filled the clear plastic pool were the only illumination. The middle of the night, and although there were seven people gathered in the small kitchen the only sound that could be heard was my panting breath. I had just finished pushing through a contraction. Gone was the extreme fear of 20 minutes ago. Gone was the never-ending feeling of pushing that my body wouldn’t stop. Now I was calmer and gathering my strength. I prayed aloud: “Dear God please help me. I’m so scared and I need your help. Please give me the strength to give birth to this child. God I need your help.” It helped to calm me, praying. I remembered that I believed I am not alone. I remembered that I was capable of doing this as millions of women before me had. When I said: “I can’t” the question had come back: “If not me than who?” Yes, indeed. If I wasn’t going to do this than who. That’s why I was praying. I had been in labour 49 hours already, I had walked, cleaned, eaten, gone to someone else’s baby shower, slept, sang, and been loved and nurtured throughout that time. Active labour had only started 7 hours earlier.

With the next contraction I gathered up all my strength and pushed with all the power of myself and the universe. My baby came shooting out of my body – head, shoulders, knees and toes. I’m told the midwife did manage to catch the baby, although everyone was surprised at the sudden delivery.

Fast forward 15 months, I’m in the same kitchen, in the same pool, with mostly the same people plus 3 more, only it’s a glorious sunny afternoon. I’m giving birth to my second child and intuitively I know this child will also be a girl. This labour has been similar to the last one but this time I know what I’m doing. I’ve only been in labour 14 hours. The family chalice is lit and everyone has assumed their positions. My husband has my back and my friends are at ready to grab a leg or hand; whatever is needed. I feel an urge to cry, which I start to hold back. Then I think of what may happen for my cervix if I allow my tears to fall. And truly, if I can’t cry here in front of my best friends and family then where is it appropriate? If not in honour of this special occasion when I am being called to tears then when? As I weep, I am moved to say “Thank you for giving me this child, Brian. I love you.” Between contractions the mood is festive and anticipatory. We all chat. I start to grunt during the contractions. Everyone waits silently. When that contraction is over, I tell everyone that I will be pushing soon. 20 minutes earlier I had been 8 centimeters. The next contraction, I scream at the top of my lungs as my child’s head comes through the birth canal. The midwife tells me to stop pushing. I turn into a sailor and start cursing as if my life depended on it. I see the midwife turn her head away so I won’t see her smile. I recognize the hilarity of the situation, I’m just in no position to laugh. Every muscle and nerve and cell in my body is concentrating on not pushing so I won’t tear. I hear the midwife say: “Look, look, did you see the baby’s head rotate?” With the next push I am allowed to deliver the rest of the baby and up into my arms, she comes, clean and calm.

Those are the shortened versions of my birth experiences. Although I eventually chose homebirth, originally, we were going to have a hospital birth. As every first time mother that I know, I excitedly read up on pregnancy, the formation of my fetus and the labour and delivery that wouldn’t happen until a time in the far distant future 9 long months down the road. Actually truth be told, during the first 7 months I read more on the growth of the baby than on what the delivery would be like. Then suddenly the 9 long months became the fast approaching, sooner than I thought, getting closer every day immanent delivery. The doctor never really talked about what the labour would be like during our appointments. She never even sat down during the brief visits. She would ask if I had any questions and if I had any, she would give me the short answer that her time schedule would allow. Then she’d be off. I figured out that if I wanted to know more about this whole labour and delivery thing, I would have to learn more about it myself. Looking back, I realize how little I knew and how much trust and faith I was putting into the system just hoping it would all work out. I was really on a pink cloud of bliss, skipping along the yellow brick road called pregnancy. Meanwhile, the fears were starting to creep in, much as I tried to ignore them. The fear of – would I be able to do it? Would I be able to cope? I was religiously watching “A baby Story” and “Birth Stories” on TV, and occasionally I would see a woman freaking out. Almost all the women had epidurals and many were ceasarean births. I saw one water birth. The fears grew silently. Birth was portrayed as being overwhelming and frightening, with doctors believing birth was a medical emergency until proven otherwise. My doctor did little to allay my fears.

One of my friends had recently had a baby and she lent me a book called “Choosing Waterbirth” that reawakened in me the long forgotten desire of my teen years to have a water birth. I had seen a video as a teen about delivering in water and the benefits of it and had decided then that’s what I wanted. And now, these many years later, it all came rushing back to me.

I asked my doctor about the possibility of having a water birth. Not at her hospital. She said she didn’t know any hospital in Edmonton that did water births. I phoned around and found out she was correct. Another friend of mine heard that I wanted to have a water birth and told me about midwives who did them. I phoned some midwives and left messages. Before I talked to any of them, I had another appointment with my doctor and I asked her how she would feel about working with a midwife so I could have a water birth in the hospital. She looked at me oddly and said she’d never heard of such a thing. At that point I was still concerned about the health risks of birth and thought the hospital to be the safest place. When I finally met my midwife and learned about the training she had and the equipment that she brings to each birth, I was no longer concerned about not being in a hospital. I had complete confidence in my midwife. And the rest, as they say, is history.

So, is giving birth a religious experience? Indeed, preparing a mother for the act of birthing a child is similar to practicing spiritual disciplines. Physical and mental preparation, visualization, and prayer have definite parallels in many forms of religious practice.

