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What is a bereavement doula? How we support families through lethal pre/perinatal diagnoses


The majority of people go into parenthood oblivious to the millions of ways a pregnancy can go wrong. Even if they know someone who has experienced miscarriage, stillbirth or the loss of an infant, its never something they could imagine happening to them.


While 2% of all pregnancies receive a life-limiting or uncertain fetal diagnosis, you would be astounded to know the actual number of families in our community (and worldwide) who are told “I’m sorry but this isn’t a viable pregnancy” by their medical care providers. Many of these conversations are occurring between 12-22 weeks during routine medical testing for genetics or the 20 week anatomy scan. These conditions could be genetic, congenital or life threatening to the gestating parent. Nearly all of the time, there is nothing the parents could have done to prevent the diagnosis and often times, there is no answer as to why this is occurring to their precious baby.


Families are then consulted to develop a plan going forward. The majority of our families are highly encouraged to terminate but provided very little resources on supporting the physical, emotional and spiritual toll it will have on both parents. Additionally, we know that while a sensitive topic globally, termination of their pregnancy is simply not a viable option.


Regardless of what our families choose, we support them in their decisions and can provide support to ensure their wishes for them and their baby, no matter when birth occurs is granted to the best of our ability.


Most are familiar with the word doula as it relates to supporting birth. Doula is a Greek word that translates to “mother’s servant”. As Bereavement Doulas who specialize in supporting perinatal families, our role is to provide comfort, validation and valuable resources for families as they work through the fog of grief, consider what is important to them and for their baby and come to an acceptance of this unfortunate situation. This fog of grief is similar to those experiencing stillbirth or a NICU loss, just on a different time frame. Three Little Birds has 15 trained volunteer bereavement doulas available across the region to support families directly.


Through our Palliative Care Program, families in our service region can reach out to us for information on our program and where else in the region they can find support specific to their diagnosis and preferences for care. We usually start with a personal consultation where we discuss the situation, listen to your thoughts and feelings, offer opportunities for families relating to prenatal bonding and preparing for birth, as well as provide up to date, useful resources for families to plan and make confident choices for their babies if/when they pass away. Equally as important is considering the plans for older siblings to be involved in these delicate moments.


While it may seem unusual to plan to welcome a baby who is expected to pass away, for families in these scenarios, they can assure you, having to consider hospice care, burial options and leaving the hospital empty armed is something no one EVER considers an option for their baby. Especially, if there is no prior indication of complications.


What is not unusual is the sacred love between parent and child that transcends death. Initially, our families are hesitant in considering our services because it just seems so impossible. After a few weeks of grieving and researching, they usually have an idea of how they want to make the most of the time they have leading up to, during and postpartum.


We have supported families whose babies were ultimately stillborn. We have held space and facilitated memory making and bonding with families at the time of birth when time is the most precious. We have even been fortunate enough to support families who were expecting the worst, but did in fact, take home a living baby despite their diagnosis. The truth is, you never know what will happen.


Therefore, regardless of a family’s choice, we support them. The services below are provided to families if they carry to term or if they terminate. Some of the offerings from our program include:


  • Complimentary Maternity Portraiture through Image is Everything Studios – For families walking this journey of uncertainty, Three Little Birds Co-Founder Desiree Miller, offers families a complimentary maternity portrait session, to include other family members in marking this delicate/special time. This is a special way to incorporate siblings, aunts/uncles, grandparents and other loved ones in your support circle and memory making.

  • Complimentary 3D/4D Ultrasound at Wondertime, LLC – Families supported by our Palliative Care Program are also provided a complimentary 3D/4D Ultrasound with our Program Sponsor, Glenda Barachko at Wondertime. This offers a non-clinical space for you to see your baby and allow other family members to spend time with baby prior to delivery.

  • Peer matching with other parents in our nest based on condition or where they live. We have found the families in our nest who attend support groups and events are empathetic and supportive to new families walking similar journeys and are always willing to listen, lend support and validate.

  • Bedside support – While our doulas do not provide active doula support while birthing, we do support the family bedside immediately after birth with memory making and bonding. Many of our families get more time with their baby than they were initially expecting which allows us to support families with other wishes for their baby such as taking them outside in the sun, breastfeeding, and sibling involvement. We have had dads dance with their babies, mom’s dress and accessories them and read stories together as a family.

  • Remembrance Portraiture – Our trained Bereavement Doulas quietly capture the love of a family through semi-posed and candid photos. Many of our families proudly share these images on social media and many of them print them to be included in their homes as a reminder of their presence in their lives now and going forward. You can read more about the importance of perinatal bereavement photography here. While all of this seems impossible to most people, this is the reality of their parenthood with their child. These moments are captured on photo and video and while it may take them some time before they are able to look at them, they are always grateful for our support in giving them the worst possible experience on the worst day of their lives.

  • Mira’s Banners of Love Gift – Our founding legacy project, Mira’s Banners of Love, was created by her parents Alison and Joe Ferrara. They received a life-limiting diagnosis for their daughter, Mira, and had an unfortunate experience with her care team. They highly encouraged them to terminate, however, her parents felt certain that their path was to carry her to term, deliver her and parent her regardless of the outcome. The medical care team lacked empathy and one particular doctor adamantly refused to refer to their daughter by her given name and only referred to her as a fetus. This enraged the Ferrara’s. Finding inspiration in her name, they decided to create a banner with her name to be included in their maternity portraiture session. After saying hello and goodbye to Mira and working through their grief, the Ferrara’s wanted to give that same gift of validation from a peer through creating name banners for other families. Mira’s banners of love have been included in dozens of sessions and are each uniquely crafted to capture the essence of the family and their love.


  • Lending library of support books – Thanks to the generous donation of families in our nest and our community, we have more than three dozen different perinatal grief support book options for families to borrow as they explore their grief.

  • Nest of support – After families leave the hospital and return home to figure out a “new normal” they know there is a nest of empathetic hearts waiting for them; many of whom have had similar journeys. This includes our monthly in-person and virtual support options, our signature events as well as the opportunity to create a legacy project in their baby’s memory that brings awareness and/or funds to support Three Little Birds mission.


These services are provided at NO COST. Additionally, we do not solicit the families we support for donations. No one should have to worry about paying for support. Our Program Sponsors also provide their services on a volunteer basis to help offset the unexpected financial burdens families experience.


If you would like to support our program, please see the information below. Tax deductible donations can be made here.






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