On being a Bereavement Doula in South Africa

But what do you DO Nicci?”

I am an internationally qualified perinatal Birth & Bereavement Doula a seemingly complicated and/or unknown term that has people asking me over and over again: “So what is it you DO Nicci?” The simple answer is nothing, yet everything. Because in medical terms I do not ‘do’ much – although I have been the only one present in more births than I care to think about and pretty much did everything – from delivering the baby to cutting the umbilical cord and delivering the placenta! But as a rule of thumb I am not supposed to ‘do’. I am supposed to ‘be’. And that I try to do to the very best of my ability.

As a bereavement doula (I really don’t care for the term ‘death doula’) I provide support in situations of fatal perinatal outcomes and I comfort parents when a baby passes away. It is not a glamorous job. I clean vomit, blood, amniotic fluid and spilled apple juice. I make a client’s bed over and over again and fluff pillows and offer ice cubes, lip balm and hugs. I kick vending machines on behalf of a father who is desperately looking for a can of soda at 2 am in the morning and I beg gynecologists to give permission for more pain meds for a mom that is writhing in pain. I beg unit managers to allow a heartbroken father to ‘sleepover’ to be with his wife who is in labour (with their dead baby,) when it is against hospital policy and sleep is the very last thing I know he is going to do. I see raw pain and I hear the most agonizing, haunting cries you will ever hear in your life. And sometimes I hold a little body and that baby’s heart beats for the last time in my hands. It is not an easy calling, but I do it with great pride and love for my clients going through the unimaginable.

If I have to make a list of everything I do, it becomes quite an impressive list. But you see, I don’t like to do that. Make lists. Or write job descriptions or limit myself to a certain number of things I can/will/want to do. Because the reason I am a Bereavement Doula, the very reason I absorb so much of my clients’ pain and heartache, is very simple: I want to comfort as much as I can. I want to console broken parents and try to make the journey of the birth of their child bearable by being there, acting as a buffer between them and the cold medical world and cruel strangers who are so wrapped up in their own little worlds they do not think twice before inflicting pain on helpless, grieving parents. I wish I could say this does not happen often. I cannot…

Not one birth or miscarriage is the same. On that note, I really do not like the word ‘miscarriage’. Because nothing is ‘missed’ – whether you are 20 or 40 weeks pregnant, you go through the same labour pains – and everything is carried: Guilt, shame, grief, anger, fear… The Oxford dictionary offers two explanations for the word miscarriage: The spontaneous or unplanned expulsion of a fetus from the womb before it is able to survive independently; and unsuccessful outcome of something planned. I prefer the second definition. Because whether it is because of a baby dying in utero, a medical termination or a stillbirth, this encompasses pretty much what it is: An unsuccessful outcome for something that was very much planned, wanted and looked forward to. I don’t like the first definition because I don’t care for the word ‘fetus’. Let me explain why:

As ex-Director of a non-profit company called ‘the Voice of the Unborn Baby’ I fought for parents’ rights to choose whether they want to say goodbye to their child by having a funeral or cremation for them. Because of an archaic law on the South African law books, “fetuses” who are born before 26 weeks of gestation have to be treated as medical waste and are incinerated with needles, syringes, amputated limbs and other medical waste products. And the only way to get around this horrific law is for parents to make an affidavit to state that they need the ‘medical tissue’ or ‘placenta’ to bury for religious and/or cultural purposes. They also have to fill out a mountain of forms required by the hospitals to enable them to have the child removed from the hospital’s premises.

I have had to do too many of these affidavits and I cannot explain to you in words how much it aggrieves me to put my clients through this horrific conundrum of paperwork to enable them to give dignity and respect to their dead child. Yes, child. Because not once have I ever heard a parent speak about their ‘fetus’. No, they speak with much love and affection about their child, their baby, their angel – never ever, their fetus.

Being a Bereavement Doula in South Africa is not easy. Very few people know about this profession and time and time again I have to explain to a nurse or a doctor or a hospital manager what it is that I do. I obtained my International Accreditation as Birth & Bereavement Doula from Stillbirthday (SBD) University and I am hoping that this qualification will give people some peace of mind as to the level of professionalism and skill I have. But at the end of the day no one piece of paper can equip you to deal with raw, unadulterated pain and grief of a mother losing her child – of a dad losing his dream of being a father. No qualification can prepare you to hold a little body in your hands and feel life slipping away without you being able to do anything about it. No university can help you deal with your tears in the night after the fact, when you cry for a little life lost and for the pain of parents who will never ever forget. Nothing can prepare you fully for this job.

I wish you could be there. I wish you could see how I hold a mom’s hand whilst she is in the throes of childbirth. How I try to console an inconsolable father who does not have the know-how or strength to carry his own grief, let alone the mother of his child’s. I wish you could see how I comfort sobbing grandparents. How I clamp the cord, gently clean and wrap a precious little baby and take photos for families to keep as a reminder that their baby was born. Born still, but still born. The reason I wish you were there isn’t to hurt or harm you but I know if you could see what I do you would be beyond motivated to get the word out there that a job like mine exists! That parents do not have to face the daunting task of the birth of their stillborn or miscarried child alone. That they do have a voice. That someone cares!

It is my dream that my profession will be formally recognized and acknowledged in South Africa and that doulas’ services, like midwives, will be covered by all medical aids.

And because I have such a passion for this awesome career, I have developed South Africa’s very first Online Bereavement Training Program!! Click here to see more:

https://ncotdoulas.wordpress.com/ncot-online-training/

(For a doula in your area, visit www.dosa.co.za)