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Birth: a rite of passage.

Childbirth has been described as a spiritual event that is a peak experience for some women (Blum, 1980; Colman & Colman, 1971; Leifer, 1980). Some women describe the birth journey as an encounter with a higher power that travels with the mother and child from conception to birth and serves as a protective force during the pregnancy. Those who are able to discuss their understanding of birth relative to their spiritual and religious beliefs are more likely to experience a positive birth experience (Schneider, 2012).

The peak experience that accompanies birth often leads to a transformation of the mother's self-concept as she transitions from pregnancy to motherhood (Benedek, 1959). The feeling of being betwixt and between the roles of a woman who is self-contained to one who is thrust into emotional and bodily change during pregnancy offers a mother the condition for the possibility of "profound interior change" (Davis-Floyd, 1992, p. 19). A holistic approach that includes the bio-psycho-social-spiritual dimensions of personhood will assist mothers in developing a perspective that allows them to perceive birth as a peak experience (Ayers-Gould, 2000).

When a woman gives birth to her child, she experiences the culmination of a rite of passage (Davis-Floyd, 1992; Schneider, 2012). Pregnancy is also a rite of passage her child experiences. Both mother and child are on the margins of life and death as the perilous process of pregnancy progresses through the many hazardous stages of the gestation period. There is a significant spiritual dimension of pregnancy experienced by many women (Trudelle, 2001). The experience of birth itself whereby the newborn bridges the time space barrier is miraculous and intensely spiritual (Schneider, 2012). One way to describe the birth journey is to understand the rite of passage framework.

Rite of Passage Framework

In most cultures there are specific rites of passage related to birth, coming of age, marriage, death, and graduation from some form of educational experience to name a few examples. Rites of passage were first discussed by van Gennep (1960). He developed a three stage description of what happens to individuals when they experience a rite of passage. The stages described by van Gennep are as follows:

1. Separation: The point at which the individual moves into the rite and leaves behind old ways of being. The individual prepares to take on a new role that will be recognized by society. In this case the woman becomes pregnant and is given the news of her status. She will begin to visualize herself as a mother, and she will anticipate the journey through pregnancy and birth.

2. Limen: The stage where the mother perceives herself as being betwixt and between the person she is now and the person she is becoming (Cote-Arsenault, Brady, & Dombeck, 2009; Turner, 1977; Turner, 1987, van Gennep, 1960). The new mother experiences all of the growth stages of her newborn. At times in this journey the mother and baby may experience quiet periods and, at other times, complications that threaten to harm one or the other.

3. Aggregation: The stage where the mother is recognized by society in her new role. Mother and child emerge together, and both are celebrated and honored by family, friends, and society.

Through the stages of pregnancy the mother is "able to integrate her religious or spiritual views in order to understand her experience of pregnancy and birth" (Schneider, 2012, p. 218). Each stage of the rite of passage brings with it unique challenges and questions that can be used as teachable moments by the birth educator. Anticipation of future role responsibilities can assist mothers in preparing for a range of issues related to child rearing. The assumption of a new role and responsibilities raises a number of concerns that birth educators will want to consider in working with women, especially if they are experiencing their first pregnancy.

Implications for Birth Educators

The expectant mother experiences the stages of pregnancy in her own specific way. Determinants of the mother's pregnancy sojourn include health related issues, use of substances that may negatively affect mother and child, environmental stressors, to include strained relationships with the father or family members, cultural expectations, mores, and a range of other factors that may lead to stress and anxiety. These issues and ones related to spiritual concerns all contribute to the journey from conception to birth. Mothers may have many questions related to the meaning of the pregnancy and the miracle of life that the mother is bestowing on her child (Schneider, 2012). This situation naturally allows mother and family to celebrate each stage of the pregnancy.

It is helpful for mother, family members and close friends to celebrate each of the stages of the pregnancy transition (McBride, 1973; Sanna, 1997). Each culture and family is unique and determining how to celebrate the stages of pregnancy may be culturally influenced. Families may want to develop their own celebrations for highpoints during the time of pregnancy to punctuate specific milestones on the path toward the birth experience. Assisting mothers in the adjustment period of pregnancy will make the birth experience welcomed. A helpful tool for women who are pregnant is the use of a journal that documents their thoughts and feelings about pregnancy, birth, and the post-partum period.

