Doula-ing the Grieving Mother

As mentioned in last week’s post The Downside of Doula-ing, a large though unanticipated portion of our role as doulas is being fully present in times of grief and pain. Births don’t always go as expected or hoped for. Not every baby is born healthy and thriving. Not every pregnancy reaches full-term. Not every baby survives the process of birth, leaving bereaved mamas and papas to struggle in a storm of powerful and frightening emotions. For mamas, this is intensified by the swirling hormone shifts that follow any birth, and is sometimes made even harder by the physical process of recovering from surgical procedures that may have also been necessary. They may feel depression, anger, and guilt. They may feel isolated and alone in their grief. Having their doula to lean on can be part of the healing process.

As doulas, loving deeply and compassionately is part of our innate gifts that have called us into a life of service. Even so, it is hard to know what to say or do when someone we care about so much is grieving. We’re afraid of intruding, or saying the wrong thing, or making our mama feel even worse. We feel helpless, knowing that there’s little we can do to make it better. While we can’t take away the pain of a loss, we can still show up fully in providing comfort and support in the unique way that doulas know.

Don’t let your discomfort stop you from reaching out. Now, more than ever, your support is needed. We don’t need to have advice or the right answers. The most important thing we can do, just as we do for birth, is to just show up. Simply being there, as a loving presence, can help our mamas cope with the pain of loss as much as it helps cope with the pain of labor.

The better we understand how grieving happens, the better we can support someone who is in the process of healing. Supporting normal grief has many parallels to supporting normal birth. As people skilled in birth support, in grief support there are a few factors  that are important to remember.

Just as there is no right way or wrong way to birth, there is no right way or wrong way to grieve. Grief, like birth, doesn’t have to happen in normal, predictable, measurable stages. Like birth, it can be messy, with highs and lows, moments of ease, moments of silence and of wailing, of forward motion and setbacks. Everyone experiences this differently. Mamas need reassurance that there are no “shoulds” about how they feel.

Grief includes intense emotions and behaviors. A grieving person may withdraw from the world, lash out at loved ones, have times of  feeling normal and times of feeling completely numb. She may try to make jokes, or may cry for hours on end. It’s important to reassure our mamas that this rollercoaster, as hard as it is, is normal. As doulas, we have the skills to remain in non-judgment, and take nothing personally.

Just as there is no set timetable for birth, there is no set timetable for healing. Recovery from grief may take weeks, months, or years. There will be people who convey the message to grieving parents that they have been grieving for too long. Don’t be one of them.

Be genuine and honest in your communication, and respect that the grieving process, just like her birth, belongs to her. We can offer support in saying, “I’m so sorry this happened. I’m not sure what to say. I want you to know that I care. Tell me how I can support you.” She may not know what support she would like, and that’s also normal. If you, as doula, are having your own normal feelings of grieving and healing, seek out your own support people for your inner healing work. It is not the mama’s job to hold space for you or anyone else. Many grieving parents express that people who call or visit, while intending to share their loving concern, are really looking for the parents to reassure them that everything is ok, when it isn’t. We can continue to let our mamas know that we honor and value their rawness and their honesty. Without forcing her to open up, let her know that she has permission to talk about her loss. We can begin by simply asking, “Do you feel like talking?”  Follow her lead when she’s ready, and talk candidly about her birth and her baby. If she has lost a child, whether early on or at full term, don’t be afraid to talk about her baby by name, if a name has been chosen and shared with you. “When Sophia was born…”, “When you were pregnant with Karl…”, “Olivia’s birth taught me…” This name is etched forever in a parent’s heart, and hearing it will provide comfort and assurance that her child and her birth experience are real and will not be forgotten.

Listen with compassion. Almost everyone wonders and worries about the right things to say, when knowing how to listen is so much more important.  Let her know that it’s ok to talk, to cry, to feel angry, to melt down. Well-meaning loved ones will often avoid talking about a difficult birth, or the loss of a baby. A mama may need to know that her grief is not too terrible to talk about – that you will not run away from it.  Sometimes, it may be just as powerfully comforting to not talk, to sit in silence together, to offer support by being present through the meeting of our eyes or offering a hand to hold through the moments in which there are no words that will come. We have no need to offer unsolicited advice, compare her experience to anyone else’s, or claim to understand her experience. As doulas, our strength is in our willingness to show up, and simply be present with what is real in this moment.

Know what NOT to say.    “I know how you feel.” You can’t possibly. No one can. Her feelings are hers alone, and may change from moment to moment. Better to ask how she’s feeling, and be prepared that she may not have an answer for that.  “This is part of God’s plan.” OR “He’s in a better place” OR anything else that reflects your personal belief system.   These may not be a comforting thing to hear. They may not fit at all with this family’s beliefs. They deny the emotions that are genuinely felt, and may even evoke anger. Best to keep your beliefs to yourself, and find your own comfort in them. “Look at what you have to be thankful for.” Chances are she knows this already.  Yes, she’s alive, or maybe she does have a healthy baby, and she and her partner still have each other, or other children, or another chance. The time will come to think about these things. Right now, that’s not important. “You should…” or “You will…”   Nobody needs judgments or to be told what to do. If you have information to share, and you are sure it is welcome and asked for, it is best to begin it with “One option is…”, or “You might consider…”, with no pressure or expectation.

