The topics of stillbirth, pregnancy loss, bereavement doula, and miscarriage are discussed in this post. Please read cautiously or don’t read this post at all if these topics are a trigger for you. This post has been written and shared with permission.**
Over the last two decades, I’ve attended many baby deliveries. In high school, I started attending births as a support person for other teen moms who were, like me, delivering babies without a partner. I then started doula-ing as a hobby for friends, family, and coworkers in Colorado.
Every birth I have attended has been special and memorable. I love birth and the connections I make with each of my clients. Some of the births really stand out, in detail, in my memory forever. There is a birth I attended nine years ago which stays close to my heart. My little sister was going to have her first baby. We were all excited to welcome a new baby to the family. I was not only going to be an aunt for the first time, I was to be her doula. Double excitement!!
But the unexpected happened. At 19 weeks into her pregnancy, she started spotting. It was a Friday morning and she called her doctor right away (as instructed) but was she told there were no open appointments until Monday. She patiently waited until Monday morning for her appointment. As she drove to her doctor appointment her water broke in the car. She quickly rerouted to the hospital in Fort Collins where my family and I met up with her.
She was admitted to the labor and delivery floor. While she waited for the on-call midwife to arrive a most wonderful and patient nurse tried unsuccessfully for over an hour to find my niece’s heartbeat. The nurse took a moment and wept with my sister when they could not find the baby’s heartbeat.
The on-call medical provider, who my sister had not met before, arrived and came into the room to talk to my sister. She stuck to the facts and quickly explained to my sister (and family) she would have to be medically induced and deliver her child – a child she would never take home. At that time, we did not know if the baby was still alive but we knew either way the baby would not live. This was too much to process. It felt deeply cruel in every way. There had to be other options – and if there were, they were not presented.
So many parts about this day seemed unfair. This was not something any of us had prepared to experience. My sister, as a mother. And certainly not me, as an aunt, sister, or doula. Birth is supposed to be happy and exciting. Not traumatic and sad. It bothered me knowing my sister was on the labor and delivery floor next door to women delivering happy, live healthy babies. I realize the medical team had their work to do but we needed emotional support and time for this to sink in. Not a cold medical presentation on induction. Why couldn’t everyone slow down and just take the time with us that we needed, as the previous nurse had done?
My sister was given an epidural and told to rest because it would be several hours before she would dilate enough to deliver the baby. We were in shock. We were sad. We were scared. I was angry. It was traumatic. I hurt so badly for my sister. All I could think to do was to stay with her, hold her hand, comfort and protect her in any way possible, as only a big sister (and doula) could.
I sat in the room alone with her, looking out the window. I remember sitting there like it was yesterday. A short time later, she called me to her bedside and told me she felt something funny. The epidural had numbed her from the waist down so this seemed odd. She asked me to check for her. I lifted the bed sheet and found the unexpected. Her body had delivered the baby, my tiny niece, who was not alive.
The two of us were alone in the room. How was I supposed to tell her what I saw? It wasn’t supposed to happen this way. But I respectfully had to tell her. I told her gently but honestly. And then I went and found help. I think I acted calm on the outside, but I was afraid. I had never seen a baby so little and one that was not breathing. My niece was so small she fit in my hand.
Much of the next several hours are a blur for me – probably for good reason as the brain is so good at protecting us from trauma. I do remember later when a lab tech came in the room to draw my sister’s blood. He congratulated my sister on her new baby. I was mortified. It was an honest mistake. But a terrible mistake. I remember the hurt on my sister’s face as she was now the one consoling the embarrassed lab tech explaining that her baby had died.
So, transition into some important facts with me for a moment:
Fact 1: One in four women experience pregnancy loss in some form. In other words, 25% of pregnancies are miscarriages. Whether you know it or not, you know someone who has experienced a miscarriage or a stillbirth. We have to do more to address this topic as a society and talk openly about pregnancy loss. There are women who are hurting right now because they feel unsupported and unable to talk about their loss.
Fact 2: Most miscarriages occur between the 7th and 12th weeks of pregnancy. This certainly doesn’t make them less painful to experience. A loss is a loss and my losses or your losses do not need to be compared as to which is worse. Women and their families experiencing these losses need safe and supportive places to get support. To grieve. To address their loss in whatever way they are affected. Loss affects everyone differently.
Fact 3: Medically speaking, the difference between a miscarriage and a stillbirth is timing. A stillbirth occurs when the pregnancy is twenty or more weeks along. According to the CDC, about 1% of pregnancies result in a stillbirth. About one in every 160 pregnancies in the U.S. ends in a stillbirth, which adds up to about 26,000 each year nationwide. Even though this is a comparatively low number, it still seems incredibly high when we consider the impact of the loss of a baby.
Fact 4: An American mother gives birth through miscarriage every minute and an American mother gives birth through stillbirth every 20 minutes. It is necessary for us – doulas and other birthworkers – to know how to hold each family entering into bereavement and to do so with professionally comprehensive services and a personal heart to serve.
Fast forward eight years: August 2015. I was given the honor to doula again for this same baby sister. She had her rainbow baby. A “rainbow baby” is a healthy baby born after the loss of a previous baby. And as her doula, I was able to support her through all the feelings she felt during her second pregnancy and the birth of my nephew.
At my nephew’s birth, it occurred to me I was no longer meant to be a hobby doula. I was meant to put my whole self into birthwork. It took a punch to the gut from the universe for me to realize I already had the heart and the baseline skills to support families through their births, even when the outcome was not as planned. After my nephew was born all I could think about was doula work. I immediately started researching training programs and knew I was going to find a way to make becoming a full time doula happen. I began formal birth doula training the following November. After completing the training to become a birth doula and postpartum doula through DONA International, I felt it was important to pursue training in bereavement doula work too. This past summer, I received my certification as a Birth and Bereavement Doula from StillBirthday University. I am now certified to support a mom and her family through any trimester of pregnancy with any birth outcome. It took me about a year and a half of working my ass off to make being a full time doula a reality. During that time, I was working twenty hour or more days, seeing clients, going to births, networking, going to training, and working nights until I had enough doula work to take the leap and leave my other job.
I realize bereavement is a tough topic for many (even medical providers and doulas) to deal with. And not every doula will be driven to do this work, and that’s okay. But, I feel it’s imperative for us as a society to start talking more about miscarriage and stillbirth. Especially because so many of us are impacted by loss and never get any support. I would bet, if you asked the people you know right now which of them have been affected by pregnancy loss, you would be shocked to find out how many of them have faced loss in one form or another and never talked about it. (I know, a completely other blog topic for later.) We have to be a culture that nurtures and cares for one another, in every birth scenario. And we have to provide an environment in which people feel safe to get support during times of loss. So this brings me to fact 5…
FACT 5: Loving, listening and emotional and physical support through loss is necessary. If you are experiencing a pregnancy loss, please reach out for support today. You don’t need to go through loss alone. When you hear of someone experiencing a loss please reach out to them. Don’t try to fix their pain just be there. Listen and hold space for them. At minimum bring them a meal or help them find a bereavement doula in their area to support them.
Local Colorado pregnancy loss resources and national pregnancy loss resources can be found here.
This post is dedicated my niece, Rebel, and my nephew, Caleb. You both are beautiful reminders of how much we don’t know what tomorrow will bring or where our lives will be lead. You both make me want to be better, listen, and serve more. You both play a significant role in who I am today.
For more information on “The Process of Bereavement Doula Support” read part 2 of this bereavement blog series.