Meg Taylor's Midwifery Writings

Labour and Spirituality

Some weeks after I gave birth to my second baby I found myself assailed by sadness because I was unlikely ever to give birth again. What I was grieving for was not more babies, but labour itself. I love my children and I am sure that the savage physicality of my feelings for them as babies was coloured by my experience of giving birth. But it is the darkness, pain and otherworldliness of labour that I was lusting for. In considering what it is about labour that drew me, what emerges is something very like a description of certain spiritual practices or the stages on a journey of self-healing.

Labour involved a withdrawal from the world, a regression inwards. Janet Balaskas (1991) writes:

"in the hours of labour you will want to withdraw from the normal day-to-day level of things and your attention will naturally turn inwards, as if the whole world contracts to what is happening in your body. In your mind, time takes on a fresh dimension. Hours can pass in what seems like minutes. It is like being in another world... this great opening of the womb happens only a few times in your life. It is a very deep emotional experience which involves a regression to your most basic and primitive feelings."

This withdrawal is occasioned by the overwhelming power of the event in simple muscular terms. Concentration on the contractions of this most powerful muscle in established labour precludes preoccupation with anything else -- in fact, this self absorption is one of the signs that labour is established and working. This focus on oneself does not mean that the outside world is shut out. I found myself aware of the passing of time and what my partner and the midwives were doing and thinking. It was as if by focusing inwards I had broadened my awareness. What I could not do was comment on or communicate my experience. There was not time or energy or language to describe this complex working on simultaneous levels. This strange simultaneous narrowing and broadening of awareness is one aspect of the altered state of consciousness which women in labour experience. This alteration is caused partly by the secretion of endorphins. I believe the secretion of endorphins is facilitated by the rhythmic intensity of the contractions and a rhythmic response to them which involves altered breathing and sometimes chanting.

The time of labour is a special time, time out, a time of transition like twilight. It is a time of heightened awareness. Time moves but the focus is on the instant. And once started there is no going back. An irrevocable threshold must be crossed -- the baby emerges under the pubic arch and the woman becomes mother to a new life. Often in labour there is a time of despair, called in the textbooks transition. This occurs just before or round the time that the cervix becomes fully open and the baby can start to move down and be born. This moment of despair must be confronted and worked through, just as the baby must go through the cervix and the pelvis. There is no going back.

The parallels between this experience and various practices designed to enhance spiritual growth are clear. I am thinking particularly of the use of rhythm and chanting both in shamanic ritual and more orthodox forms of worship. Shamanic ritual requires the participant to seek to alter states of consciousness to effect healing or for initiation. The boundaries of the ritual set the event apart from ordinary day-to-day life, as does the altered awareness. There is a withdrawing, often into literal darkness.

Tibetan Buddhism is the result of the mutual influence of Buddhism and shamanistic Bon thought and practice. Walt Adamson (1989) writes of Tibetan Buddhism:

"the Buddhist technology of growth includes many forms of regression... Meditation, the most common feature of Buddhist practice is itself a retreat... It can be a restful nourishing withdrawal into passivity, or it can be a daring descent into the darkest depths of the psyche. The elaborate visualisation practices of the Vajrayana are disciplined regression."

Labour, ritual, worship, can enable us to be aware of and enter a Bardo state. Chogyam Trungpa (1992) describes the Bardo as:

"(a) gap; it is not only the interval of suspension after we die but also suspension in the living situation...There are all kinds of Bardo experiences happening all the time... it is like not being sure of our ground, not knowing quite what we have asked for or what we are getting."

Ornstein (1992) describes a state of consciousness which resembles the altered consciousness of labour:

"A state of darkness, a shift in the receptive characteristics of consciousness, so that sensitivity is increased to a new segment of the internal, personal and geophysical environment."

To bring this shift about there must be a withdrawal from the day-to-day, a concentration on a single focus -- the breath, a candle flame, labour contractions -- and the shift in consciousness can be measured using an EEG. One effect of this shift in consciousness is that the automatic, habitual responses to stimuli are made conscious. One becomes dehabituated and the world appears fresh. The familiar is seen as if for the first time. (One could perhaps employ the term jamais vu. Labour also brings forth something which is seen for the first time: the baby is literally jamais vu.) Ornstein also describes a type of perception with a profound sense of unity. He claims that we all have the capacity for mystic experience and that it need not be the result of meditation but can also be produced by fasting, ritual dance, psychoactive drugs, or by a life crisis. Labour and birth form a life crisis. Within our current midwifery practice, is it cruel to deny women this opportunity to confront and work through this crisis?

Marion Woodman (1985) quoting Bruce Lincoln, states that for women initiation should be described in terms of "enclosure, metamorphosis (or magnification) and emergence"-- from where do these images come if not from pregnancy and birth? Birth may also be described in terms of a spiritual emergency (Grof & Grof, 1989). It has the potential for women to grow or to face devastation.

