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Tips for Supporting Doula Clients Who Have Experienced Loss or Miscarriage

Lyani Powers | October 12, 2021

I remember the look on the tech’s face when the ultrasound popped up on the screen… no heartbeat. I knew immediately, but my husband didn’t. I sat there feeling emotions swell and writhe, but on the outside, I was completely frozen. The doctor came in and I remember hearing the pained cry of my husband as he received the news that I had already begun to wrap my head around. The baby was gone and nothing would ever be the same.

I grieved and mourned and some time passed. It was different, I was different, and as I headed into my next pregnancy, the experience was different. I didn’t trust that “everything was going to be alright.” I held my breath a little at every ultrasound. I became obsessed with trying to hear the heartbeat with gadgets and cellphone apps.

I needed guidance on how to reestablish trust in my body’s abilities. I needed tools to help when I started to spiral into intrusive thoughts. I needed to be reminded to celebrate and enjoy my pregnancy. I was focused on the goal of bringing my child into the world. Yet, even on his safe arrival, I didn’t fall immediately in love. I was still in survival mode. Was he breathing alright? Was the latch correct? The stakes felt so high for everything. My loved ones lacked the tools to help me. Instead, they said all the wrong things. I was too busy obsessed with ensuring his survival to allow myself to melt into him. It wasn’t until around his third month that it felt safe enough to fall hopelessly in love with my son.

Based on my personal experience and the support I wish I had, here are the tips I will share with my doula sisters when it comes to caring for a rainbow baby mama, from pregnancy and into postpartum.

During pregnancy:

  • Help re-establish trust in the body’s ability to carry the pregnancy.
  • Give mantras to repeat or place in plain view. Help them connect with whichever beliefs system they follow for added strength.
  • Send encouraging texts or suggest they sign up for an app that can message them positive thought starters to interrupt intrusive thoughts (“I am” is a great one).
  • Reassure what happened before is not guaranteed to happen again.
  • Don’t say potentially triggering/insensitive things like “your baby is now an angel,” “it was for the best,” or that “this new baby will replace the lost one,” etc.
  • Honor their pace and don’t let them feel judged for their grief.

Postpartum:

  • Once the baby arrives, remember they may still be in survival mode.
  • Watch for any feeding issues.  If feeding doesn’t go as planned it can lead to them revisiting the negative dogma that they are failing at something they “should” be able to do.
  • Be vigilant with mood support. They may be grieving the lost baby and celebrating the new one simultaneously.
  • Suggest as much skin to skin as possible. It will boost oxytocin and the physical connection can be reassuring.
  • Not knowing how to do something can be a trigger. Especially, if it is something that they thought would innately and easily just happen.
  • Remember the base of their emotion may be helplessness. It’s not only that they fear their baby might die but that they are aware that they have no control and that can be a scary place.
  • Be an anchor and sounding board for the fears they won’t share with others (within scope).
  • Check-in on them. If it’s wanted, consider arranging a small symbolic gesture or ceremony to honor the first baby.
  • Research local or virtual pregnancy loss support groups and hotlines so you can offer materials and resources at the first sign of them needing additional assistance.

There are a lot of emotions that may spring up in this dynamic with your client. They may feel that it is only acceptable for them to feel joy and push down and suppress any other feelings. I am reminded of the listening exercise from my Mama Glow doula training, where we practiced how to sit and hold space without needing to fill up the silence. You don’t have to have all the answers. Just being a nonjudgmental ally and positive presence in their life can make an impactful difference in their postpartum experience.


Lyani Powers is a clinical herbalist, full-spectrum doula, lactation consultant, urban farmer, and beekeeper. She is the founder of Modern Herbal Apothecary: a clinical herbalist practice, bulk herb apothecary, and micro-farm. She dedicates her work and time to creating practices and products to support wellness for all families. Her key focus is holistic postpartum care specifically, helping mothers curate their healing golden month. She is a certified Clinical Herbalist and an ALPP Certified Lactation Consultant. She is trained and certified in Ayurvedic Postpartum Practice, Herbalism in the Tradition of the Southern Black Midwives, the Indigenous ceremony of A Cerrar de Las Calderas, and is a certified Peristeam Facilitator. She currently lives in Tampa, Florida with her husband, three sons, and bulldog.

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