Know how to offer real help. Many people will say, “Tell me if there’s anything I can do.” Keep in mind that a person in grief may not have the energy or motivation to even know how to ask, or what to ask for. They might feel guilty or uncomfortable for being on the receiving end of so much attention. It’s better to be willing to be one to take the initiative and to check in. “I’m stopping by the store on the way. What do you need?” may be an easier question to answer. Drop off food, throw in a load of laundry, or do the dishes that are in the sink without being asked.  Keep visits short, unless you have been asked to come and stay a while.

Provide ongoing support, as needed. Grief can last much longer than most people may expect. Grief may be there long after the cards, calls,  and flowers have stopped. Stay in touch, and let it be known that you are still there, long after the initial shock has worn off. Avoid saying “You look great.” Appearances can be deceiving, and it’s important for her to know that there’s no pressure to hide her feelings through keeping up appearances. Know that her life may not ever feel the same. The pain may lessen over time, and life does go on, but the sadness may not ever completely fade away. Know that some days, like holidays and birthdays, may be especially vulnerable, and reach out and check in if you are able. Let her know that you are still there, caring about her. She may not ever take you up on an offer for help, but knowing that her doula’s support is available may matter more than you know.

Watch for red flags. It is common for a healing person to feel sad, depressed, disconnected, and even a little lost in the chaos of the emotional whirlwind of grief. If, as weeks progress, she seems to feel worse instead of better, cannot function through daily life, begins to ignore basic self-care such as hygiene, or begins to talk of suicide or self-harm, these may be signs that more heavy-duty professional help is needed.  As always, medical judgment calls are way beyond the doula’s scope of practice. Though necessary, it can be difficult to express your concerns without being invasive or intrusive. It’s ok to share your thoughts from your own point of view, without “shoulds” or telling her what to do. “I’m troubled that these thoughts you mention are keeping you from being able to eat or sleep. Have you considered  mentioning this to your doctor?”

Take excellent care of yourself.  As doulas, our love is our power. We show up fully, knowing that the unexpected is part of life, just as birth is part of life, and we love with our hearts wide open. This is part of the journey that we have accepted, when we choose to walk the doula path. There is a lesson in supporting a grieving mother – or any mother –  one of knowing how to give, without becoming used up and given out. Remember that this is her experience. It is yours to witness, but not to fix. She will have her own community, her own family, her own care providers, and her own experience. Take care of yourself, and your own gentle, loving and compassionate heart as you experience what it is to support a mama in whatever form her birth may take. Remember to pay attention to your own feelings. Seek out your mentors, your wise women in counsel, and your own care providers as needed. Check in with yourself on your own basic needs – nourishment of both the physical and spiritual, hydration, self-expression, sleep. Pay attention to how your needs are being sufficiently met, so that you are filled up enough to have caring to give to your own family, to your own community, to this mama and the many others who may come your way.

 

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4 thoughts on “Doula-ing the Grieving Mother

  1. Jodi,
    You are offering such a deep understanding of how families feel and what doulas can do when a baby dies (no matter the gestation or age of the infant). You are right on about so many things including– how discomfort can keep people from reaching out, that grief is very intense, how to offer help in a more specific manner, that listening is so very critical, and some advice and comments are inappropriate and may cause more pain…and so much more. Great job. I hope lots and lots of doulas read your column and take it to heart.

    I wonder if you know about our relatively new Baby Loss/Perinatal Loss Certification Program for doulas and others who wish to care for newly bereaved families? Having just finished a 22 hour 2.5 day training of BLD candidates in Phoenix, I am wishing I had your blog to share with them. To that end, would you be okay if we offer a link to your site and this entry specifically to all of our Baby Loss Doulas and those still in the process of becoming certified? Maybe we could even put a link on our website?

    If you wish to learn more about our program and even become involved in some way, we would love that. Clearly, you get it; you have the heart and awareness that is so important for these families and their doulas. Parents do NOT get a ‘do-over,’ so everything that happens during the time of preparing, birthing, and saying goodbye matters. EVERY doula should be well-trained and prepared to be an expert in this arena. Either that, or they ought to have a Loss Doula colleague to be on call when the bad news comes that a baby has died or will die. We can offer those partners through our Baby Loss/Perinatal Loss Doula program.
    Thank you!
    Sherokee Ilse, Co-founder, http://www.LossDoulasInternational.com
    Author, Empty Arms: Coping with Miscarriage, Stillbirth, and Infant Death
    International grief and loss speaker and trainer

  2. Sherokee, I would be honored to have this article and a link to my site posted on your website. I read Empty Arms years ago, and greatly respect your work. Thank you for reaching out to me. It sounds like you have a great doula training program going on, and I’m happy to be a part of offering encouragement and support to others who are also doing this work.

    Be well,
    Jodi

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