A parable which describes an initiation, provides a parallel with labour and which moves me deeply is found in Sarah Maitland's novel Three Times Table (1991).

Margaret of Antioch was an independent woman; this independence was marked by her Christianity in a secular society and her stubborn refusal to marry. As a virgin, she was desired by and consumed by a dragon. Her unusual independence of mind allowed her to find this experience initially amusing, and she laughed at the panic the dragon's arrival had caused her fellow humans. Her laughter so shocked the dragon that he swallowed her alive and whole. In the belly of the dragon she became afraid and her fear communicated itself to the dragon, whose gastric juices started to flow in anticipation. But at the climax of her fear she realised that what she was frightened of was death, and that the process of dying might in itself offer excitement and beauty. So her fear evaporated and turned into a joyful acceptance. And the dragon, feeling the change, opened his mouth and let her out. Margaret of Antioch became Saint Margaret and the patron saint of women in childbirth. She had been reborn of the dragon's belly and during that experience she had faced the darkness that women must face in the depths of the labour.

Margaret has since been demoted by the Vatican, who seem to think that this story cannot be true. This is a patriarchal attempt to demote symbol and metaphor. This links in with the power of obstetrics and other male-dominated institutions. The power of the institution is paramount when it comes to making choices -- not just the institutions of medicine and doctors, but social assumptions. In recent years attitudes to vaginal birth and caesarean section have changed, with the former being viewed in parts of the media with distaste and the latter seen as a safe and preferable option.

The myth related above shares similarities with that of Inanna, goddess of the Sumerians, whose power consists of her willingness to divest herself of the worldly and confront death, and with the more familiar story of Persephone.

These stories are stories of initiation, symbolic birth, rebirth. They are stories of survival and transformation. One aim of spiritual practice is to enable us to find the discipline and courage to regard the mundane as offering the opportunity for both survival and transformation. And the mundane includes both birth and death. Chogyam Trungpa (1992) writes of the Tibetan Book of the Dead that it "is not only a message for those who are going to die and those who are already dead, but it is also a message for those who are already born; birth and death apply constantly, at this very moment".

Another aim of spiritual practice is to develop an awareness of unity in multiplicity, an integration of the disparate, an acceptance of ambivalence. Labour offers an integration of the physical and the psychic. Endorphins alter consciousness. Consciousness allows the woman to make choices which will enhance the secretion of endorphins -- however, the most powerful determinant of the choices most women believe they make is the institution. The hugeness of the experience demands a focus of awareness, a concentration of the physical and the psychic on a single aim.

Labour also integrates the spiritual and the sexual. Childbirth is the culmination of a sexual act. It involves the hormones which induce and express excitement and orgasm, but to a huge degree. Beside childbirth, orgasm is puny. But orgasm's relation even to death is explicit in the term la petite mort: orgasm is also a Bardo state. In the Bardo, profound change can occur. The work of the contractions of labour, I was told in my Active Birth classes, happens in the moment between the in-breath and the out-breath. And the opening of labour links subtle and gross anatomy. I was especially aware of an open throat, an open diaphragm and an opening cervix, and a channel of energy between these points of anatomy which also correspond to chakras.

The experience of labour is the bridge between pregnancy and afterwards. For me, there was a continuity between the increasing waves of excitement as my pregnancy got bigger, then the tumultuous waves of labour and the rushes of milk and love afterwards. I felt no hiatus. The whole event was charged with a sexual energy and I was sexually active again within a week. Sometimes (mostly?) this continuity is broken by unwarranted medical interventions which make labour a physical and psychic trauma: no longer a bridge but a gap.

There is the concept of a doula -- an experienced woman who guides and supports the mother-to-be through labour, just as the initiate is guided by the teacher. Both women in labour and initiates need what Alida Gerslie (1994) calls "quiet mothering" at this time. Ideally a midwife (whose title means with-woman in Old English) should be able to provide this quiet mothering. This issue of doula and midwife has changed in recent years. A division of labour, with an overemphasis on the medical in what is expected of midwifery care, has become hardened in the economic context of a midwife shortage. In normal cases most prescribed schedules for observations are unnecessary. It is totally unnecessary, or example, to take a woman's pulse every quarter of an hour. To some extent I believe midwives have welcomed this overmedicalisation because it can be seen to enhance prestige and enable the midwife to flee from the emotional heat of caring for woman in labour.

To give birth one needs to go through the pain of labour, to survive the darkness and the fear, which is the fear of death. To go through this easiest requires acceptance, an opening to the experience, which is also an opening of the cervix. Balaskas (1991) states:

"In a way you need to lose control, to surrender and trust in the birth process which takes place involuntarily without your conscious control. You need to let go of your mind, of everything you know and just let it happen. This is a time to turn inwards, to abandon oneself to the unknown, not to think ahead to what is to come, just to take it moment by moment and let the natural involuntary rhythms of your body take over."

