Birthing From Within Book Review

Book Review Birthing From Within by Pam England and Rob Horowitz.

The profound mystery and spirituality of birth can never be understood with the mind; they are known through the heart. It is this knowing from the heart which is critical for women in preparing for their rite of passage. Birthing From Within’s multi-sensory approach has evolved to help women and their partners make that journey in awareness and with heightened confidence. 

Birthing From Within is a dynamic, organic and internally lead approach to childbirth education and preparation. The method was created and refined over eight years as a series of childbirth classes, originally called The Art of Birthing, by Pam England, a mid wife and nurse based in the United States. In writing this book, in collaboration with her psychologist husband, Rob Horowitz, Pam compiled all her experiences of working with couples with her vast range of exercises and activities, along with her knowledge, philosophy and understanding of pregnancy, labour and the preparation process.

What is covered in the book has been determined by this experience and feedback and evolving her techniques based on what worked and brought insight and success to the women and couples, as opposed to an approach based on theory. Her classes are always adapted and individualised to the parents participating and the readers of the book are encouraged to take the same approach.

“Birthing From Within” is not a script or a rigid method. Every parent or professional who reads this book should choose and adapt what matches their personality and their needs. 

Birthing From Within is extremely comprehensive and covers all levels of preparation from the practical, to the spiritual, mental and emotional.

Image by Anna Cocks


What does it mean- to Birth From Within?

The Birthing From Within approach stems from the vision of ‘parents learning through interactive, creative participation, in a spirit of fun and curiosity’ and it is this foundation of creativity and curiosity which I feel is the biggest strength of this method. Birthing From Within leads women into a profound process of self-discovery that prompts them to ask questions in an open-ended way that seeks to learn, grow, adapt and access their own personal ‘truths’ rather than achieve a particular outcome or only assimilate ‘outside’ information. It proposes they ask the question- ‘What do I need to know to give birth?’ And gives them many tools to discover their own answer/s.

The philosophy of the method also looks at providing support and approaching any birth option from this place (within)- whether it be the need for intervention or drugs, the use of technology, a home birth or bottle-feeding. Birthing From Within does not limit itself to birth looking any particular way, but is all about the way we approach birth- which is with a cultivated confidence in our own ‘knowing’. There is no ‘right’ answer to any question or prescriptive ‘way’ of walking the path towards parenthood, only that it is done with trust and in integrity to what is true for us.

Just as there are many ways to explore unknown territory, there are countless paths to take through pregnancy and birth. The most rewarding outcomes tend to spring from an openness to the unpredictable, and a mindset that embraces them all. 


Image by Anna Cocks


What does Birthing From Within involve?

The Birthing From Within approach to pregnancy, birth and motherhood is very holistic and covers so many topics, divided into seven sections and 43 chapters. It’s very comprehensive and unbiased, covering a range of topics of discussion from ‘eating in awareness’ to ‘the ecology of pain’, ‘how to give birth if you need a caesarian’, ‘childbirth as a rite of passage’, ‘baby-proofing your marriage’, and my favourite ‘don’t give birth without a doula’ (to name just a few).

The sections follow a trajectory beginning with preparing the women to ease into this perhaps new way of approaching her pregnancy (and even life), to taking her through different creative processes, then moving into preparation on a more practical and psychological level- looking at the importance of preparing the birth ‘place’, what birth looks like from many angles, a chapter on birth companions and how another another person (partner, friend, doula) can support the woman in labour, a chapter on pain with lots of practical techniques to practice and then the final part on motherhood and parenthood.

For me the parts of the book that I found most interesting and that I think stand out as being of the most benefit to women are the chapters on the creative practices and on pain.

The ‘Art of Birthing’ section invites women to create images around their experiences, expectations, fears and wishes mainly through prompts, in the form of a series of questions or images to consider, such as –

What is ‘being’ pregnant like for you? (a physical experience, a spiritual experience, a thought or even an abstract image), If there was a secret door to birth, to giving birth, what would it look like? What’s behind, around or in front of it? Is anyone in the picture? Imagine you are an artist-historian showing someone from another planet or culture what birth in our culture is like. How do women give birth in this time and place?

Sitting with these questions and with a blank sheet of paper, the women are invited to express whatever comes up for them and then usually through a process of sharing and discussing they discover more is revealed to them in the image they have created. A friend of mine who originally recommended this book to me, knowing my art practice and that I was going to become a doula, wrote this of her experience –

I would nestle into a bean bag with Birthing From Within and sit under a single lamp in the cool winters nights dreaming about my baby. Being 25 years old, and a first time mum with no friends who were parents, I had no idea what was ahead of me. There was a mystery in the waiting and Birthing From Within allowed me to connect with that mystery. Trailing wet brush across paper I let the bristles find their way, revealing to me my most tender wonderings. Some of my most treasured memories are sitting alone with this book and my journal – a feeling that lays deep in my flesh. I had my birth at home and as I gave over to the newness of it all I realised I’d drawn out the fears of this moment long before. Birthing, particularly when it is your first time, opens a chasm that Birthing From Within turns into an unfolding of nourishment.


Image by Anna Cocks


The pain section is also very comprehensive and I loved her practical exercises that you can try. The process is basically holding a block of ice for 1 minute (the contraction) and trying different tools, such as breath awareness, non-focused awareness, using sound/your voice, to see how these might affect your experience of ‘pain’ or discomfort. I love how pain is discussed openly and honestly and as a natural part of the childbirth process (though not always a word women would use to describe the sensations that they feel). It is also very emphasised, when it comes to any kind of technique, the importance of practice so that rather than being a ‘technique’ these tools become a ‘habit’- something we will more instinctively turn to to help us navigate an intense experience rather than wait for that intense moment to try it out.

Why should you read this book? 

The great thing about the book is it is very anecdotal and contains many, many images and stories of women’s ‘birth art’ and birth experiences with quotes of what they have said about their images and sometimes more information about how they went on to experience birth or motherhood. I think this helps women feel less inhibited to make images and gives more insight into the benefits of the process and how much can be uncovered. The only disparity between reading the book and the actual Birthing From Within classes is that you miss the group experience of sharing and discussing the images which I feel is where the a lot of the insight comes. This will depend on how comfortable a woman already is with self inquiry and her willingness to sit with the unknown and take her time with the process, to let it unfold. An alternative would be to seek other women who wanted to form their own Birthing From Within group or a doula who can help guide you in creative practices (me! 😉

I think this is a beautiful, holistic, simple and profound method that can really assist women to feel confident and in their power when it comes to their pregnancy, birth and choices. As an artist I found it very insightful as to ways I can incorporate creative processes into my business and support women in their journey towards birthing from within.



(All images are my own recent exploration of sitting with a blank sheet of paper and letting whatever was within be expressed).

My name is Anna Cocks and I am a Doula who has trained with Vicki Hobbs at the Doula Training Academy. If you would like more information about my doula services please contact me:

Business Name:
Creative Magic – Doula Services

0404 914 419

[email protected]




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