In her 2013 essay, Holding the Space, doula Aimee Brill speaks of the crucial role that doulas play during childbirth. “In the moments when circumstances are snowballing and an undesirable outcome is knocking at the door, it is still possible to maintain clarity, to stay present and grounded, and to hold the space," she writes.
The role of a doula is to provide assistance to a mother during childbirth and during the postpartum recovery period. They are trained to offer support during labor and delivery and assist a mother during her postpartum recovery period, proudly taking on the task of “mothering the mother.” But what happens if, as Brill writes, "an undesirable outcome is knocking at the door"? Who is there for the mothers who do not bring a baby home from the hospital? Who is there to mother the mother during the heart-wrenching experience of stillbirth or infant loss?
This is a role that bereavement doulas like Heidi Faith hope to fill.
Faith is the creator and owner of Stillbirthday, an organization that focuses specifically on training doulas, as well as midwives, nurses, and other health care professionals, to support and comfort mothers after the loss of a pregnancy.
Bereavement doulas provide a wide range of support, from accompanying a mother to her doctor to confirm the pregnancy loss, to helping her arrange for funeral or cremation services. If the mother knows in advance that her baby will not survive childbirth, the doula's goal is to "enter into the space, with a skilled love, to touch the mother in labor, to brush her hair from her face, to offer comfort during contractions, [and] to aid in the safest and most supportive childbirth experience," Faith tells Romper.
Faith was inspired to create the organization after she experienced a pregnancy loss in 2011.
“I had been a doula for nearly 10 years,” she tells me in an interview for Romper. “I still felt wildly ill-equipped to know what to do, what options I had and how to navigate such an entirely overwhelming experience.”
"The line is thin between welcoming life and saying good-bye."
After a mother loses a pregnancy or gives birth to a stillborn baby, she is changed forever. Even if a mother goes on to have healthy children after a loss, the death of her child can affect her mental health for many years, according to a 2011 study from the University of Rochester Medical Center. Women who experience a pregnancy loss need support, but their health providers may not have the tools necessary to provide them with the support they need.
Not having access to mental health resources following a loss can lead to women experiencing "social isolation and distress," according to the Journal of Obstetric, Gynecologic and Neonatal Nursing. This is where many doulas who specialize in comforting mothers after a loss hope to fill in the gap.
Alisa Blackwood is a doula and prenatal yoga teacher as well as the owner of Breath & Birth, which is based in St. Paul, MN. She became a bereavement doula when she learned that a hospital where she volunteered was offering emergency room bereavement services to mothers who had just had a miscarriage. Blackwood decided to undergo training to become an ER doula to "support women and their partners during what can be an emotionally gut-wrenching and confusing time."
“Some doulas understandably feel comfortable only in the joyful spaces of welcoming new life, yet I strongly believe that the line is thin between welcoming life and saying goodbye," Blackwood says. "Mothers deserve to be nurtured, cared for and listened to, whether they're birthing a full-term, healthy baby or a baby who isn't going to live.”
"In that moment, she knew she was a mother — not just someone who'd had a miscarriage.”
Among a bereavement doula's services is to provide emotional support to a mother who wishes to see her deceased baby. Blackwood says she once worked as a doula for a mother whose baby was born at 15 weeks gestation in the emergency room. “She couldn't bear to look at it at first," Blackwood says. "The nurses weren't really sure how to emotionally handle the situation either."
So Blackwood removed the baby from the room and wrapped him carefully in a blanket, just in case the mother changed her mind and decided she wanted to see him. Just before she was discharged, she asked to see her child. "She burst into tears and said, ‘He's beautiful!’," Blackwood tells Romper. "In that moment, she knew she was a mother — not just someone who'd had a miscarriage.”
Becoming a bereavement doula is not for everyone. The role requires doulas to maintain control of their emotions, at least in the mother's presence. (Blackwood recalled sobbing in her car following her encounter with the mother who'd lost her baby in the ER.) Bereavement doulas must also be able to shoulder the weight of being a safe and trusted resource for mothers experiencing unimaginable grief.
But women like Faith and Blackwood are committed to their goal of staying present and grounded for the sake of grieving mothers everywhere. Above all else, they want a woman who loses a child to know that she "is a mother no matter what," Blackwood says. "Her tender heart needs love and support no matter what. I feel incredibly honored to hold space for a woman and her partner during what may be a time of deep and unspeakable grief.”