I'm starting a new character that I will be capping at level 20, and I won't be raising my endurance. I'm considering The Ritual as a Birthsign since, according to UESPWiki, it effect undead up to level 25 and since I'll have a low amount of health the heal should give me a full or close to full heal.

Anyone out there using The Ritual as there Birthsign? Opinions please

I haven't played a Ritual-sign character, as far as I recall, but I think your question deserves at least some sort of answer.

It seems to me that The Ritual is one of the handful of signs (along with Mage, Apprentice, Atronach, and Lord) that would actually have value beyond the starting character. I'm assuming that you have a role-playing interest in the sign, since healing is easily accomplished through alchemy and/or restoration spells. I'd say it would be a good choice for some sort of "holy paladin" knightly type.

I used it once, due purely to role-playing, and liked it way more than I expected. I also got the ritual doomstone thing power so I had like all the power of Mara in this character (she was a priestess of Mara). My character sounds kind of like yours as far as not leveling up too high and not getting a lot of health. I remember that her own restoration and the powers of Mara combined to make her a powerful healer.

After trying it out a bit... I just don't care for it much. Thanks for the input thought guys.

I've used the sign for a majority of my characters for the 'in-battle' relief of using Mara's gift. It was a life saver in Morrowind and I never really broke the habit. Pretty useless for me after higher levels though.