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Birth and Death as Sisters




As a midwife, I am honored to witness families welcoming new beings on to the earth plane through my work. Pregnancy and birth are not the only way this story can go, sometimes pregnancy results in death, which also must be birthed. Having myself gone through two late 1st trimester miscarriages, I have danced with this added dimension of pregnancy resulting in birthing that which will not turn into life. I realize this conversation is taboo in our culture and have felt through my own experiences that it ought to be brought out in support for all the women who have become pregnant and lost at some point during that process. We deserve a space to digest this experience and it is our responsibility to fully feel our stories in our own psyche and share with each other to help integrate the challenges and healing needed when miscarriage or demise steps into our lives as a teacher.


Any birth worker can tell you, arriving with clients at pregnancy loss is our least desired experience that falls under our job title. We come to birth in hopes to witness the joy and the beauty and to support the struggles that family’s overcome as they meet their living children on the other side of their birth experience. It is through our deep relationship building with families during their pregnancy journey that we come to feel that their joy is our joy and similarly that their loss is also our loss. It is so sad that the history of midwifery includes a deeply felt trauma of being blamed for loss. That being said, it is a distortion of unprocessed grief to blame another for the mysteries of the universe. With the advances of medical technology, including NICU capabilities to support artificial breathing in prematurely born infants, emergency cesarean surgeries to intervene with labor complications, and the whole system of malpractice insurance prevalent in our current culture, death seems to be avoidable at all costs. Modern Midwifery works to avoid death by building in certain conditions for care such as restricting our offerings to assist only those who fit into the category of low risk and who have normal pregnancies and births. Our training teaches us to constantly assess safety and when situations move out of the range of normal to initiate transport to medical institutions where avoidance of death can be elongated with technology. That being said, both in the hospital and in out of hospital settings, some pregnancies result in death before birth.


Birth and death are sisters, they always have been, for they dance in the same places where the veil is thin and the mystery works her magic. As I have mentioned before in my other writing, birth inherently holds a metaphoric death, as a process where women meet with the mystery and make a bidding for their transformation as an offering for the birth of new life. Sometimes in this dance with the mystery, the death is not metaphoric, but actual and results in the loss of a pregnancy. That process still requires the woman to go through the birth process is some way or other to expel and release the creations of the pregnancy. This can be a super hard process for some women, however far along they were in their gestation, and requires time for integration. For me in processing both my miscarriages, i went through stages of blaming myself, deep felt sadness and grief, isolation, depression, and eventually integration and deeper understanding that helps me to this day. It is a process that takes time and if provided proper support, can become an experience of growth and healing for all involved.


Becoming pregnant, one is flooded with a cocktail of hormones, physical changes and possible pregnancy symptoms along with the full range of felt emotions and personal experiences. It is a full being process and thoroughly calls a woman to her body, mind, emotions, and spirit, if she is listening. This pregnancy state also opens up a direct access line to the realm of spirit as the unborn one is tethered to that dimension, all the while, physically anchoring in through the mothers body. As women create, house, and nourish a growing spirit, they themselves receive an opportunity to more deeply connect to the mystery. For myself, I felt highly sensitive and more connected to my intuitive nature during both pregnancies. I felt powerful as i realized the full extent of my physical capabilities for creating new life and a sense of being more alive through that experience than ever before. For some women, who experience a full physical take over, such as severe nausea and vomiting to conditions such as pre-eclampsia or HELLP syndrome, it can be a different experience all together of connecting more directly with death as the body is pushed to physical extremes and the mother left incapacitated by her bodies response to pregnancy. These are two poles of what the connection to spirit can look like during pregnancy and represent different expressions of the thinning of the veil between life and death that becomes prevalent during pregnancy.


This closeness in proximity between birth and death and our cultural fear of the subject of death is one reason why birth is surrounded by layers of anxiety as well as the resulting hyper vigilance seen in the medical approach. We can see the medicalization of pregnancy and birth as a direct result of the anxiety that humans have towards facing our shared inevitable end in death. Because historically birth was associated with possible death for mothers and babies, our cultural advancements have overcompensated in that area to create a false façade that the more institutionalized your birth setting is, the more hidden this possibility becomes in your story . This is a disservice to the truth that there is no risk free life, let alone a risk free birthing option that can insulate you from the inherent connection of birth and death. The more we push this reality into the shadows, the more marginalized families who actually experience loss become in our culture. Not only does this avoidance of death punish the families who experience it , it riddles the ones who are pregnant with anxiety of unacknowledged fears and also contributes to maintaining a constriction around the whole experience of birth in general.


When matters of life and death are present, this unresolved cultural avoidance of death tends to rear its head in other ways, creating labor complications, birth trauma, and postpartum depression. This reminds me of the working with the Amish community who I had the honor of serving during my training as a midwife and in my first years practicing. The deep faith I witnessed in this community and the innate spiritual compass guiding them through their experiences translated as a deep trust in birth even when it resulted in loss. The conviction they have of being aligned with gods will resulted in the show of a lot of grace when integrating or facing risk or death around birth. This is not to say that any family who lost in pregnancy or at birth would not be emotionally crushed by that outcome, but they rarely searched for blame in loss or carried that fear around like a ball and chain into their pregnancies and births. They birthed honestly and clearly, showing up to labor present and unburdened by the layers of avoidance that can hold women back in labor.


My proposal here is that in facing death as a sister to birth and an inherent force and element worth honoring and addressing during pregnancy, women can show up more prepared for whatever their story may be. If death is given a space to be considered and accepted in each women’s psyche during pregnancy as a routine measure, the trauma of loss loses its impact shock and families who experience this is their story are better embraced and supported as they integrate their experience. Families who don’t face an actual death through their pregnancies are given permission to address their fears before birth and can feel better prepared for the metaphorical and spiritual death that occurs through the initiation of birth. In order to create a culture where communities provide actual support for death and grief, we must be willing to have the conversations and provide tools for acknowledging this mysterious event with more honesty and reverence. As a woman who has danced with the mysteries of birthing death through my own womb, I work with death as an ally in my own life. Through my experience and in my work, I offer this reframe of death to all who approach the altar of birth. Because we are not in control, death is an inevitable threshold we as humans will all cross through at some point. The more we can connect to our deceased ancestors and lost loved ones as well as be present with death all around us, as witnessed through the cycles of the seasons and ever prevalent in the natural environment, we see that death is a teacher of life. With open hearts and deep gratitude, we bow to death for teaching us to be present and to love the life we are living now.


Dedicated to all those who have lost in pregnancy, birth and beyond.


Rachael Jean


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