by Holly Yeager
The not discussed truth in birth work is that not every pregnancy leads to a happy ending. Having the tools to work with clients through pregnancy and infant loss is paramount.
All loss is equal:
Whether the loss happened at 8 weeks or 40 weeks all pregnancy loss is equally hard. There is still a grieving process that needs to happen and as birth workers we need to hold space for that process to unfold. Familiarize yourself with the stages of grief (from Elisabeth Kubler-Ross’s 1969 book: On Death and Dying) and be prepared to walk hand in hand with your client as they move through them.
Words matter:
Choose your words very carefully. If their baby has a name , call them by their name. Acknowledge that even if they never took a breath they still exist and matter. They were still part of this world and they are still precious.
We tend to fall back on old tropes when we are at a loss for what to say. Never say things like: “they are in a better place” or “this was Gods plan”. Even if your client is religious. If you cannot think of something positive and uplifting to fill the space its okay to not say anything at all.
Create Lasting Memories:
When a family is in the throes of grief they tend to focus on the here and now. They are not thinking into the future and preserving their babies memory. Take pictures if you are able to. Even if they do not want to look at them right away, it is nice to have the option later. Keep them in a safe place until the family is ready.
Keep everything the baby touches; Blankets, hats, hospital bands, etc. and create a memory box. These are the only physical items left to remember baby by and will be cherished. Some hospitals offer a memory box with clay that can be used to create a handprint or footprint.
Talk about the tough stuff:
Many times there is not an obvious cause of death, but if there is answer questions honestly and frankly. Talk to your clients about the hard choices they now face. Are they able to keep the child’s remains? Would they like to bury or cremate the baby? Is there a religious ceremony like a baptism or blessing that is important to them?
Talk to them about what postnatal healing will look like without a baby. If they will be producing milk, do they want to donate it or dry it up as fast as possible? Talk to them about what their healing will look
like. Some people want to “try again as soon as possible” It is advised to wait three months after a loss before trying to conceive again.
Self care:
It is ultra important not to neglect your own self care during this time. Make sure you are eating, drinking, and resting as well as you can. Fall back on your birth community for resources and help processing. It is okay to be sad and cry. It is okay for your clients to see it. Take the time you need to process your own grief cycle.
While pregnancy and infant loss are hard for everyone involved, your loving and gentle guidance will help the family more than you know. It is our sacred duty to usher in new life and sometimes along with it death.
Holly Yeager has been a birth and postpartum doula for 10 years. She owns Lancaster Doulas in Central PA. Along with her doula business she volunteers her services to families with an “incompatible with life” diagnosis.