This is a passive acceptance of a huge activity. Sexuality and regression, eros and thanatos are aspects of the same energy, are mutually dependent.

The opportunities which labour offers for survival and transformation and for integration also allow for profound healing. Labour is healing because any rite of passage which involves confronting and surviving fear, pain and darkness is healing. It is also healing because it both requires and gives strength. It gives what it demands. There is a reflexivity about this which leads me to see labour (and mothering) as a clear and undistorting mirror. There is no distortion because the experience is immense to the point where there is no disguise. Contemplation of this undistorted image is healing because it offers the chance to accept what might otherwise be rejected as negative, parts of oneself that we might prefer to be kept hidden, social and personal shame, physical shame. Women often shit in the second stage of labour. This fact, which in this culture is usually private and associated with shame, is here public. Ironically (or not) babies exposed to their mothers' shit get fewer infections because they are able to produce appropriate antibodies. In the Buddhist tradition, meditation provides an undistorting mirror in which to view our own minds and encourages the development of an equanimity such that shit and roses evoke the same response.

Women, according to Susie Orbach and Luise Eichenbaum (1987), subtly learn that they are intrinsically wrong. The social yardstick is male. And the female genitalia are particularly shameworthy. Labour exposes these shameful areas. Cultural institutions of childbirth enhance the shameful evaluation of women's bodies. While women are no longer shaved in labour (an act which was shown in the 1920s to increase rather than decrease infection and which took over fifty years to eradicate) women are far too often mutilated by episiotomy and operative delivery. This is probably the crudest response to shameworthiness of the female, but there are many others more subtle.

To some extent the learnt shame is a result of the fear of the powerful. Women's genitalia are both despised and desired. A common graffito is that of a woman with her legs apart. Women seeing this might feel shame at the exposure of the private and fear at the implied violence of that exposure. As they are intended to. But they might also feel pride that what is exposed is the gateway through which we are born, and they may be able to recognise that the fear they feel in meeting this is no greater than the fear that lies behind its expression. There is powerful ambivalence here.

The greater the negative contained within the ambivalent, the greater the power when this is recognised and acknowledged. Accepting ambivalence can be said to put us in touch with the source of our power if it is accepted that psychic energy is unnecessarily bound up in keeping ourselves cut off from the negative. If the female is greatly despised it is a testament to her power. Accepting ambivalence is healing because it integrates the negative and the positive and reduces the tendency to project what is negative on to others. It is also healing because it puts us in touch with the source of our power. And in childbirth the greatest negative of all is hovering. Margaret of Antioch confronted the fear of DEATH. Modern childbirth practices have as their rationale the obviation of death. They must fail because there is no escaping death. Lama Anagarika Govinda (1992) writes that physical continuity, immortality, does not allow for physical or material difference and neither therefore the capacity for spiritual integration. This is expressed more poetically in the myth cited by Gerslie (1994):

"In the earliest days the first human couple lived in heaven. One day God spoke to them and said: "What kind of death do you want, the kind of death the moon has, or the death of the banana?" The couple did not have a clue and was somewhat panic stricken at having to make a decision. God therefore explained to them what the difference between the two different kinds of death was. The banana puts forth shoots which eventually take its place, while the moon renews herself. The couple pondered their choice for a long time, then they made up their minds. They thought that if they had chosen to remain childless, then they would have avoided death, but they would also have been rather lonely. There would not be anybody to work with or to care for. They therefore asked God for the death of the banana. Their wish was granted and since that time people do not live on this earth for a very long time."

The moon does not change its substance. If there is to be growth there must also be differentiation and dissolution.

Giving birth is an involuntary act of great physical and psychic power. By psychic I do not mean telepathy -- for me the word implies a sense of deeper, unneurotic self. As Caroline Flint says, giving birth is never forgotten (1986). A testament to its power is the lengths to which the culture, expressed as medicine, goes in its attempt to attenuate and control that power. The circumstances in which I gave birth, at home, with loved and trusted attendants, are profoundly different from the norm. I am not seduced by nostalgia for an imagined ideal past or present simpler society. Many such societies see birth as filthy. Milarepa (1983) described pregnancy as hell:

Driven by lust and hatred
It enters the mother's womb
Therein it feels like a fish
In a rock's crevice caught.
Sleeping in blood and yellow fluid,
It is pillowed in discharges,
Crammed in filth, it suffers pain.

This is truly hellish, though the hell consists not of blood and amniotic fluid, but the values put upon them.

