(Mis)Conceptions on Perinatal Loss Support
As a Doula specializing in perinatal loss support, I find many reactions to the work I do. Some people stop at the word ‘Doula’ (“I’ve never heard of that.”), others mentally stumble over the term ‘perinatal loss’ (“What does that mean?”), and many immediately respond while cringing, “Thanks for what you do...but I could never do that.”
The latter has always been interesting to me and, when the conversation offers the opportunity, something I’ve learned to lean into (especially with birth workers) over the years. Aiming to broaden this industry of specified care and increase general awareness, I ask as often as I can what the person is thinking of when they think of my line of work. While most immediately react that they agree this type of care is desperately needed for people, they don’t feel they have the capacity to contribute for whatever reason.
Pregnancy and infant loss is a topic that can instantly stop us in our tracks; but without mindfully exploring our capacity to contribute to this specific birth experience, we may indirectly be causing even more harm to those already finding themselves in a traumatic birth event.
I hope you will follow along in this three part series, as we discuss just a few misconceptions on what supporting pregnancy loss and infant death looks like. I’d like to share some of the more common - and understandable - reasons I hear for professionals thinking they cannot ‘handle’ contributing to perinatal loss support and offer my feedback on the reality of those concerns. We will be touching on:
Considering what pregnancy and infant loss support may or may not look like
Why this specific type of support matters
How you may have worked with a family experiencing the grief of loss and not even know it
Please know, this is not an article meant to recruit, guilt, or shame anyone into working beyond their capacity or emotional boundaries. My hope and intention is to begin a conversation you may not have had otherwise, shed some light on how we can work better together as a birth collective, and provide some helpful tips on how you may be able to be of better support than you ever knew possible.
You will often hear me say this line of work isn’t for everyone and I don’t pretend that it should be. This is a calling...but even callings can give us pause.
So let’s begin by exploring the first misconception I often hear: “I Could Never Work in Perinatal Loss”
As you will find me often saying, it is true that this work is not for everyone; but I find that many don’t know what this work actually consists of. So, I would like to ask you the following questions to consider:
Have you ever felt curious as to what working in perinatal loss support may look like?
If you have concerns working in this area, what are those concerns, specifically?
If you work in a field where pregnancy or infant loss is a possibility in occurring and you don’t feel you have the capacity to assist, do you have resources available for those who do?
I find that one of the biggest misconceptions in taking steps towards improving care in miscarriage, stillbirth, termination, or life limiting diagnosis is making the assumption that it all takes place in the physical birthing space. Like most aspects of birth, this couldn’t be further from the truth, as there is so much to learn and prepare for beforehand when simultaneously preparing for birth and death of a wanted pregnancy. Like an anticipated ‘easy’ pregnancy and birth, there are some things we cannot control or will be unexpected; however, we still encourage and empower our birth clients to learn, research, practice, and prepare for, well before even stepping into the birth space.
This is why the second question, what are your specific hesitations or concerns, is important to explore. Often when I discuss working with families anticipating or experiencing infant loss with coworkers, I break down some of the actions I take which allows them to reflect on actions they actually already do or resources they already have on hand. Pregnancy loss and infant death isn’t easy for anyone to talk about, work with, or experience; however, if we don’t allow ourselves to gently explore how we may have already been doing what is necessary for our clients, only to shift those actions to clients seeking bereavement care, we are simply setting those families up for more trauma than they should have to endure.
Rather than choose one extreme or the other - ignore our potential capacity to support families experiencing loss or jump into an anticipated stillbirth without consideration - I encourage individuals to find someone (or better yet, several people) they trust in the loss field and have a conversation with them. Find the areas you feel comfortable with and lean in; take note of the specific details that may start to make you uncomfortable and consider revisiting at another time - or not at all. It’s understandable, acceptable, healthy, and most of all, helpful to families when we know our boundaries, honor them, and don’t cause unnecessary harm to ourselves. Being able to assist within our capacities is always better than not assisting at all.
And this is why I want to bring up one last thought...in my opinion, possibly one of the most important...know who you can count on as your perinatal loss resources/community. As I mentioned before, you don’t have to be present during birth to be a contributing support. Helping guide your client to people who are there to walk with them on their birth journey is a tremendous help. Especially when we certainly have a choice as to how much or little of a role we play in perinatal loss support, this is unfortunately a line of work where the reality of this is unavoidable and one we have a responsibility to take seriously.
I once had an OB/GYN provider say to me, ‘I got into this line of work because delivering babies is happy. I don’t like to focus on the sad.’ It should go without saying that this is not realistic, responsible, or helpful to the care of the patient.
I’ve also found myself, after having worked several times with the same Labor and Delivery bereavement team, arriving to meet my client and been greeted with, “Oh, I wish I would have had your name and number last week. We had a family that really could have used your services, I just couldn’t find your name or number.” Another repeated response is, “I didn’t realize people worked with families in this capacity.”
As birth professionals, we can’t avoid the fact that pregnancy and infant loss occurs, and avoiding it certainly doesn’t make it go away. It makes all the difference in the world to be able to locate our colleagues doing this work, collect as many resources as we can gather, keep them in a place that is easily accessible, and readily share them with our colleagues. By engaging in vulnerable conversations, exploring individual comfort levels, and continuing to build upon a reliable perinatal loss support community, we can elevate care to some of the families who need it from us the most.
Contributed by Teresa Robertson, BFA, CD(DONA), PAILAdvocate