Midwife Elizabeth Lesser on Finding Your Toolbox for Navigating Life’s Beginnings and Endings

Trailing Clouds of Glory

But trailing clouds of glory do we come
From God, who is our home. . .

                                   —William Wordsworth

Longing for a sense of the sacred as I navigate my way through the realms of life and death, I have read hundreds of spiritual books, made pilgrimages to holy sites around the world, and sat in meditation until my legs fell asleep. Sometimes these techniques have helped, and sometimes they haven’t. But in my quest for the divine I have discovered one foolproof way that allows me to peek for a moment beyond the veil of my own limited vision. That way is in the role of midwife.

When I was younger, I was a birth midwife. More recently I have begun to sit with people as they die. It is during these experiences, as a midwife to arriving and departing souls, when I am most able to step out of the way, and be bowled over by something a lot grander than my own opinions, fears, and misconceptions. Maybe every citizen should be required to watch at least one baby being born, and to sit with one person as he takes his last breath. In the same way that you can’t drive a car without passing a road test, you wouldn’t be able to become an adult without witnessing the miracles of birth and death. 

Being at the birth of a baby has humbled me, awakened me, challenged me, and healed me. Tending to the needs of a dying person has done the same. Following the first and last breaths of a human soul has connected me to that which came before life on earth, and that which follows. Wordsworth wrote that babies come into the world trailing clouds of glory, and I concur. I have also witnessed the dying grab hold of the same cloud, and ride it back to God, who is our home.

The first time I assisted at a birth I had the feeling that I belonged exactly where I was, that there was nowhere else I would rather be. Everything about the process of delivery and birth seemed familiar to me, even though I was just twenty years old, and the closest I had come to a delivery room was a barn in Vermont, where I had watched a lamb being pulled feet-first from its mother.

I knew little about my own birth—something about a Catholic hospital, where I was delivered by nuns who scolded my mother for making noise during labor, and knocked her out with her ether when it was time to push. My mother glued our birth certificates, each with a tiny footprint in the upper right corner, into the family picture albums.  I used to stare at my page and wonder what it had been like, having my brand-new foot dipped in black ink, and pressed onto a legal document. My thoughts stopped there. In the antiseptic 1950s, things like birth and death happened somewhere else, and were handled by the experts. No one talked about being born or dying. My mother would go off to the hospital and return home a few days later with a baby sister and a new birth certificate. A neighbor, or my grandmother, would leave in an ambulance and never come home. 

Any discussion about the two bookends that surround our lives—birth and death—had been excised from everyday living and relegated to the upper reaches of religion and science. The messiness and ecstasy of birth had been cleaned up; the nobility and power of death, anesthetized. This was not always so. The ancients knew that the rites of birth and death were valuable opportunities to part the veil that separated human life from eternal life. The midwife who sat with the babies being born and the old people dying was held in the same high esteem as the village shaman or priest.

When I first watched a baby making its way out of the birth canal, trailing not only clouds of glory, but also blood and mucus and amniotic fluid, I felt no queasiness, but only a sense of wonder. Perhaps my childhood attraction to the insides of plants and creatures prepared me. From an early age I liked to dissect dead bugs and birds, to pull apart bee hives and anthills, and to dig into my father’s compost pile to watch the worms transforming mucky, old vegetables into fresh soil. I liked the smell of new life emerging from decay; I still associate that smell with the miracle of transformation.

Childbirth seemed a similar miracle of nature. It had the sounds and smells of a barn. It was earthy, yet elevated; common, yet mysterious. Only one thing frightened me at the first birth I attended. In the last stage of labor, a baby emerges slowly with each powerful push, conforming its soft head to the bony length of the birth canal. Especially if the pushing stage of labor is long, a baby can be born with a misshapen head. Even in an easy birth, when the head is only slightly molded, the first peek at the baby is unsettling. With its hair slicked and darkened by blood and mucus, and its crown ridged and puffy, a newborn can appear deformed. I was sure the there was something horribly wrong with the first baby I saw born. But within minutes an astonishing change occurred. As the midwife washed the baby’s tiny face, the swelling subsided. When she laid the baby on the mother’s belly, his skin was pink and his head was perfectly round. And the mother, who just minutes before, had been screaming in pain, was radiant and peaceful. The baby’s descent had ended in life; the mother’s pain was transformed into love. 

During my career as a midwife I always warned the first-time fathers what to expect when their baby’s head crowned. Still, several fathers fainted at that very instant, and I understood why. Birth is shocking—it is graphic and gory, painful and intimate. For these reasons many people shy away from the delivery room. And yet, once again, it is through the very terror of the birth process that the miracle is revealed.   

It is not easy to stay conscious during a painful and frightening process. We would rather turn away, drug ourselves, or feign indifference. It requires a delicate blend of curiosity, fortitude, and patience to trust in the wisdom and purpose of pain. Understanding what’s happening on the inside is key. At the beginning of the prenatal class series I used to teach, I told the expecting mothers and fathers that they would only get a passing grade if they fell in love with the uterus. This always got a laugh, but I was serious, because I had discovered that while breathing and relaxation exercises were helpful during labor, understanding the anatomy and physiology of the birth process helped even more.

Normally, we don’t pay much attention to the hidden ways of our bodies. Most of us know more about the carburetor of a car than the function and location of our own gall bladder or kidney or uterus. But a little knowledge of the body goes a long way. Moving beyond habitual squeamishness and fear, and into an attitude of openness, increases our desire to care for and work with the body. If you know how your digestive system works, you’re less likely to fill it with junk food. And if you can picture the color and fragility of the lung’s inner lining, you’ll find it easier to quit smoking. 

If a woman knows how her uterus works, she will be less reactive to the tsunami strength of a labor contraction. The uterus is really a collection of muscles, closed at its base with a feisty little muscle called the cervix. Grip your hand tightly in a fist, and you will have a good idea of what the pre-labor cervix looks like. Now take both hands and form a wide circle with your thumbs touching at the bottom and your index fingers touching at the top. This is the size, give or take a few inches, that the cervix must stretch to in order to let the baby’s head pass through.  That’s a lot of stretching in a short amount of time, and to a laboring woman, it feels as if you are being torn inside out. 

In the same way that you would flinch and draw back if someone threw a punch at you—or screw your face into a tight knot anticipating a shot at the doctors—so does a laboring woman instinctively tighten when the pain of a contraction begins. But a woman who has fallen in love with her uterus knows that a contraction is really the uterus’ brilliant way of stretching the birth canal and loosening the cervix so that the baby can move down and out. If she fights back as her uterus does its work, she will only slow the progress of labor. If she greets the pain with all the love and respect she can muster, her cervix will stretch, her heart will break open, and her baby will be delivered.

Although I am no longer a practicing midwife, I use the metaphor of falling in love with my uterus all the time. If I can approach change with an understanding of the process and an openness to the pain, then my daily labors will be swift and fruitful. As the surgeon Bernie Siegel says, “Life is a labor pain; we are here to give birth to ourself.”

ELIZABETH LESSER is the author of several bestselling books, including Cassandra Speaks: When Women are the Storytellers, the Human Story Changes and Broken Open: How Difficult Times Can Help Us Grow. She is the cofounder of Omega Institute and is one of Oprah Winfrey’s Super Soul 100, a collection of a hundred leaders who are using their voices and talent to elevate humanity.