When Baby Dies—A Guide for Doulas

By Lindsay Dougal, CD(BAI), RYT

A sometimes hard truth to swallow is the fact that death is a part of life. Even harder to acknowledge is the truth that babies are among those who die. In the United States, 1 in every100 pregnancies end in stillbirth (fetal death after 20 weeks gestation)—roughly 24,000 babies every year.¹ Another 20% of pregnancies end in miscarriage (fetal death before 20 weeks gestation). And an additional 23,000 infants die each year before their first birthdays.²

These numbers are scary. These numbers also mean that there is a great likelihood each of us will encounter loss in our work as doulas and birth professionals. Because we are scared or feel ill-equipped, we may inadvertently silence those experiencing loss. It’s understandable. Pregnancy and birth is an exciting time in the life of a family. From the minute those two lines appear, we are new. We have hopes and dreams for the future of our children and our families. We tend to keep things light and happy, as we don’t want to consider the possibility of not bringing baby home—of losing that future with that child. For the great majority of families, baby is born healthy and makes that beautiful trip home. But for many families, loss is the reality. Silencing these outcomes brings stigma and limits opportunity for support.

So, what can we—as birth workers—do to support families experiencing loss? As both a bereaved mother and birth and bereavement doula, let me offer up seven practical tips for supporting families experiencing loss:

1. First and foremost, hold space for the expression of grief: Feelings associated with grief may not be shared if the person does not feel safe and supported. Let the family know you are willing to just be with them. Words may be spoken, they may not be. It’s important to be okay with either of these expressions, and not expect a certain reaction. Simply having a calming presence in the room means so much to a family.
   
2. Get comfortable being uncomfortable: I’ll be the first to admit death is uncomfortable. Many of us aren’t exposed to death until much later in life, and don’t know what to say or how to interact with those who have lost. Remember, you will be uncomfortable for a few hours; the grieving parents will live with some level of discomfort for the rest of their lives. Don’t shy away from offering love, validation, and support.

3. Labor and birth support: Physical and emotional support during the birthing process is so important. Try to make the birthing experience as “normal” as possible by offering encouragement. As appropriate, remind the birthing person of their birth preferences and help them understand which parts of the birth plan can still be fulfilled. If imagery, visualizations, and affirmations are used, make sure they have a positive tone and reflect the situation appropriately.

4. Encourage parents and family to bond with baby: Memories made in those few precious hours or days will need to last a lifetime. Encourage parents to hold baby, and to allow other family members to meet and bond with baby. Maybe they were looking forward to reading a certain story or singing certain songs to their baby. They can still do these things. Offer to take photos of the new family. Facilitate the creation of keepsakes (hair clippings, hand/footprints, molds of hands/feet, etc.). They may not want to see them right away, but there will come a day when they do. The hospital may have resources to help with some of this, so check with staff to see what is and isn’t available.

5. Use baby’s name, and congratulate parents on the birth of their baby: Bringing a baby earthside is hard work and deserving of congratulations and commendation, no matter the outcome. It may feel counterintuitive to congratulate, but remember that this baby is a beloved member of the family. You may say something like, “Arthur is a perfect, beautiful boy. He is so loved.”

6. Attend memorial service and/or celebration of life: If the family invites you to attend the celebration of their baby, go. You are one of a handful of people who met and beheld their child. That—in and of itself—means so much. Having you at the service adds another level of love and support. Consider taking a card or letter sharing your beautiful memories of the day baby was born.

7. Connect the family to resources: Educate yourself on the services for bereaved families in your community—grief support groups, postpartum depression groups, counseling services, children’s grief support providers, bereavement specialists, etc. Families may not be receptive to this information right away. Respect that space and be prepared for when they are ready.
   

The death of a baby is a profound loss, and it is important we recognize the need for families to mourn their babies. The loss of a baby is the loss of a person and a future. Every person grieves differently. As we learn more about the experience of loss and work on our own feelings and emotions surrounding death, we become better able to provide meaningful support during birth in any trimester and in any outcome. 

References:

1. “Facts about Stillbirth.” Centers for Disease Control and Prevention. Center for Disease Control and Prevention, 16 Aug. 2018. Web. 23 Oct. 2018.

<https://www.cdc.gov/ncbddd/stillbirth/facts.html>.

2. “Infant Health.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 31 Mr. 2017. Web. 07 Apr. 2017. <https://www.cdc.gov/nchs/fastats/infant-health.htm>.