Doulas Provide Support Through Life and Loss

by guest blogger, Sarah DiMarco

An open letter from a certified bereavement doula to other doulas dealing with loss. Statistically speaking, every doula will likely encounter the death of a client's baby. This is how you can help those clients, and yourself, grieve for that loss.


One in every 160 babies are born sleeping. One in every four pregnancies ends in miscarriage. The reality of these statistics is that eventually, as doulas, we will all experience the loss of a client’s baby. For me, I’ve been practicing as a doula less than a year, and my first professional experience with loss was during my third birth. That loss was what prompted me to train with Stillbirthday. I wanted to be able to share my training and experience so that I can help you, sweet doula, if you have found yourself in a place that you are unprepared for.



Filling the Space Where Birth and Bereavement Meet

After receiving the news that their baby will not make it, there are many things that must happen next for the parents. Many well meaning obstetricians, nurses, and midwives think to ease the family’s grief by making these decisions for them. For example, if a couple has been told at 36 weeks gestation that their baby has passed away, a midwife may think that it would make things easier on the family to induce labor as soon as possible, but in many cases, it can be safe to continue to carry the baby until labor begins on its own. Choosing to do so can allow the parents time to come to terms with the news and make plans and arrangements for the welcoming and farewell of their baby.

Just as it is your job as a birth doula to provide the expectant family with options, choices, and resources; it is your job as a bereavement doula to do the same. The death of a baby does not mean that those options and choices are taken from the pregnant or laboring mother but sometimes she needs a gentle reminder of this fact. In truth, the role of a bereavement doula is very similar to the role of a birth doula.

When Hello Becomes Goodbye

But of course, there are parts of being a bereavement doula that differ. It’s a difficult but important part of your job to help the family transition from welcoming their baby into the world, and telling him farewell. Even if their baby is born sleeping, his birth can be a beautiful and even joyful experience for the mother and father. It should be your goal to remind them that they have given birth and they are parents.

It’s also important to preserve the memory of their baby’s birth. Encourage parents to have a photographer, such as one from Now I Lay Me Down to Sleep (NILMDTS) to take pictures of their baby and of themselves, as well as older siblings or other family members holding her. If the family seems apprehensive about this you can offer to show them photos from the NILMDTS website and give them time to decide. If they have chosen to have a photographer come, it can ease their minds if you offer to stay in the room, perhaps behind the curtain or just inside the door to give them privacy. This way, if you sense they are overwhelmed with their grief, you will be there to provide comfort or ask a nurse to take the baby back.

A doula can help walk the family through the process of planning the farewell ceremonies. If you are unfamiliar what that process is, you can just be there to provide support while the parents make the difficult decisions on what to do with their baby’s body. Often, just sitting quietly and being there with the family is the only thing you can or need to do.

It’s also so important for a doula providing support to families during loss to know what NOT to say or do. Things such as “you can always try again” or “God has plans” are said with the intent of comforting, but they can do just the opposite. Also, any phrase that starts with the words “at least” is not going to be as helpful as one would think.

The most important thing to remember when you’re providing support to families enduring loss is to allow yourself to grieve as well. Don’t hold back your emotions in front of your client to be “strong” for them because it is actually comforting for the parents to see that their baby’s life touched others. If you need to, pause and take a moment for yourself during the labor and birth to collect your thoughts and check-in with your mind and body.

Be Gentle With Yourself: Self-care is Imperative

Once you’ve arrived home after the birth, take a warm bath with pretty candles and a hot cup of tea, do some yoga, or sit with a good book. You must remember self-care and to allow yourself time to grieve. It’s important to debrief with a trusted doula-friend, family member, or therapist, so that you may heal and continue to provide support for the families you work with.

As doulas, we are truly unique women. We have chosen a path that requires much love and compassion and we all have that inside of us. You are already equipped with exactly what you need to provide the support your clients need, in any birth outcome. You are amazing. You are valuable. You are needed.

Sarah is a mother of five children; two step-daughters ages 16 and 8, a 5 year old daughter of her own, and two angel babies born in the first trimester on September 2, 2013 and March 8, 2014. Sarah is a certified Stilbirthday Birth and Bereavement Doula, and a MotherMe Graduate Birth and Postpartum Doula. For more info about Sarah and her life's work, please visit her website.