STILL BORN as part of the birth plan

[BirthLove]

Hey there ladies,

While getting ideas on re-doing my birth plans I came across the list for birth plan stuff in The Birth Partner. The section on Stillborns made me a little uncomfortable, I am wondering how many of you include this discussion, and how you go about doing it. I feel that it is important, but I can't imagine that people want to talk about it, or that it is very comfortable.

THanks!

[AmandaB]

Honestly it is an important discussion but an inappropriate one with clients who are fully expecting a living breathing child. I would never and have never had "in case your baby dies" conversation with clients. Unless it is known that the baby may not survive the birth or will pass shortly there after then a plan of action before hand can be put together. But to do that with every client is not appropriate as that just implements unnecessary fear into the birth. I am sure for the Doulas here who have witnessed the loss of a baby (either personally or professionally) there is no one way to prepare or to anticipate reaction. As a Doula it is best to have resources on hand and that knowing that death is a part of birth you will be well equipped if a tragic situation for your clients occur.

[BirthLove]

Thanks.. I think the same thing. I was thinking that this was a conversation to be had between the mother and actual partner, not the doula. And there are sections of this part of the birth partner only for the people intimately involved with the mother, but thought that I would get a second opinion.

[happydoula]

Quote:

Originally Posted by AmandaB Honestly it is an important discussion but an inappropriate one with clients who are fully expecting a living breathing child. I would never and have never had "in case your baby dies" conversation with clients. Unless it is known that the baby may not survive the birth or will pass shortly there after then a plan of action before hand can be put together. But to do that with every client is not appropriate as that just implements unnecessary fear into the birth. I am sure for the Doulas here who have witnessed the loss of a baby (either personally or professionally) there is no one way to prepare or to anticipate reaction. As a Doula it is best to have resources on hand and that knowing that death is a part of birth you will be well equipped if a tragic situation for your clients occur.

I agree with this 100%. Unless there's a reason to believe otherwise, I don't think it's necessarily a good idea for moms to be thinking about their baby dying. If something did happen, then I do know of resources that I could suggest/ give them options.

[WestsideDoula]

I have a friend who's family has a history of still births. They don't even have baby showers until after the babies are born. That said, I wouldn't bring it up on my own. But I do have the names of some grief counselors that specialize in families who have lost children. If I ever have the misfortune of attending a stillbrith, I would give that information to the family after the fact.
I also gave that name out when a mom called me for an interview and told me that she had miscarriage at 20 weeks with twins.

[doulafava]

I think women *are* thinking about their baby's dying, even if they aren't talking about it.

When I do a fear release exercise with folks, they very often choose this fear to work with. like 9 out of ten times. It seems everyone feels better for it afterward. Our culture makes it taboo which I'm not sure helps anyone. For me, personally, I liked acknowledging the fact that pregnancy and birth are fairly fragile times. Infant mortality may be at a low point in our history, but it happens. I think pretending like it doesn't makes it seem even scarier.

I don't really think I plan to bring it up with all my clients, mostly because it is such a taboo, but I like creating space for people to talk about it if they choose to.

3rd trimester infant death and stillbirth are really not that uncommon. In my relatively small group of friends we have lost 4 or 5 babies.

[momof ten]

As a mom who has had a still born baby I just can't imagine EVER talking about this ahead of time with my clients. I am very open about my experience and have counseled women in the same situation; so it is not that I don't feel like I could deal with the situation. I just feel like it is an innappropriate conversation for me to have with clients in the birth plan part of planning. It doesn't matter HOW you think you will react in this situation; you can't plan for it. Shock will smack you in the face and you will need all the help you can to get through it. A good doula would offer support, listen, and offer options to mom (help with burrial arrangements, calling family members, take pictures of the baby, etc.) and keep her own emotions on a leash (there is a time later for you to fall apart about it; you need to be there for the mom and dad).

I don't care who says to do this, even if Penny Simikin is the one (and I love her stuff). You won't see me bringing it up....moms already have so many fears walking into the labor room. I am not even going to entertain this one.

[chloe2326]

I guess I'm in the minority here - I do talk about this with my clients and was advised to do so in my training. It is a taboo and definitely an area to tread lightly upon, but I do think it's important. Mostly likely mom and dad have had "what if" thoughts and perhaps didn't feel comfortable sharing them. This can also be a way of validating their concerns.

What I do is after we have talked about/drafted the birth plan, take a moment to give them a short list of considerations/questions that they can discuss on their own...or put aside if they want to and never look at them...or involve me in the conversation as they feel comfortable. I don't load them up on information about grief and mourning or anything like that - but more thoughts about would they like to dress baby, or photograph baby, and most importantly - is there a spiritual or religious or personal support person that you would like called...things like that. Again if mom and dad aren't comfortable or aren't interested I don't force the issue. In all things, it's the parents that set the tone and agenda - not me.

