The mess, grit, and dirt of the post-partum stable

No cheerleaders, nor midwives, no older women who had walked Mary's path before.

Imogen Ball

Imogen is a writer, mum, and priest on a new housing development in the South-West of England.

A Korean style historic illustration of the nativity.

Kim Hueng Jong (Korean, 1928-), Christmas Scene.

Clean, calm and collected,

That’s how it would have been.

The stable of filtered imaginings,

A picture perfect scene.

Perhaps more messy -

Undignified, unexpected, unseemly -

A not-so dream-like site,

As a king’s birthing barn that night.

Our unimagined stable.

No perfectly planned polaroid,

But in mess, mud, blood,

Is God with us

The stable of our Christmas cards, illuminated shop window scenes, and our children’s nativity plays is neat and tidy. A newborn babe lies quietly sleeping in a straw-filled trough, wrapped perfectly in a Persil white blanket. The mother, clothed and clean, looks on adoringly, standing over her child. Any animals present are gentle, still, and lying on the ground, unaffected by this unusual occurrence in their home. This is the stable of our imaginations.

However, the Bethlehem stable was the delivery suite for the Saviour of the world. And even a Saviour’s birth includes mess. I have experienced a variety of delivery rooms over my three pregnancies and each one has been messy. From birthing pool to theatre there is noise, blood, water, and tears. Birth is messy. And that’s not even beginning to acknowledge the mess that would have been in the stable to begin with! Despite this, the stables we see and celebrate never include the mess that Jesus would have been born into.

Birth is also extreme. It pushes the woman’s body to the limit of her physical and emotional capacity. She has laboured - aptly named for it is indeed hard work. Her body has been torn to enable this little life to be pushed or pulled into the world. She is exhausted. And now the work begins to sustain this little one outside of the womb. While inside he has been given all that he needs, now outside they must learn together how to feed. As the newborn babe is held close to his mother, he recognises her rhythmic heartbeat, his temperature regulates, his smell and touch encourages her milk to develop, and as he feeds, he contracts her womb for the placenta to be born and her body to begin to heal. They are still dependent on each other in these early hours.

Usually, this extreme and messy moment is done in community. It is not something we embark on alone. We have a support network of skilled people to help and guide us through birth. We have birth partners who encourage us, champion us, and remind us of our body’s innate ability to birth this baby. But Mary did not have this normal group of cheerleaders. There were no midwives at her birth, no older women who had walked this path before. Only her new husband, afraid and unsure of what his young wife was about to do. And then soon after, the Shepherds arrived. A bunch of slightly smelly, nocturnal chaps walking into a delivery room. Although they would have been familiar with mess, noisy animals, and birth, I’m not sure I would have rejoiced at their unexpected arrival. Somehow though, Mary graciously welcomes them into the space of what was probably a very messy stable.

Perhaps instead of the sanitised stable of our imaginations, we might consider an alternative imagining - the messy stable of the Saviour. A stable where the humanness of birth, of mother and child, and of life’s mess is fully felt. Because it was into the mess, grit, and dirt that the Saviour came. And it was from this mess that he was going to save.

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Assisted dying

Care

Comment

Ethics

27 November 2024

2 min read

Who holds the keys of death? The logic of assisted dying

The ethical principle of double effect.

Tom Dove

Tom has a PhD in Theology and works as a hospital physician.

white pills form an angle on a blue background

Hal Gatewood on Unsplash.

Healthcare hinges on the principle of double effect. This ethical principle makes the vital distinction between intent and effect. That is, one’s intent does not always result in a single intended effect, whether foreseen or not. In taking a patient’s blood, for example, my intent is to acquire information to aid treatment. An additional effect of this process is that—almost inevitably—this patient will experience pain, albeit minor. This principle of single intent and multiple effects applies throughout the practice of caring for human bodies, in all those instances where caring for those bodies involves physical interference, from prescribing medications to surgical procedures. And, in some instances, identifying and treating symptoms (such as terminal breathlessness) involves the use of medications that, as an unintended effect, result in death.

In the case of assisted dying, the distinction is important. The intent of assisted dying is to end pain and suffering by ending life. The ending of life is the treatment used to relieve pain and suffering. The intent is not to isolate and treat particular symptoms associated with a condition. The intent is to bring the condition itself to an end—which requires bringing the patient’s life to an end. This is not to make any judgment whatsoever about whether such a course is “right” or “wrong”, but rather to draw out the simple observation that this course involves an unprecedented change in medical practice. Assisted dying involves the categorical adoption of ending life as a possible treatment for a condition.

This is not quite the same as the slippery slope argument; it is about the logic of assisted dying. The point I am making is this: once ending life is introduced as a treatment, the key ethical step has already been taken. Applying that treatment in other instances of “suffering” (be they mental illness or ageing, for example) does not involve any new ethical steps. It simply involves the further application of a principle that has already been adopted. Despite the considered safeguards of the bill, therefore, the moral-ethical arguments against applying this treatment more widely will, at best, stand on shaky ground. For who could be so bold as to insist on what constitutes “suffering” for an individual?

Should the bill hold out the keys of death in this way? I can only think of One who is strong enough to wield those…