Here are some of the spiritual disciplines I practiced during my pregnancies. In preparation for my births I rested on hands and knees for hours at a time to ensure the baby would be in a good position. I also sat on a special chair that aligned my belly over my hips. With the birth of my second child I visualized the desired outcome and even went so far as to make up a little rhyme that I repeated with great regularity. You see, I was encouraging my subconscious to act in my favor. I ate nutritious food to ensure health for myself and my baby… mostly. I went for long walks and exercised my body. I took a class from a doula who led me through some visualizing exercises around the birth, we made birth art and I learned more about myself.

When it came to being in labour and delivering my children, we definitely practiced many spiritual disciplines. My husband and I took time to talk together about what was about to happen and to connect it to the root of our relationship – love. We always lit our family chalice, as the symbol of our Unitarian Universalist faith and the connection it holds to our wider community.

I took time to cry during each of the births. With my first child I needed to take time out to evaluate why I wasn’t progressing. The reflection process made me realize how fearful I was and I asked my husband to hold me while I cried and released the fear. After I cried, the quality of my contractions changed and became stronger and more intense. I finally transitioned into active labour. I’ve already recounted how I cried with my second child as I was overwhelmed with gratitude.

We shared a meal with our loved ones. In the case of that long awaited, 49 hour, first child, many meals. There is something about dining that is very sacred if we let it be. In society we center many celebrations around meals. In religion too, we can see the sanctity of food in the last supper and the spiritual insight that comes from fasting as many other religions practice. We made the planning of the menu an important part of our birth plan. And we invited people over early, before active labour began. It was a birthday party and we wanted to celebrate.

I tried a variety of positions during labour and delivery as I felt moved to do. I also tried a variety of rooms in my house in which to labour. I spent quite a bit of time in the bathroom, which I’m told is not uncommon. Even labouring animals prefer to labour in a small den.

I prayed. I prayed before I was in labour, when I found out I was in labour and when I felt like I couldn’t do it anymore. In this church we don’t have a doctrine as to what people need to believe. My own personal beliefs hold that there is something much larger and powerful than me and that power is loving and a source of great strength and inspiration to me. Therefore, prayer was very helpful. Prayer also reminds me to be grateful.

My husband took a minute to say some special words to our children right after they were born. As he was leaning over my shoulder, looking down on the faces of each child on different occasions, he said the same words to each: “Welcome to the earth my child. We time worn folk renew ourselves at your enchanted spring as though life had begun again in you.” -C. Day Lewis

We didn’t check the sex until we had held and admired and greeted our child. It was something we had talked about beforehand and specifically told everyone present what our wishes were, although everyone in the room knew what sex our children were before we did.

My support people listened to me, they didn’t chastise me, belittle me or get angry. They held my hand tightly during each contraction, and massaged me and played cards with me in the wee hours of the morning when I couldn’t sleep. My spirit was cradled as I gave birth. Imagining my spirit as a vessel, it was filled to overflowing. Although I had a serious hemorage following my second daughter’s birth, that didn’t even register on the scale of how my birth was evaluated in my mind.

As I’ve already talked about, a religious approach to birthing can come into tension with science in the birthing room. The pressure to accept the medical perspective as being “the right path” can conflict with a mother’s intuition of what might be best for her own experience. We see this parallel in many religions that define one and only one path to God. The medical doctrine may be finding itself in conflict with what women want.

Unfortunately, most women never realize what they wanted or even what mght have been possible until after the birth. I think it’s time to remember what has worked for centuries. Birth belonged not to the doctors but to the women who used wisdom, prayer and love to help bring new life into the world. We need to bring Spirit back into the equation and rely a little less on standard hospital practices.

The most important thing a woman can do is to choose carefully who she wants as her caregiver; doctor or midwife. Unfortunately, here in Edmonton our choices are restricted by our incomes and caregiver availability. We are further restricted by distance to our doctors and hospitals. Information on options is compartmentalized by the system. You really need to research in order to find that different options even exist.

One way to access information on what is available, what are common hospital practices, and how to get your needs met is to hire a doula. Since giving birth to my babies, I have become a doula. I had such empowering experiences, I want to help every woman have fabulous births. A doula’s job is to help support you through the emotional, mental, physical and spiritual aspects of your labour and delivery. She wants you to be happy with your birth experience. She will help you ahead of time to go over possible scenarios, so you can figure out what is best for you. Whatever your choice involves, she will not judge you. She will support you because you know best your body and yourself. A doula uses non-medical techniques to help you cope with labour. She will encourage you to try different things. She will stimulate all the senses and help your body distract from the intensity of contractions. She may use visualization with you. Your doula will have learned the signs of progression and she may be able to tell you what the immediate road ahead holds for you. Your doula will try to create a safe space around you and encourage your partner to be your buffer zone. A doula will respect you, your partner, your family and all your wishes. My goal as a doula is to help each woman find power through her birth experience, to receive respect and maintain dignity and mostly to experience joy and love during this life altering event.

My birth experiences were unforgettable blessings. With the birthing style that I chose, I got to have as many people there as I wanted, to stay in the comfort of my own home, make as much or as little noise as I wanted, eat and drink at my leisure, choose positions of my choice, feel respect for any decisions I made and bring my spiritual disciplines into practice as I laboured. I had an amazing, life-enhancing, strengthening, spiritual experience. May every woman be as blessed as me. Amen.