The self-doubt that most women experience during the transition from contractions to pushing is a spiritual sign that you can turn into a positive by practicing what St. Frances de Sales calls “self abjection.”
by Susan Windley-Daoust
This article is adapted from chapter twelve of The Gift of Birth: Discerning God’s Presence During Childbirth by Susan Windley-Daoust: “Trusting: The Transition from Contractions to Pushing.” Read other chapters as they become available by clicking on the chapter links in the sidebar. Get the whole book in print or ebook formats at the Gracewatch Media store.
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You have worked with active labor for a while now, trying to relax, trust, and ride the contractions like waves. You’re far along at this point, and the contractions are at their most intense.
Suddenly, you’re confused, unsure, staring blankly at people. You are expressing the expected “sign of self-doubt.”
The sign of self-doubt may be the first thing you have read so far that gives you pause. People who give birth according to the Bradley Method actually learn to recognize this sign and turn it into a positive: the coach, doula, or savvy medical professional will often counter, “You are doing so well, and you are getting really close to holding your baby. This is nearly the end, you’re handling this wonderfully! You can do this!”
But the mother’s statement that elicits such an affirmative reaction is a tough one: “I don’t think I can do this.”
Why the self-doubt, suddenly? Even the woman who is a rock star at handling labor is prone to make such a statement, or at least think it, in this phase of transition. Thank goodness it is a very short phase (perhaps thirty minutes at most). But still.
There is no question this phase is intense. The contractions are hard, it is increasingly hard to relax, and the probability of painful work is high. The “rest time” between contractions is briefer. All the relaxation techniques and posture cues still help, but it may feel less like it. Basically, your uterus is now working at full capacity and speed to get the cervix dilated and the baby ready for birth. It is good, and not a sign of something wrong, but it is hard. One way to think of it: literally, there is no way out but through. You need to commit to it. And that means trying to relax every muscle, letting the uterus do its work, and in that relaxation, opening yourself to the help of God.
If you have an epidural, most of the physical challenge of this stage may be missed. But you can still give yourself in love in a deliberate way by relaxing, praying, and visualizing your cervix opening and the Holy Spirit working to bring forth new life.
What does it mean to give oneself in love?
That signal of “self-doubt,” I would argue, is a spiritual observation. It is a recognition of what St. Francis de Sales calls “self-abjection.”
Self-abjection? That is a loaded word. But it is basic to the Christian life. To consider oneself abject is to recognize oneself as poor, without the resources to save one’s own life. And at this point in labor, it fits: the mother is usually very tired and without reserves, and recognizes that what is asked of her—to work through the most difficult part of the labor—feels, and may well be, completely beyond her. It is a recognition of her poverty, that she needs help. It is a loaded word, but it is an accurate assessment of her spiritual reality. In fact, it is a window into every human being’s spiritual reality: we need God.
If you have a coach or doula, you could ask them to affirm you in this manner, if you express self-doubt rooted in that poverty: “You can do this with the help of God. God is going to see you through this. You are safe, and the medical team is making sure you and the baby are safe. You can do this with God’s help.” Coaches or doulas could pray with you. I strongly recommend keeping it simple and short, because as soon as a contraction begins again, you are going to need to focus on relaxing and sounding the contraction.
Another prayerful way to handle transition, whether you are birthing naturally or with the help of an epidural: give your birthing work, everything in the moment, to God. Your husband or doula could remind you: “The Holy Spirit is helping you and is right here. Give it to God. You are opening up, your body is doing hard work. You are almost there. Put any self-doubt in a box and give it to God.” If you typically pray to Jesus Christ, or God the Father, or a saint, it may be appropriate to address your prayer during transition in the same way. But to pray to the Holy Spirit as “the Lord and Giver of Life” may be especially meaningful here.
If you have been working with water imagery, “riding the waves” of contractions—or if you are doing a water birth— remembering that the Spirit surrounds you like water, and that you yield to the Spirit of God surrounding you and your child in this birth, may also be powerful.
