When you’re pregnant after loss, one of the things you will likely need most is support. And that support can come in many ways — a partner who listens to your fears, a friend who drops off a meal, or possibly a doula who answers your questions about giving birth to a rainbow baby.

pregnant woman - What is a Doula and Do I Need One for my Pregnancy and Birth After Loss?

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Originating from the Greek for “servant,” the word doula might conjure up thoughts of an unmedicated home birth in a pool of water with twinkle lights strung across the room. While a birth doula certainly can (and does!) provide support in this environment, doulas are actually trained to serve pregnant, birthing, and postpartum people in all settings, including hospitals, birth centers, and homes.

At the foundation of everything a doula does is serving. That means doulas serve families through all types of pregnancies and births, including those that happen after loss, whether unmedicated or medicated, pelvic or surgical[1]“Having a Doula – What are the Benefits?” American Pregnancy Association, April 25, 2019, https://americanpregnancy.org/healthy-pregnancy/labor-and-birth/having-a-doula-616/. So, how do you know if hiring a doula is right for you? Read on to learn about the doula’s role and how it can help parents expecting after loss.

What Is a Doula?

A doula is an individual who is trained to provide continuous informational, physical, and emotional support for families during pregnancy, birth, and postpartum[2]“What is a Doula,” DONA International, https://www.dona.org/what-is-a-doula/. While labor and birth doulas are the most common, there are actually several kinds of doulas.

Antepartum Doula

Antepartum means “before birth.” Therefore, antepartum doulas offer support to expectant parents. For example, a doula might serve pregnant people with severe morning sickness, single parents, pregnant teens, and folks with high-risk pregnancies, including those who require bed rest.

Birth Doula

During labor and birth, doulas provide non-clinical support in various settings. This might mean suggesting positions for coping with pain or giving verbal encouragement during a C-section. They can also provide comfort measures, like massage, acupressure, and aromatherapy.

Postpartum Doula

Postpartum doulas support the family following the baby’s birth. Services depend on the family’s specific needs, but postpartum doulas are knowledgeable about postpartum recovery, lactation, and newborn care. They also might hold the baby while you take a shower, prepare a healthy meal, or fold your laundry.

Bereavement Doula

Sometimes called a loss doula, a bereavement doula helps families who are experiencing the loss of a baby. This includes miscarriage, stillbirth, or a diagnosis that means the baby will not live long after birth[3]“When the Baby Dies: Advice for Birth Doulas who Companion the Bereaved,” Star Legacy Foundation, https://starlegacyfoundation.org/baby-dies-advice-birth-doulas-companion-bereaved/.

Sibling Doula

Sibling doulas focus on supporting older children as their parents are ushering new life into the world. This can mean helping parents prepare siblings for a new baby as well as caring for and playing with older children while parents are at the birthing facility.

Some doulas offer multiple services, while others focus on one specific area. And while all of these services are important, we want to further explore the reasons you might consider partnering with a birth doula, especially when pregnant after loss.

What Are the Benefits of a Birth Doula?

When you hire a birth doula, you will build that relationship during your pregnancy over the course of a few virtual or in-person meetings. Your doula will ask about your hopes for your birth experience. She can help you articulate your birth preferences and determine whether those align with your provider and birthing facility. Depending on your previous prenatal and birth experiences, you may have specific concerns about things going wrong or ways you’d like to redeem your past experiences with pregnancy and birth.

No matter what type of birth you are planning, it’s important to understand that doulas offer support that is not clinical. During labor and birth, physicians, midwives, nurses, and birth assistants perform regular checks to make sure you and your baby are safe, but they do not stay with you for the entire duration of your labor. Your doula is your right-hand person during labor and should not be viewed as “icing” or “gravy.”

Research has shown there are many benefits for birthing parents when they have a birth doula[4]“Continuous support for women during childbirth,” Meghan A Bohren et al., Cochrane Database of Systematic Reviews, July 6, 2017, … Continue reading. These include the following.

  • Less medical intervention during labor
  • Reduction in the cesarean birth rate
  • Decrease in the total length of labor
  • Less use of synthetic oxytocin
  • Decreased need for forceps delivery
  • Increased likelihood of spontaneous vaginal birth
  • Lessened risk of a low five-minute Apgar score
  • Higher parental satisfaction with the birth experience

Do I Need a Doula for My Pregnancy and Birth After Loss?

Only you can decide if hiring a doula is right for you, but many loss families find a doula’s services to be incredibly valuable. Doulas are trained to view pregnancy and birth as normal, physiological events, not medical emergencies. But many times, those who are pregnant after loss struggle with distrust in their body’s ability to carry and give birth to a live baby. This is understandable, and a doula can remind you that everything is progressing normally and it’s highly likely that you will deliver a living child.

In some cases, especially after a stillbirth, the healthcare team might recommend inducing labor. You might wholeheartedly agree with that choice, or you might have reservations about induction, especially if you are planning an intervention-free birth. Your care should be individualized. If you find yourself feeling like you are being lumped into a one-size-fits-all approach, consider finding a new provider. This is something a doula may be able to help with. Many doulas have extensive knowledge about providers and birthing facilities and can assist you with selecting one who respects your wishes.

No matter the situation or setting, a doula can walk with you through tough experiences. For example, if the baby you lost was delivered by C-section, just the sight of an operating room might be a trigger for you. If your previous birth was eerily quiet because there was no baby crying, a delivery ringing with the sound of a newborn’s wail, while joyful, might also be a painful reminder of loss. Doulas are trained to support you through these types of experiences.

Finally, doulas offer objective guidance. They are there for you, but they don’t have the deep emotional connection that a family member has with you[5]“Evidence on: Doulas,” Rebecca Dekker, PhD, RN, Evidence Based Birth,  May 4, 2019, https://evidencebasedbirth.com/the-evidence-for-doulas/. In fact, doulas often step back and suggest positions that keep partners close, helping the birthing parent to feel safe and loved. This is beneficial during all births, but it’s especially important when welcoming a baby after loss.

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