Stillbirth is Still Birth - a doulas perspective on pregnancy loss support

As humans we hold life and birth, but we also hold death.

This is an inescapable part of being alive and it's something I wish people felt like they could talk about more. It's taboo to even tell people you're pregnant before you get to twelve weeks (the window in which you are most likely to experience a pregnancy loss) meaning if it does happen people often go through it alone and unsupported.

I ask myself, why is this?

Is it so that other family members don't have to feel uncomfortable hearing about it?

Is it because people feel some shame around the idea of pregnancy loss and that they would be somehow to blame?

Is it superstition?

Is it just 'how things are done' in our society.

Whatever it is, it's not uncommon. Most people will either experience it, or know someone who has, and yet its whispered about as if it's the biggest taboo.

As a doula, I recently had the privilege (and yes I still see it as a privilege, although obviously it's not the outcome anyone wants, it's still an honour to be invited into such a sacred space) to support one of my wonderful clients through the stillbirth* of her baby, at almost 20 weeks gestation.

*Before 24 weeks the loss of a baby is technically defined as a miscarriage, but I think anyone sensible would agree when you are still having to go through contractions and actually give birth, the word miscarriage just doesn't seem to cut it. It's not for me to define it for anyone else, so if you have been through it, of course, use whatever terminology aligns with you and your experience.

Of course I won't be sharing specifics about my clients story as it's not mine to tell, but I can share some insights from a birth support perspective. I was struck by the grace, calm and strength of my client, and by her support system - her family were by her side, steadfastly throughout the whole experience.

From a doula support perspective, of course the atmosphere is different, but much of my care remains the same. A big part of my role is holding space for whatever emotions arise during birth, and using my instincts to react responsively to what is needed in each moment. I am there for the highs and the lows, the births and the losses, and everything in between. To serve, to witness, and to support people, through some of the most profound, transformative, devastating and beautiful experiences.

My hope is that this might be helpful to anyone who is experiencing pregnancy or baby loss or supporting someone who is.

Firstly, you didn't cause this

It is incredibly common to blame yourself, and in many ways this is a normal part of the grieving process. But I'm here to tell you: you did not cause this to happen.

There are many reasons why pregnancy loss can occur. Sometimes there are congenital abnormalities that mean a baby would not have survived, or would have faced significant lifelong challenges. Sometimes there are medical complications that nobody could have predicted or prevented. And sometimes, despite investigations, there is simply no clear explanation.

What I do know is this: you did not cause this by being too active, drinking a glass of wine before you knew you were pregnant, lifting your toddler, working too hard, or feeling stressed.

You are not to blame.

You still need support

Depending on your gestation, the situation may look very different. Earlier in pregnancy, you may be more likely to be at home, while later in pregnancy you may be navigating hospital care and medical management.

Whatever the circumstances, you still need support.

Just because your labour does not end with a live baby in your arms, does not mean you don't deserve to be held, seen, nourished and cared for. If anything, these things may be even more important when navigating loss.

If you have friends and family who can support you, I encourage you to let them know what is happening and, where possible, be specific about what might help you. People often want to support but just don't really know how. If you have family who might not be so good with the emotional side of it, rope them in to help with practicalities.

If you already have a doula (and this is one of the benefits of booking doula support early in pregnancy), they can continue to guide and support you through this experience too.

There are also a number of local and national organisations that can offer practical and emotional support, which I'll share later on.

You may need to navigate decisions and medical care

If you are navigating medical management, you may find yourself being asked to make decisions about which pathway feels right for you. There shouldn't be a one-size-fits-all approach, and options can vary depending on your individual circumstances.

It can be helpful to ask questions, take time where possible, and seek additional perspectives so you can make decisions that feel informed and right for you.

If you are being recommended a particular medical pathway, here are some questions that may be helpful to ask:

• Why is this being recommended?

• What are the risks and benefits involved?

• Are there any alternatives?

• Can we have some time to think about this decision?

• Is it possible to seek a second opinion?

• Can you talk me through exactly what to expect over the next hours or days?

Support can make a significant difference in these moments. Having someone with you who is not directly part of the clinical team or as emotionally involved as family members, can help you feel more confident and help you gain the knowledge to make informed decisions that feel right for your unique situation.

Nourishment is key

Your body is going through a great deal, and it’s really important to support the process with nourishing food and regular hydration where possible.

If you are in hospital, you may be cared for on a bereavement suite. Unlike standard labour wards, these often have access to a small private kitchen area with a fridge and microwave.