[raeben]

i have a very through birth plan worksheet that i have all the families do between our first and second prenatals. the last section is a category about unexpected events -unplanned c-sections, baby taken to nicu, problems with mom or baby, baby born with disability, and stillbirth. i go over the worksheet briefly when i give it to them and with the unexpected events section i tell them, if its too intense or you just don't want to put any energy into thinking about parts of it, then you are welcome to skip that section but i think it can be good to briefly think through all possibilities. sometimes it does open up a good conversation about fears and can be an opportunity to face some of their tigers. if not, i just gently let them know that i have lots of resources available and that i can hold that space for them if they don't want to think about it.

[DL]

Quote:

Originally Posted by AmandaB I am sure for the Doulas here who have witnessed the loss of a baby (either personally or professionally) there is no one way to prepare or to anticipate reaction. As a Doula it is best to have resources on hand and that knowing that death is a part of birth you will be well equipped if a tragic situation for your clients occur.

Well said, Amanda.

Quote:

Originally Posted by momof ten As a mom who has had a still born baby I just can't imagine EVER talking about this ahead of time with my clients. I am very open about my experience and have counseled women in the same situation; so it is not that I don't feel like I could deal with the situation. I just feel like it is an innappropriate conversation for me to have with clients in the birth plan part of planning. It doesn't matter HOW you think you will react in this situation; you can't plan for it. Shock will smack you in the face and you will need all the help you can to get through it. A good doula would offer support, listen, and offer options to mom (help with burrial arrangements, calling family members, take pictures of the baby, etc.) and keep her own emotions on a leash (there is a time later for you to fall apart about it; you need to be there for the mom and dad). I don't care who says to do this, even if Penny Simikin is the one (and I love her stuff). You won't see me bringing it up....moms already have so many fears walking into the labor room. I am not even going to entertain this one.

I know it's redundant to quote your whole post, but I wholeheartedly agree. I've not had a stillborn myself, but the very first birth I ever saw (other than my own) was a stillbirth.....when my sister had her stillborn baby. Me attending my stillborn niece's birth was what drew me into becoming a doula. Having had that experience, I won't bring it up to the parents, either, unless they bring it up to me first. If it were to happen to any of my clients, then I know what to do to support them. I do have a "Taming Your Tigers" (or something similar to that title) handout that is included in the educational binder. If they read that and want to bring stillbirth/early infant death up to me, then that is fine. Otherwise, I'm not initiating that topic. Them discussing it will not really prepare them, and unless those parents are the type that need to talk in order to lessen the fear, then I see no reason to mention it . ETA: I know that not everyone needs to talk in order to lessen a fear (I know that I'm not that way nor is my sister).

[DoulaCBE]

Quote:

Originally Posted by doulafava 3rd trimester infant death and stillbirth are really not that uncommon. In my relatively small group of friends we have lost 4 or 5 babies.

Really? I've been a doula for almost 10 years and I've been a part of a large doula practice serving over a hundred clients a year and in all the years I've been a doula I've never had a stillbirth and I've only heard of two from our practice. We've lost one mother.

[sunshine]

Quote:

Originally Posted by doulafava When I do a fear release exercise with folks, they very often choose this fear to work with. like 9 out of ten times. It seems everyone feels better for it afterward. Our culture makes it taboo which I'm not sure helps anyone. For me, personally, I liked acknowledging the fact that pregnancy and birth are fairly fragile times. Infant mortality may be at a low point in our history, but it happens. I think pretending like it doesn't makes it seem even scarier.

can you describe more about how you do this? i like this idea a lot, do some work w/ fears myself and i'm curious if you might be willing to share in a new thread or PM me.

[sunshine]

Quote:

Originally Posted by Doula Lori I do have a "Taming Your Tigers" (or something similar to that title) handout that is included in the educational binder. If they read that and want to bring stillbirth/early infant death up to me, then that is fine. Otherwise, I'm not initiating that topic. Them discussing it will not really prepare them, and unless those parents are the type that need to talk in order to lessen the fear, then I see no reason to mention it . ETA: I know that not everyone needs to talk in order to lessen a fear (I know that I'm not that way nor is my sister).

i think that the two basic choices people are talking about are 1. routinely bringing it up w/ clients, as part of birth planning or preparing for the unexpected, OR as a common fear. 2. listening as it comes up from the client, and then discussing, providing resources for it.

i take the 2nd approach, absolutely not shying away IF the couple brings it up, but not bringing it up myself. i try to create a space where these type of fears can safely be brought up if the couple wants to, so that they know from the beginning i am a safe person to share fears with and hopefully help them deal with them. i feel like i don't want to plant fears or bring fears to the surface if the couple is not wanting that. i do believe almost every single woman fears this on some level.

[DL]

It sounds like we pretty much have the same view on this, Sasha, but you said it much better. I am the "Queen of Ramble" afterall!

[sunshine]

Quote:

Originally Posted by Doula Lori It sounds like we pretty much have the same view on this, Sasha, but you said it much better. I am the "Queen of Ramble" afterall!

oh lori, i think we can share that crown.