Why Faith Matters in Maternity Care

Apr 17

7 min read

Updated: Oct 28

When we talk about personalised maternity care, I think we can be quite quick to focus on things like; where a woman wants to give birth, what pain relief she might want and how she plans to feed her baby. And obviously those things are important, but there’s so much more to a person than their preferences around the practicalities of birth. Their values, beliefs and the things that are fundamentally important to them all have a part to play too.

And for some women, that includes their faith.

I think sometimes we forget that faith isn’t necessarily something that can be separated from the rest of somebody’s life. For some people, it influences everything, including the decisions they make during pregnancy and the way they want to approach birth. And yet I think within maternity services, we can be quite dismissive of that, sometimes without even realising we’re doing it.

“God can’t help you here”

There’s a memory I have from when I was working in the NHS that has stayed with me for years.

I was working alongside a senior midwife, and there was a woman in labour who cried out, “Oh God, help me.” The midwife responded with, “God can’t help you here.”

And I think what really struck me was just how casually she said it. It was really flippant, and I don’t think it was even on her radar that what she’d said might be offensive. In some ways, I think she probably thought it was funny.

Now, the woman wasn’t a Christian, and she didn’t seem particularly bothered by the comment. And I think what the midwife was probably trying to get at was that the woman needed to dig a bit deeper and push a bit harder. That God wasn’t going to just pop the baby out without her putting in some effort. But it’s difficult to read between the lines of a throwaway comment somebody else has made, so I can’t say for certain what she meant by it.

What I do know, is that had I been that labouring woman, it would have completely shut me down.

I would have felt really judged, and I would have felt unsafe. And I think there’s something about the fact that it came from a senior midwife too. When somebody is senior, what they say automatically carries weight, and I wonder whether she had any idea how differently that comment could have landed.

I think it’s quite easy for us to make these throwaway comments, and they don’t necessarily mean anything to the person who says them. We all do it. Something just comes out of your mouth, you move on and you probably don’t give it another thought. But the person on the receiving end can experience it in such a different way.

A big part of the way I work, and something that’s really important to me, is being trauma-informed. And I think that’s partly why this has stayed with me. Because although that particular woman didn’t seem affected by what was said, another woman could have been. A comment that was probably intended to be funny, or perhaps encouraging, in a slightly strange way, could actually have contributed to somebody feeling unsafe or even traumatised during their birth.

My birth plan

When I came to write my own birth plans, I was very aware of how other midwives might respond to my faith. And I think that was particularly difficult because the midwives who were caring for me were also my colleagues.

I actually included a disclaimer at the beginning of my birth plan

Explaining that my husband and I are Christians, that we might pray during labour, that we might speak in tongues and that we would probably have worship music playing.

And I think there was almost an unspoken, “We’re not crazy!” attached to it.

I was worried about what people would think. And I think, to a certain extent, I can understand why somebody who has never been to church, who has never heard someone praying in tongues or who doesn’t regularly listen to worship music might find those things a bit unusual. It might be quite jarring if it’s something they’ve never come across before, and perhaps that could bring out a negative response.

But having already seen how another midwife had responded to somebody calling out to God during labour, I just didn’t want that negativity in my birth space.

Looking back on it now, I can see that it was definitely a defensive move. And probably one that came from a place of insecurity about how I might be judged.

The thing is, when you’re the labouring woman, all of that should really go out of the window. Labour is all-consuming, and you need to be able to be fully yourself. You shouldn’t be worrying about what the midwife thinks of you or whether something that is completely normal to you might seem a bit strange to somebody else.

Labour is not a performance.

And I think that’s what I find quite sad about the way I approached my own birth plan. I was trying to explain myself, and almost make excuses for something that is just a part of who I am.

If I were writing that birth plan now, I would do it differently. I would strip it right back and simply say that this is who I am and this is what’s important to me. We might pray, we might speak in tongues and we will probably listen to worship music. I wouldn’t feel the need to justify any of that or explain why it matters.

Because fundamentally, that’s what a birth plan should be doing. It should be communicating who you are and what’s important to you, not trying to make other people comfortable with your choices.

Faith isn’t just a tick-box question

I think one of the things maternity services get wrong is the way we approach faith in the first place.

At the beginning of pregnancy, women are asked whether they have a religion and, if so, what it is. And then a box gets ticked, presumably for some sort of data collection, and who knows what happens to that information afterwards.

But I think that’s such a fundamental misunderstanding of what faith or religion can mean to a person.

For me, being a Christian isn’t just something I do on a Sunday. It’s an intrinsic part of who I am. It influences how I approach life, how I make decisions and how I respond to things that happen to me. And so inevitably it’s going to influence the way I approach pregnancy and birth too.

But equally, I don’t think we should be making assumptions about what somebody wants just because they’ve said they’re a Christian.

Different Christians want different things. Some women are perfectly happy to compartmentalise their faith and not have it be a major focus within their maternity journey. For others, it’s going to be fundamentally there in everything they do. And that’s why I wouldn’t automatically start talking to another Christian woman about how to make sure her faith is taken seriously.

If she brought up that she felt her faith had been dismissed, or that she was worried about how people might respond to it, then of course that’s something I would want to explore with her. But I wouldn’t assume that it was something she was concerned about just because she’s a Christian.

I think what matters is that we actually get to know the woman in front of us, rather than thinking we’ve understood something about her because we’ve ticked a box on a form.

What does this mean for maternity care?

The NMC Code is clear that midwives have a responsibility to respect people’s beliefs and values and provide care that responds to their individual needs. And I think that should include their spiritual needs where those are important to them.

That doesn’t mean a midwife needs to share a woman’s faith, or even particularly understand it. But I do think it means being willing to have a conversation about what that faith means for the woman and whether there are things she would like to incorporate into her care.

And I think that’s quite different from a midwife imposing her own beliefs on somebody, which is obviously not appropriate.

I’m very open about being a Christian midwife, but plenty of the women I care for aren’t Christians. Some are agnostic or athiest, some don’t have any particular faith and some have spiritual beliefs that are quite different from mine. And I’ve developed some really good relationships with women whose beliefs are very different from my own.

I think we can acknowledge that we see the world through a slightly different lens, without that getting in the way of the relationship or the care being provided. And I think the same should be true when a Christian woman is being cared for by a midwife who isn’t a Christian.

For me, this is also one of the reasons why continuity of care is so important. When you’ve got the opportunity to get to know somebody throughout their pregnancy, you can have conversations about these things long before labour begins. You can explore what’s important to them and what they might need from you, rather than leaving them trying to explain something deeply personal to a complete stranger whilst they’re also having contractions.

You don’t have to compartmentalise who you are

I guess the main thing I want you to take away from this is that if your faith is important to you, you don’t have to compartmentalise it when you enter maternity services. You don’t have to box it away, and you don’t have to feel awkward or uncomfortable about bringing it up.

If your faith is influencing the way you’re processing decisions about your care, then that’s relevant. If it’s influencing what you want your birth space to look like, feel like or sound like, then that’s relevant too.

And if it isn’t something you particularly want to focus on, that’s fine. Nobody should be making assumptions about what you need based on your religion.

But fundamentally, as a pregnant woman, the whole service and experience is supposed to be about you. It’s not about the midwife or the doctor. And so the care being provided needs to suit your needs, not just the things that happen to fit neatly into a maternity care pathway.

We talk a lot about providing individualised care, but I don’t think we can really do that if we’re only interested in certain parts of the person we’re looking after.

And for women whose faith is an important part of who they are, that has to include their spiritual needs too.