**4. Spirituality at the Start of Life**

Spirituality at the start of life has been gaining attention in the literature (Callister and Khalaf 2010). Crowther has written extensively within the last years on the importance of acknowledging spirituality at the start of life (Crowther and Hall 2015, 2018; Crowther et al. 2014a, 2014b, 2020). Ignoring the subject of spirituality at childbirth neglects a fundamental aspect of humanity and care practice as well. Similar to end of life care, the beginning of life also deserves focus and attention regarding questions of meaning and spirituality (Wojtkowiak and Crowther 2018). Crowther et al. (2020) define spirituality as "an aspect of our lives that brings meaning, sense of purpose, unifies our life narrative, feelings of interconnectivity and of deepening relationships with self and others ('others' being seen and unseen). It may be connected to religion and a belief in a quality of divinity but not necessarily. Spirituality is part of our wellbeing and includes psychological, emotional and cultural aspects of being and becoming" (Crowther et al. 2020, p. 2). McGuire (2008) writes that material bodies are linked to spirituality through "healing, sexuality, and gender, through fertility, childbirth and nursing, and a myriad other forms of embodied practices" (McGuire 2008, p. 118). Ammerman (2010) describes spirituality in pluralistic terms, not necessarily being experienced in *either* religious *or* secular terms, but often a mix of them.

Ammerman (2010) defines spiritualty in five dimensions. First, spiritualty refers to a moral dimension in terms of what people experience as the good and what is distinguished as right or wrong (Ammerman 2010). Second, spiritual experiences come forward when people feel awe, wonder and beauty in the world. This refers to majestic experiences. Third, spirituality is found in the mysterious: experiences that we cannot explain. Fourth, spirituality brings forward a connection with others that goes beyond the boundaries of one's self (Ammerman 2010; Knoblauch 2009). A spiritual connection goes beyond the self, such as in unification or loosing oneself within the other. Finally, questions of meaning are also found in spiritual experiences: asking yourself, what is the meaning of this life event? A spiritual experience is something that we cannot grasp, that is out of the reach of rational and scientific explanations, which perhaps explains the fuzziness of the concept (Watts 2020).

What can we learn from rituals in understanding meaning and spirituality at the start of life? A survey study (*n* = 517) in Denmark, a secular society, revealed that 65% of first-time mothers pray during their pregnancy (Prinds et al. 2014). However, only 33% believed in God and 37% in a higher power (Prinds et al. 2016). The most common reported forms of prayer were an inner dialogue with God (46%) or an inner dialogue addressing something greater than the self (40%). Only 26% of mothers prayed in the context of a church. These descriptive statistics reveal a tendency of existential and spiritual search for meaning and contemplation among new mothers. From a literature review, we learn that in the reported empirical studies across the world, women describe many references towards meaning making and spirituality in relation to becoming a mother (Prinds et al. 2014). Mothers describe the birth of their child as the "most significant thing I have ever done" (p. 737) or a deep connection with previous generations, as well as something that goes beyond a rational understanding. Other research shows similar results referring to birth as a deep transitional experience (Crowther and Hall 2018). When linking these results to the previous description of spirituality, we recognize all of the previously described notions of spirituality emerging at childbirth.

In Table 1, the five notions of spirituality by Ammerman (2010) and others (Knoblauch 2009) are described in relation to the start of life. The different notions of spirituality, such as the moral, majestic, mysterious, unification and questions of meaning, are not necessarily separative dimensions but contemplative. For the sake of clarity, I have stated them as separate notions, but in reality, they do cross-over. The examples are meant purely as illustration, not as a complete or fixed description of spirituality at the start of life. In the next section, I will further investigate these notions from a ritual lens, by analyzing two cases.