If you are able to, ask someone to bring in comforting food (ideally home cooked) that can be easily reheated as needed. Obviously hospital food is not the most nourishing, so having access to your own snacks, fruit drinks and familiar comforting meals and drinks can make a real difference in helping your body through the process.

Environment matters

If you are in hospital, the environment is usually fairly clinical. LED tea lights or fairy lights can be really helpful at making it feel more cosy and calm. Equally any other home comforts, comfortable clothes, things to distract you/watch and help pass the time can also be really helpful.

Time with your baby

Depending on how far along in pregnancy you are, you may be offered time with your baby after they are born.

Please know that you do not have to make any decisions in the moment. Some people choose to have their baby taken, clothed and cared for by the hospital before deciding whether they would like to see them. The hospital can usually keep your baby cool and cared for for the hours and days that follow, while you decide what feels right for you.

There is no right or wrong way to approach this. It is entirely about what feels right for you and your family in that moment. You may also find that you and your partner feel differently, and it is completely okay if one of you chooses to spend time with your baby while the other does not.

I would also gently encourage you to consider having photographs taken, even if you are unsure whether you will ever look at them (many hospital trusts offer this as standard practice). These images can be safely stored for you in case you ever want them in the future. You will usually also be offered keepsakes such as hand or footprints, and you may wish to leave something of yours with your baby, such as a special blanket or teddy.

This is a deeply personal experience.

Take your time, and allow yourself as much grace and compassion as you possibly can.

Rest and recovery

After you have given brith, your body is still postpartum, even if you don’t have a baby to care for. It will still take time to heal and recover physically, and the emotional healing process may take much longer.

Try not to rush back into “normal life.” In many ways, the same principles of rest after birth can be helpful here: a week in the bed, a week around the bed or sofa, and a couple of further weeks prioritising rest, nourishment and gentle recovery.

This kind of rest is often more straightforward to access after a loss at 24 weeks or later, as you should be entitled to maternity leave. Unfortunately, in the UK, there is currently no guaranteed bereavement leave for pregnancy loss before 24 weeks (which is absolutely unacceptable in my opinion). In these situations, people may need to rely on sick leave or, in some workplaces, discretionary compassionate leave. It is always worth speaking to your employer or HR department if you have one, to understand your options.

Your support network will come in really handy here, you may need care for other children or pets, someone to bring you food or help with practical household chores. Don't be afraid to ask for help, and be specific about what you actually need. Women are normally so used to just getting on with things, without asking for help, but if there was ever a time to let someone else take some of the load- it's now.

Partners and support people

Partners and other close support people are also deeply affected by pregnancy loss, but their experience can sometimes feel less visible or less supported.

Grief can show up differently for each person. Some may feel the need to talk and process everything, while others may go quiet or focus on practical tasks, but there is absolutely no right or wrong way to deal with loss.

It can also feel really difficult, and sometimes isolating, when you are both experiencing loss in different ways, or when you are trying to support each other while also navigating your own emotions.

If you are the partner or support person, you may find yourself wanting to “hold it together” for someone else, or unsure of what to say or do. Often, simply being present is enough.

Where possible, try to communicate gently with each other about what you need, even if that is as simple as space, quiet, reassurance, or physical presence.

Partners may also benefit from their own support, whether through friends, family, counselling or pregnancy and baby loss organisations. Their grief is valid too, even if it is expressed differently.

Where you can go for pregnancy loss or stillbirth support

There are several different local organisations you can contact, or that your hospital team will put you in touch with. Here are some that could be useful:

• Zephyrs - A Nottingham based charity that offers holistic care and support for families following pregnancy loss or the death of a baby or child

• Forever Stars - An east midlands charity dedicated to supporting families who have experienced stillbirth, infant loss and perinatal or neonatal death

  
  

• Tommys - A nationwide charity researching the causes and prevention of pregnancy complications, miscarriage, stillbirth and premature birth

  
  

• SANDS - A nationwide charity offering support for all kinds of pregnancy and baby loss as well as support for men, those bereaved a long time ago, TFMR, and those from black and south asian backgrounds.

  
  

If you don't already have a doula, I would also consider reaching out to some local full spectrum doulas. Many of us will offer donation based support for those going through loss, or can offer postpartum care afterwards.

Your experience matters.

I just want to end by sending you solidarity and love if you, or someone you know is going through pregnancy or baby loss. There is no single way to go through this, no right or wrong way to grieve, and no timeframe for healing.

You don't have to go through this alone and unsupported, you deserve to be held through this, in whatever way feels right for you. Sending lots of love, and a big hug if you'd like one.

Amy x