Grieving Birth

Many years ago, I sat in a restaurant with a woman who poured out her heart to me over the loss of her child to miscarriage. Miscarriages are common enough, a sad part of the real world for women. When we hear of such a loss, what is our reaction? Sympathy? Compassion? Sadness? Would we ever think to say that she should be happy? Or that she maybe wasn't pregnant in the first place? Sounds crude to even imagine such a reaction. Yet those were exactly the reactions this woman had dealt with.

You see, her miscarriage was different than most. She gave birth to a healthy child at around 40 weeks gestation. He's alive and well today. But she was originally pregnant with twins and one of them died much earlier in that pregnancy. The response from her family and friends was mixed. Some offered tentative condolences, not quite sure how to handle the fact that she was still obviously pregnant. Some congratulated her that she had a healthy baby. Some thought she was crazy to believe she had ever been pregnant with twins.

Regardless of what everyone else thought or how they responded, one thing was certain: this woman had lost a child and needed to grieve. But how and when does that occur? How does a woman grieve a death and celebrate a life all at the same time? It is complex. It is confusing. It is real. In this case, I believe it took years for her to feel free to fully embrace the pain of her loss. How many women are never given the permission to acknowledge that grief?

In our day of advanced technology, women learn so much sooner that they are pregnant. Miscarriages that would have gone completely unnoticed because they occur so early are now officially documented. I read somewhere that a high percentage of pregnancies actually begin as twins, yet in most of those cases only one of the babies survive to term. Add to that the frequent use of fertility treatments that result in higher numbers of multiples, and it is clear to see that there are many, many women facing the conflict between the emotions of life and death.

Having a living, healthy child does not diminish the pain of the death of that child's sibling. Ask any parent who has suffered the death of a child at any point in life. The fact that a child dies in utero and hasn't yet been held and kissed and touched only means that those longed-for moments are also lost.

Do you relate to this story? I encourage you to embrace the grief. Give yourself permission to feel it fully and allow yourself the time to heal.

All In A Day's Work

A Day’s Work: Heidi Gonzales and Heidi Rau
by Emilie Bahr

Posted: Friday, February 15, 2008

Heidi Gonzales and Heidi Rau share a name and a passion for the birthing process; they are doulas — professionals who assist women before, during and after labor but do not deliver the baby. If you’ve never heard of a doula you’re probably not alone. Although women have been assisting in births for as long as women have been having babies, the idea of hiring a professional is creeping into vogue, at least in the New Orleans area, Gonzales and Rau said. A doula is not the same thing as a midwife, who often is certified to deliver babies and, in the case of some certified nurse midwives, can even prescribe medicine. Gonzales is in her second year of training to become a midwife, a process she expects to take five years. Doulas offer emotional support and advice and calm the patients during labor. They instruct in techniques some believe can shorten labor and lessen pain. The women also help soon-to-be mothers craft a birthing plan — a guide kept in their medical file that includes what type of laboring methods they prefer and what drugs, if any, they want to rely on, when they want to begin breastfeeding — and help ensure their wishes are honored. “We’re there really as educators and supporters,” Rau said. Many of Rau and Gonzales’ clients are first-time mothers confronted with what can be a confusing and intimidating process. Others have used a doula for a previous pregnancy and can’t imagine labor without one, the women said. Life as a doula can be stressful. Much like an obstetrician, doulas can face around-the-clock call and lengthy labors. “It’s one of the professions that you have to be dedicated to,” Gonzales said. But “it’s a privilege” to be so intimately involved in the birthing process. Over the past few years, Gonzales and Rau, who recently formed a business partnership, said they’ve noticed an increased demand for their services. It’s a result they attribute in large part to media attention, the increased presence of doulas and midwives on various cable baby shows and a renewed emphasis on natural birthing practices. Today, Gonzales and Rau each assist in anywhere between 40 and 60 births per year. The women have worked in just about every hospital in the city and say their presence in the birthing room is no longer viewed as extraordinary. “When you walk into a hospital, people are no longer asking, ‘Who are you and what are you here for?’” Rau said. Nurses are often thankful for a doula’s involvement, she said, particularly because women who labor naturally often require more attention. One thing typical of any woman who enlists a doula’s help, she said, is that “she wants to be in control of the birthing process.” Gonzales and Rau estimate there are about a dozen doulas in the metro region. Gonzales started her practice, Mommies Matter, after Hurricane Katrina. She was in her 11th year in the Navy at the time. “I wanted to be a part of birth in the city,” she said. Rau, a part-time office administrator and editor, began Choices in Childbirth in 2000. She turned to the profession based on a desire to get involved in maternity education. “I wanted to dispel a lot of the myths that are propagated about delivery and birth,” she said. Rau described her standard client as on the higher end of the educational and income spectrums while Gonzales has often worked with teen mothers. The standard cost for a doula runs between $500 and $1,000, a fee often paid out-of-pocket, Rau said, though some insurers are beginning to cover part of the cost. Doulas often become closely connected to their clients, the women said. “There are certain ones that you become a part of their lives,” Rau said. “I’m not Aunt Heidi, I’m Doula Heidi for some of them.”•