Questionnaire for birth professionals (self awareness)

Ask yourself the question and then write down the answer(s) that pop into your head. Don’t figure it out. There are no right or wrong answers. What pops into your head may open up some awareness of your subconscious fear of birth.

1. With regard to having babies, what my mother said is_______________________________
2. With regard to having babies, what my father said is_________________________________
3. With regard to having babies, what I learned in school is _____________________________
4. With regard to my clients, what I have done that doesn’t meet my standards is ____________________________________________________________________
5. With regard to my birth practice, what I would be willing to forgive myself for is _____________________________________________________________________
6. With regard to pregnancy/birth, my biggest fear is________________________________________________________
7. How I feel when I’m standing in the lobby of a hospital is ______________________________
8. What I know about my own birth is_______________________________________________
9. If I could go back to the womb and re-create my own birth experience, I would: (write out all the elements of your fantasy ideal birth)
10. If I had beautiful, ecstatic births happening in my practice, who might be wrong? Who might be upset?
11. Some ways that I could be nicer to myself are _________________________________________