But for years I have listened to the pain of women as they have told me their unexceptional experiences of giving birth, and I should like to see changes for the future in the institutions of childbirth so that labour is not a medical event but more a rite of initiation. Marion Woodman (1985) states that in genuine ritual both body and psyche are involved. Current practice attends only to the body; I should like to see attention also to the psyche. According to Woodman, such ritual extends body and psyche to the limits. Certainly women in labour feel their bodies to be stretched to the limit and I believe that if more attention were paid to the psychic aspects of birth women would find the physical extremes they encounter more tolerable, they would use less analgesia and anaesthesia and they would find within themselves the resources to survive and transform the experience. But such intensity requires a socially acceptable form to contain the ritual within a facilitating environment. The containers of the ritual of birth could be the midwives. Midwifery can, as Flint (1986) has shown, be organised in such a way that small groups of midwives practise autonomously and no woman need give birth in the presence of strangers. But to do this, midwives need more financial, institutional, political and psychological support than they get at present.

Redgrove and Shuttle (1999) acknowledge that women who can integrate their sexuality and experience of menstruation are less likely to find labour traumatic. This would require confronting huge cultural and political barriers which render female physiology taboo, even now, even in a culture which has soft porn on mainstream terrestrial TV channels. Also, there are issues of individual trauma such as sexual abuse. I recognise too that women are afraid and that this fear has deep physical, psychic and cultural roots. Many women may need some prior healing if they are to integrate their experience of birth. For some the events may be, as it is now, the precipitant into psychotic chaos. But for others it may be, as it was for me, the beginning of a process of profound healing and growth.


  1. Adamson W., Aldridge A. 1989. Open Secrets: a western guide to Tibetan Buddhism for western spiritual seekers. Jeremy P. Tarcher Inc.
  2. Balaskas J. 1991. New Active Birth. HarperCollins.
  3. Flint C. 1986. Sensitive Midwifery. Butterworth Heinemann.
  4. Gerslie A. 1992. Storytelling in Bereavement. Jessica Kingsley Publications.
  5. Govinda A. 1992. The Way of the White Clouds. Rider Books.
  6. Grof S., Grof C. 1989. Spiritual Emergency: understanding evolutionary crisis. Jeremy P. Tarcher Inc.
  7. Maitland S. 1991. Three Times Table. Henry Holt & Co.
  8. Milarepa. 1983. In: Meltzer D. (Ed) Birth. North Point Publishers.
  9. Orbach S., Eichenbaum L. 1987. In: Ernst S. & Maguire M. (Eds) living with the Sphinx. The Women's Press.
  10. Ornstein R. 1992. The Evolution of Consciousness: the origins of the way we think. Touchstone Books.
  11. Shuttle P., Redgrove P. 1999. The Wise Wound. Marion Boyers.
  12. Trungpa C., Fremantle F. (translators) 1992. The Tibetan Book of the Dead. Shambala Publications.
  13. Woodman M. 1985. The Pregnant Virgin: a process of psychological transformation. Inner City Books.

This was originally written during the year after Huw was born, in 1992. I submitted it to Resurgence, but it was rejected. I showed it to various people including Alli Fern and Mavis Kirkham. Alli was convinced that it was too dark in tone for Resurgence. Mavis was critical on two points. She was concerned about my emphasis on sexuality and said that she thought that for many women it was important not to feel pressured into sexually satisfying their husbands at a time when their new baby should be the focus of their concern. I agree with this. My personal experience was that the event was charged with sexuality and it was I who needed that release. She was also critical of my comments on the quotation from Milarepa. I think she thought that I was misunderstanding the Tibetan Buddhist doctrine. This may be so. But I stand by what I wrote above. I think that all organised religions are misogynistic to some extent and that that misogyny is often expressed by disgust of the physical in general, and the female in particular.

In 2002 I was asked to co-write a chapter on birth and spirituality with Jenny Hall for Soo Downe's book on normal birth and Jenny decided that Labour and Spirituality could be published by The Practising Midwife and it came out in December of that year. On the whole it was unchanged (apart from substituting defecate and faeces for my use of the word shit). But many of the original references which I had used were by now out of print, so Jenny has changed the references to more up-to-date ones. I am concerned that by doing so the references may no longer be accurate. I had myself included a couple of sentences to bring it more up-to-date.

It was not originally aimed at midwives, but the readership of Resurgence, in other words people who I assumed were spiritual practitioners.

I have decided that I want to have it available on computer so I have transcribed it (if dictating to voice activated software can be described as transcription) and finished today: 10th August 2003. I am astounded by the certainty of my tone and by my confidence. I think that what I wrote about accepting ambivalence is correct, and well put. I am aware that I no longer relate to spiritual practice: I am too ground down by my physical condition and too regressed psychologically. I am ashamed that I cannot respond to multiple sclerosis in the way that I responded to childbirth. I do feel that my experiences of giving birth and motherhood provoked a calling in spiritual terms which I ignored. If I had not done so I might be responding better now. I also wonder sometimes if I had responded to this call whether I would be as badly impacted on by the MS as I am.