The rite of passage that encompasses pregnancy runs parallel to the rite of passage of the developing child. Both journey together until the birth experience. Then a physical separation takes place at birth, and a different kind of caregiving ensues. The mother assumes her parental role and the newborn the role of infant. Caregiving, at that point, becomes different and requires an active approach that includes feeding, attending to physical needs, and nurturing the infant. At this point, the mother attends to the child by providing a range of activities, feeding, nurturing, and orienting to a changed environment to support the growing child.

Assisting the new mother in her journey through this rite of passage will set the foundation for successful transition through post-partum issues, taking on the role of "Mother", parenting demands, and an adjustment in her relationship to the father of the child. Some suggestions for birth educators at each stage of the rite of passage are offered in the following discussion.

Separation Stage

Receiving the news that one is pregnant brings with it a range of feelings that a new mother might experience. From feelings of joy to surprise and sadness depending on whether or not the pregnancy was intended. Whatever the reason, the mother-to-be experiences a shift in her societal role. Soon she will be engaged in attending to the every need of her child; however, before birth she may undergo a journey that may bring her to the edge of death and back.

During the separation stage birth educators may want to focus on multiple feelings including a sense of ambivalence about assuming the caregiver parent role. Rituals that may be used to mark this transition include having the mother plant a flower that she nurtures during pregnancy, or having the mother visualize her nine month pregnancy as uncomplicated with a safe birth and healthy baby. Trying to visualize the pregnancy journey and adjustment afterward will allow the birth educator and mother to explore concerns and fears that the mother may have. In addition to the personal rituals it is important to determine the new mother's social support group. Family and friends may be included in her rituals and they may celebrate her changing status at each stage of the pregnancy (Cote-Arsenault, Brody & Dombeck, 2009; Schneider, 2012).

Limen Stage

Transitioning through the limen stage brings with it many days of anticipation of the unknown. It is during the limen stage that the mother may experience significant interior refocusing as she is caught in the throes of maturing gestation, pregnancy and impending birth. Many questions develop during this time. Will my child develop normally? Will the birth be safe? Will the baby be healthy? Will I be safe during the pregnancy and birth? What will being a mother be like for me? How will my relationship with the baby's father be affected by the birth? Will I give the baby up for adoption? Will I be healthy enough to raise my child?

During the limen stage, birth educators may want to focus on the mother's ambivalent feelings. The birth educator may discuss with the mother her sense of not being who she was and not yet assuming the role of mother that will become as a result of her pregnancy. Rituals that emphasize the role of mother would be appropriate during this stage. For instance, beginning to review the tasks that are required of a mother such as feeding, cleaning, and nurturing the child can be viewed as daily rituals included in a routine that will not be perceived as boring. Discussions of the mothers' support network and the importance of respite must be emphasized. Respite is necessary in order that the mother can return to be fully present to the child. In addition, concern about preventing protracted postpartum depression must be explored with each mother. The Limen stage is one of anticipation and ready making for the many years of caregiving that will follow. Engaging in discussion of a range of tasks and concerns is a helpful preparation that builds confidence in the mother that she is fully capable of successfully training the newborn. Birth is the beginning of a change in relationship between mother and child, so too is birth an event that will affect the mother's relationship with the father. It is important when possible to include the father in the planning process for the care of the child after birth.

Aggregation Stage

The peak experience that emanates from birth shifts the mother out of the limen stage. Birth is the mother's arrival at a new stage of life where her role significantly changes (Blum, 1980; Leifer, 1979; Schneider, 2012). The aggregation stage is the time in which the mother and child are reintroduced to their family and society after the birth journey. Mother and child are recognized in their new roles.

