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How to Create a Sustainable Birth Community

Birth workers enter their occupations (midwifery, nursing, doula, obstetrics, etc.) to help women have a positive pregnancy, birth and postpartum. How we make that happen is unique to each individual, but I think we have that main goal in common. Birth workers are very passionate about what they do and are typically not in it to get rich (that’s impossible in many cases!).

When I first became a doula, much to my shock and confusion, I watched a small doula group completely fizzle out due to internal conflicts. I also saw how, when a local doula went rogue, her actions and therefore negative consequences, lingered and tainted the relationships between all doulas and many care providers from then on.

These two stories left their mark on me and I believe I saw them for a reason. They gave me the motivation to learn what will and will not create a sustainable birth community. Since then I have learned some extremely useful information that has been an asset to my local birthing community and has also helped to co-create and maintain the Tallahassee Doula Co-Op.

Now I want to give this information to you.

In this post I will share with you exactly how to create a healthy and effective birth community. I will share with you four simple, yet hard to master, ideas that can radically transform your local birth community enabling you to effectively help more women have positive pregnancies, births and transitions to motherhood.

birth community

Define “Birth Community”

Before I begin, I thought it would be helpful to explain what I mean by “birth community”. To me, the term birth community means a group of people in a city/town that petition themselves and/or care providers to use evidenced based birth practices, educate women about their options and support women through their process. Often people in a birth community are women, care providers, mothers and doulas but can consist of many other varied people.

Now that we know what a birth community is, let’s start learning how to foster its growth and sustainability. To do that I will refer to a book called The Four Agreements by Don Miguel Ruiz. I’m in no way saying that everything Ruiz has written I ascribe to, but for this example his book is perfect.

Don-Miguel-Ruiz-The-Four-Agreements-Book-Cover-originalFrom the book cover… “The Four Agreements offer a powerful code of conduct that can rapidly transform our lives to a new experience of freedom, true happiness, and love.”

Doesn’t that sound like something your birth community could use? I know mine could always use a little bit more freedom, happiness and love.

The following are the four agreements and how to apply them to our birth communities. (Please know that I am in no way perfectly practicing these agreements. However, I aspire to them. I hope others can forgive me for my shortcomings and know I will continue to try to do better.)


According to Ruiz, “The first agreement is the most important one and also the most difficult one to honor.” “The word is the most powerful tool you have as a human.”

What does it mean to be impeccable with your word? First, I’ll tell you what it is not. It is not using your words to express anger, jealousy, envy and hate. It is not planning revenge. It is not creating chaos. It is not gossip.

“Gossip is … pure poison.” ~Ruiz

Have you ever known a person to say something, maybe in passing or off the cuff (likely in confidence), that spread like wildfire and hurt other people’s feelings or made someone mad? Ever seen that happen in your birth community? I have, many times.

Ladies, what we say matters. Our words matters so much that they can either build up or destroy others. Our common goal of helping childbearing women will never happen if we are constantly speaking poison towards others. Seriously.

According to Ruiz, “You can measure the impeccability of your word by your level of self-love. How much you love yourself and how you feel about yourself are directly proportionate to the quality and integrity of your word.” “Use the word to share your love, beginning with yourself. Tell yourself how wonderful you are, how great you are. Tell yourself how much you love yourself.”

From here on out remember that your words are powerful. Choose them wisely. Choose to love yourself and others. Do not participate in gossip. Encourage one another. Do not slander other birth businesses. Do not compete with each other.

A note on competition: While working in the birth industry you cannot compete against other businesses in the traditional sense. The only way to effectively compete in the birth industry is to follow these four agreements. Only then, will you have long term success. By helping other birth businesses grow you will find yourself and your business growing in unison.


The next agreement is to not take anything personally. What this means is that if someone calls you stupid, you would know that them saying this, in fact, has nothing to do with you. Their words have everything to do with themselves, their world, their agreements, their lives, their experiences.

“Their point of view comes from all the programming they received during their early years.”

“If you decide to believe them and take it personally, you are taking their poison and it becomes yours. If you do not take it personally, you are immune.”

“You are never responsible for the actions of others; you are only responsible for you.”

How we can apply this amazing agreement is to literally not take anything personally. When a nurse is snippy to a doula, know that it’s not personal. Maybe she is having a hard day, or worked with another doula earlier and had a bad experience, or maybe she’s going through a divorce? We probably will never really know what was really going on. Just know that you can’t take it personally.

Side note: I do think, however, that if you hear something said about you or if something is said to your face, you can absolutely ask direct questions to the person who originally said the offense. The purpose of the confrontation is, however, only to get to the bottom of the problem in order to try to find a possible solution. Of course, the words we use in this confrontation will be impeccable, right?


It’s easy to make assumptions. Our interpretation of cause and effect may seem logical to us, but in fact our revelations may be wrong, wrong, wrong.

“We make an assumption, we misunderstand, we take it personally, and we end up creating a whole big drama for nothing.” “It is always better to ask questions than to make an assumption, because assumptions set us up for suffering.”

I remember in my early adult life I would hardly ever ask for clarification. I was too afraid of people thinking I was stupid and would therefore make my own assumptions of what was originally meant. Now, I actively seek clarification – even about words I don’t understand! It requires bravery to ask for clarification.

Humility and bravery are two excellent skills you will acquire when not making assumptions.

If a situation presents itself, say an OBGYN rolls their eyes towards a nurse in the delivery room, you cannot assume the meaning of this gesture. For all we know, they have some inside joke or maybe they’re communicating about the patient next door. The fact is, we just don’t know. Unless we ask, we cannot assume to know the truth.


The last agreement is to always do your best. The most we can give any situation or moment is our best. If our goal is to do our best, and we do it, we know there was nothing more to do or give to that moment.

“Doing your best, you are going to live your life intensely. You are going to be productive, you are going to be good to yourself, because you will be giving yourself to your family, to your community, to everything. But it is the action that is going to make you feel intensely happy. When you always do your best, you take action. Doing your best is taking the action because you love it, not because you’re expecting a reward.”

“When you do your best you learn to accept yourself. But you have to be aware and learn from your mistakes. Learning from your mistakes means you practice, look honestly at the results, and keep practicing. This increases your awareness.”

Imagine a birth community that was purely doing their best? I think we could get some work done, ladies. Our energy would be focused on what is important and not drained on various other worthless directions. Imagine if instead of worrying about what doula or care provider said what, we would use our energy to create positive change for the women who matter most to us. THAT would be amazing.

Where to Start?

So you’ve read this blog post and you (mostly) liked what I said but you’re a little overwhelmed and it’s unclear where to start. Well, if it were me I would buy and read the book The Four Agreements. I think that would be good first place to start. After that, I would write the four agreements down on note cards and stick them places that you’ll see – mirrors, doors, etc. Last, I would share what I learned with someone in your birth community.