Mary had a baby boy...

Some of us will celebrate Christmas in the snow. Others in the sun. Those facing water shortages may be praying for rain on our special day of holy celebration.  Under whatever circumstance we find ourselves in, we will once again hear the story of a teenage mother left to deliver her own baby one draughty evening in a stable. Trying to put my imagination into a situation 2000 years past, I wonder whether that was actually very far removed from what Mary was expecting. Certainly there were no other options than giving birth at home. And homes were places shared by all-comers, including animals.

Perhaps Mary would have called in the local birth attendant? Joseph may well have had an idea what was involved, but there were probably women who made it their business in rural communities to support women as they gave birth.

This is a situation familiar to many women even now. Qualified midwives and clinical facilities are in relatively short supply throughout the developing world. 'Traditional birth attendants' (TBAs) are the only support many women can find as they anticipate the joyous yet sometimes dangerous birth of their child. Naturally, the medical community wants to offer the highest level of support to women in pregnancy. The World Health Organization is campaigning for countries to marginalise TBAs and train more midwives. Many governments are actively discouraging these men and women from acting in their 'amateurish' fashion. But despite this, a high percentage of births are still overseen by TBAs.

In Ghana recently I was challenged by a compromise solution in the face of limited maternity services. The Diocese of Accra was running a project to improve the skills of TBAs. I went to the 'graduation' ceremony, where each TBA was offered a box of useful equipment following 9 days of training under supervision of staff from a hospital in the UK. Each graduating TBA was accompanied by one of their 'clients'. In fact, one of them reported attending a labour a couple of days before and finding the training for a difficult birth precisely relevant, leading to a positive outcome in the face of real danger.

A number of things took me by surprise. One was that there were some men who had come for training. It was said that most pregnant women prefer male TBAs, though the majority were women. The other surprise was that Ghanian women were deliberately choosing TBAs rather than maternity clinics. Local culture valued the opportunity to bury a placenta under a tree in order to gain blessings. The local hospital was required to treat the placenta as clinical waste. A difficult tension in the face of long held cultural practices.

Our Christmas story reminds us that Jesus emerged into the same uncertain conditions as so many babies in rural communities. Mary was fortunate not to suffer complications and was able to devote herself to Jesus' upbringing. A holy mystery shone into their lives that night as they encountered some strange and varied visitors to this place of blood, amniotic fluid and breast milk. This is the heart of our religious experience; that God emerged in this messy and unscripted manner.

Wherever a woman gives birth, whether supported by more or less skilled attendants, we are reminded of the first cry of Emmanuel into our world. This is where it happened. This is the setting we should support and honour.

A blessed Christmas to all

Paul