During the aggregation stage, birth educators may want to focus on the new mother's feelings of completion and transition from the limen stage. Post-partum concerns are present and require careful assessment in order to assure that mother and child are safe. The caregiver tasks that lie ahead can seem overwhelming at times. A new set of questions to address the role of mother emerge. What are the implications for the mother in her new role that becomes all consuming at times? If the mother is married or in a relationship, how does she balance time with the newborn and time with the significant other? What role does the mother's partner play in the child care tasks? What self-care concerns does the mother need to be aware of and develop a plan to address? What child care tasks must the mother learn? Who will make up the new mother's support group? How will she arrange respite time for herself? Who can care for the child to assist the mother? If the mother works, when will she have to return to work? Who will take care of the child while she is working? The birth educator and mother can process through these questions during the aggregation stage. In this way, birth educators can aid new mothers in acclimating to their new roles while simultaneously guiding them through the associated tasks represented at each stage in the birth process.

Conclusion

Responsibilities of birth educators extend from meeting women at the time they discover they are pregnant to assisting them in transitioning after giving birth. Application of van Gennep's (1960) rite of passage framework by birth educators with expectant mothers provides a plan to assist women through the journey of pregnancy to birth and the post partum period. Depending on when childbirth educators encounter expectant mothers, the stages of separation, limen, and aggregation applied to pregnancy and birth provides expanded opportunities for work with new mothers, with or without partner or familial support systems. Thus, the rite of passage model can augment birth education of new mothers, expanding that education beyond the more traditional physical and physiological changes that accompany this unique developmental rite of passage for women.

George A. Jacinto, Associate Professor and MSW Program Coordinator at the University of Central Florida School of Social Work teaches clinical practice, policy, and spirituality courses. His research interests include rites of passage, forgiveness and self-forgiveness, spirituality and clinical practice, LGBT issues, and mental health concerns of adults.

Julia W. Buckey, Assistant Professor at UCF School of Social Work, teaches clinical practice, research, and spirituality courses. Her research interests include factors affecting surrogate decision-making in the ICU, and factors influencing surrogate and student perceptions of spirituality in medical and classroom environments.

References

Ayers-Gould, J. N. (2000). Spirituality in birth: Creating sacred space within the medical model. International Journal of Childbirth Education, 15(1), 14-17.

Benedek, T. (1959). Parenthood as a developmental phase. Journal of the American Psychoanalytic Association, 7, 395.

Blum, B. L. (Ed.). (1980). Psychological aspects of pregnancy, birthing, and bonding. New York, NY: Human Sciences Press.

Colman, A. D., & Colman, L. L. (1971). Pregnancy: The psychological experience. New York, NY: Herder and Herder.

Cote-Arsenault, D., Brody, D., & Dombeck, M. (2009, Winter). Pregnancy as a Rite of Passage: Liminality, rituals and communitas. Journal of prenatal and perinatal psychology and health, 24(2), 69-88.

Davis-Floyd, R. E. (1992). Birth as an American rite of passage. Los Angeles, CA: University of California Press.

Leifer, M. (1980). Psychological effects of motherhood: A study of first pregnancy. New York, NY: Praeger Publishers.

McBride, A. (1973). The growth and development of mothers. New York, NY: Harper Colophon.

Sanna, E. (1997). Motherhood: A spiritual journey. New York, NY: Paulist Press.

Schneider, D.A. (2012). The miracle bearers: Narratives of birthing women and implications for spiritually informed social work practice. Journal of Social Service Research, 38(2), 212-230.

Trudelle, T. (2001, Winter). Becoming a mother: Matrescence as spiritual formation. Religious Education, 96(1), 88-105.

Turner, V. (1977). The ritual process: Structure and anti-structure. Ithaca, NY: Cornell University Press.

Turner, V. (1987). Betwixt and between: The liminal period in rites of passage. In I. C. Mahdi & M. Little (Eds.), Betwixt and between: patterns of feminine initiation (pp. 3-19). La Salle, IL: Open Court.

van Gennep, A. (1960). The rites of passage (M. B. Vizedom & G. L. Caffe, Trans.). Chicago, IL: The University of Chicago Press.
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Title Annotation:Features
Author:Jacinto, George A.; Buckey, Julia W.
Publication:International Journal of Childbirth Education
Article Type:Essay
Geographic Code:1USA
Date:Jan 1, 2013
Words:2412
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