Does the Holy Spirit pray through you?
The previous chapter mentioned that “sounding” (or groaning) may be helpful in yielding to the contractions, especially if the mother is able to vocalize the contractions with a low moan— the open mouth and low tone helps the mother stay relaxed and release stress. But could it also be a prayer of poverty? We don’t need to pray through words; in fact, St. Paul said himself that the Spirit intercedes for us when we do not know how to pray:
We know that the whole creation has been groaning in labor pains until now; and not only the creation, but we ourselves, who have the first fruits of the Spirit, groan inwardly while we wait for adoption, the redemption of our bodies. . . . Likewise the Spirit helps us in our weakness; for we do not know how to pray as we ought, but that very Spirit intercedes with sighs too deep for words. And God, who searches the heart, knows what is the mind of the Spirit, because the Spirit intercedes for the saints according to the will of God. (Romans 8:22–23, 26–28)
If you have given birth previously: Could you prayerfully imagine the Holy Spirit, the One who initiates all prayer, as the One helping bring you to birth—in part, through your sounding? If you anticipate giving birth, are you willing to stand with St. Paul and recognize these “groanings” or “sighs” as your prayer? It may be a lament, it may be yearning, it may be self-abjection vocalized. But it is the Holy Spirit’s gift and his work through you to pray in this way.
It may be a radical change to not just pray to God, but to open yourself to allow the Holy Spirit to pray through you. Self-abjection calls us to lean on God, to relax into God. Your body has been fearfully and wonderfully made, but He alone is trustworthy.
For prayerful reflection
- The key to handling transition in an unmedicated birth is to know what to expect: a short but very intense and possibly painful phase of contractions where you may begin to doubt you can do this. Medical staff and doulas can address pain with positioning, water submersion, and some anesthesia options. But going into transition with a “spiritual bag of tricks” is wise. How will you pray? Will you ask others (in the birthing room or away) to pray?
- Can you practice a prayer during your relaxation exercises that imagines the Holy Spirit working with and through you? All while supporting you? It stretches the imagination, but God will do that, whether you are in pain or not. Our problem is not that we make God too big, but that we make God too small. As St. Teresa of Avila said, ask God great things; it flatters him!
- You may want to add this prayer to your “spiritual bag of tricks” as a way of reminding you of God’s strength when you are weak. This snippet comes from a hymn commonly called “The Breastplate of St. Patrick”:
I arise today, through God’s strength to pilot me:
God’s might to uphold me, God’s wisdom to guide me, God’s eye to look before me, God’s ear to hear me, God’s word to speak for me, God’s hand to guard me, God’s way to lie before me, God’s shield to protect me, God’s host to secure me:
against snares of devils, against temptations of vices, against inclinations of nature, against everyone who shall wish me ill, afar and anear, alone and in a crowd.
. . .
Christ with me, Christ before me, Christ behind me, Christ in me,
Christ beneath me, Christ above me, Christ on my right, Christ on my left,
Christ in breadth, Christ in length, Christ in height,
Christ in the heart of every man who thinks of me, Christ in the mouth of every man who speaks of me, Christ in every eye that sees me,
Christ in every ear that hears me.
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 Catechism §2672 says the Holy Spirit is “the interior Master of Christian prayer,” and the instigator of prayer as the work of the Holy Spirit in a person is witnessed at Romans 8:26 above, as well as Ephesians 6:18, and Luke 11:13. Catechism of the Catholic Church, 2nd ed. (Washington, D.C: United States Catholic Conference, 2011) (digital edition), #2672, reprinted at: http://www. vatican.va/archive/ccc_css/archive/catechism/p4s1c2a2.htm.
 http://catholicism.about.com/od/prayers/qt/Lorica_Patrick. htm.
Susan Windley-Daoust is a Catholic theologian, spiritual director, and award-winning author of Theology of the Body, Extended: The Spiritual Signs of Birth, Impairment, and Dying. She teaches theology at Saint Mary’s University in Winona, Minnesota, where she lives with her husband and five children.