Initiating, Nurturing, and Supporting Birth Workers

In 2010, Pam England wrote a series of pieces about ways in which we can change birth in our culture. The Birthing from Within leadership and blog team has chosen some of these pieces as inspiration and jumping-off points to create a new 12-part series about changing birth in our culture that reflects current understandings within the birth world as well as our current approaches and offerings as an organization. We hope you enjoy this wonderful material, both the archival treasure and the new, innovative insights!


When someone is drawn to birth work, we often say that they were “called.”

Don’t think of this Call in a romantic, adventurous sense, but rather as a soul-calling. Birth work is not a job that simply falls in your lap; it is, at its core, soul work that you are compelled to choose and re-choose again and again. What calls someone to birth work? Sometimes it is a tangible event in our lives that awakens the interest. Some philosophers say it is work we “agreed to do before we were born.” So, at some point after first hearing it, we say “yes” to this Call, and off we go!

Every experience a birth worker has when training and then working with an expecting family ignites many sparks, guiding them further down the path of deeper knowing and wisdom.

This is good, but it is not free from challenges and discomfort that can spark anger, fear, and disappointment; without the proper support, this can lead to depression, inflexible thinking, and/or burnout. Unhappy, inflexible, burnt-out birth workers cannot keep themselves healthy, let alone the birthing people with whom they work. This brings us to the next important shift that needs to happen in order to change birth in our culture: initiating, nurturing, and holding space for birth workers during their training and throughout their careers thereafter.

To “initiate” someone means to guide them through a transformative experience that allows them to experience the personal development necessary to join a new group within their culture. For example, many traditional cultures included initiatory ceremonies, rituals, and experiences meant to mark the passage from childhood to adulthood. Within such traditional and wise cultures, initiates often had to fully participate in the preparation for their ceremonies. They had tasks to complete, and were often guided in these tasks by elders. A Great Story often provided a "map" for the initiates to follow, and preparation often included real or symbolic risk, illustrating the death of the initiate's old self, and allowing a new self to be born. The preparation was itself a soulful journey, taking the initiate away from an old life toward new understanding and self-knowledge. Childbirth educator and doula training organizations often neglect this initiatory function, and they fail to provide the support that fledgling birth workers need in order to complete their transformations. They tend to value, and therefore focus primarily on, “evidence-based” material, techniques, performance evaluations and outcomes. They also tend to value the concept of objectivity - the ability to remain impersonal, professional, and in-service to the client or corporation, rather than to themselves. As a result, there are many birth workers who are taught to give endlessly to their clients, without being adequately supported by their training organizations. This is problematic because birth work, while beautiful, meaningful, important, and inspiring, can exhaust a person who is not held by a supportive community of others on similar initiatory journeys.

The intensity of birth work requires community, wise counsel, emotional support, safe spaces for processing, and a lot of soul exploration. With these things in place, a birth worker can evolve spiritually and emotionally with the work, rather than remaining perpetually exhausted and wounded by it.

Without others to lean on and seek counsel from after beginning such a profound journey of service, it is far too easy for an initiate to become lost and strangled by doubts, fears, traumas, and pure emotional fatigue. A lack of true soul preparation and support can result in defeating burnout, which is itself a harrowing journey. Equally important to providing soulful trainings is the willingness of the initiate to participate in and take advantage of all that is available to them, without any concern of appearing incapable or weak. Just as a new parent needs validation, support, story, ritual and ceremony to complete their journey, so does a doula, mentor, midwife, obstetrician, labor and delivery nurse, pediatrician, and so forth. In the absence of these components, the likelihood of feeling that something is missing from the preparatory process is strong. For birth to really change in our culture, childbirth educator and doula training organizations must understand the initiatory nature of their work, recognize and welcome their trainees as initiates, and deliberately nurture and grow them as they evolve. These organizations must become the elders who answer their own Call to "heal the healers," not only in training but throughout the new birth workers’ careers.

Birthing from Within’s childbirth educator and doula trainings are specifically designed with initiation in mind, and include the ongoing community and support that all birth workers need to maintain the integrity and health of their work.

Crossing the Threshold and Heart of Mentoring are coupled initiatory offerings that are part of the Birthing from Within certification programs - and they can be taken independently from the certification programs as well. This is Birthing from Within’s way of providing heart-opening initiatory ritual and ceremony to those answering the Call to birth work. These offerings allow initiates (some of whom may already be established birth professionals) to take the time and space required to look within themselves and discover new insights about what they believe to be true, and why. This is such a crucial part of laying the foundation for a sustainable birth work career; we must tend to the soulful aspect of the person answering the Call before they can share their soul with the families they support. This is why we also conduct regularly scheduled live calls and online support groups for all initiates and members, certified or not. We encourage all of our members to reach out to their peers and colleagues when they feel they need to work through something they’ve experienced, or are struggling with some of the more emotional aspects of the work.

As an organization, we continuously work to establish a stronger foundation upon which birth professionals and care providers can build their practices, filling them with a sense of deep meaning for what it is they do or hope to do.

Through our enhanced training and certification programs, workshops, and active, inclusive member community, we are taking the initial steps required to truly change birth in our culture. Together, with proper preparation and support, we are bringing about the change that we seek and crave.

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Report: Crossing the Threshold Workshop

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BFW Dictionary: Birth Art