Being a US-based doula, it is easy for me to assume the general ways we practice as doulas are similar around the world. This 31 Days project gives me a dose of reality and shakes up my US-centric thinking when I read stories from doulas like Nicci. I wish Nicci and everyone like her the strength to keep supporting families, the courage to continue the uphill battle, and the heart to handle so much pain. The title for her post is also the motto for her bereavement training program -- thank you, Nicci, for allowing me to share your powerful words here.
My name is Nicci and I am a Bereavement Doula from Pretoria (Gauteng Province, South Africa), dealing exclusively with miscarriage, stillbirth and infant loss. I have been a "death doula" since 2015 and I am currently one of the most experienced bereavement doulas in the country.
Death humbles you. It leaves many wounded and scared (and scarred!) but also just as many people are awakened to the miracle and the fragility that is life. It opens your eyes to the absolute gift it is to breathe (and have those you love breathe) every single day. I deal with indescribable pain and heartache. My job is not an easy one, in fact, it’s probably one of the most emotionally challenging professions out there. But it is made bearable by knowing that I could help a mommy or daddy carry the load, even if it’s only for a little while. There is something unique about child loss. Because you don’t only lose a child you love, you lose the promise of that child’s life. You lose the "could have beens". You miss their first day of school. You miss their 16th and 21st and 30th birthdays. You miss out on every little thing that would have made that child "yours".
Like the character in the book The Shack, I carry The Great Sadness with me every single day of my life. Sometimes The Great Sadness is quite satisfied to sit in the corner of a room or on the roof of my car and just leave me alone – sometimes even for a day or two. Other days, The Great Sadness would just not let go of me. It will cling to me whilst I brush my teeth, when I feed the dogs, when I pray, when I speak to a telesales agent and decline a cellphone contract for the umpteenth time. It will rear its sad head when I walk in a shopping centre and see something or someone that triggers a memory. Sometimes when I walk passed a baby store The Great Sadness would hug me so tight that I struggle to breathe. But the Great Sadness and I have come to an agreement: Whenever I am with a client, it will not show up for a while. But sometimes The Great Sadness breaks its word and all that I can do is be sad with them.
The parents I assist and I usually have a lot of time talk and cry and yes, even laugh. Sometimes it’s much easier to talk about your pain to a stranger – somebody that you don’t feel guilty over because you are "burdening" them with your pain. Someone that won’t judge, just listen – who may shed a tear or two with you but who will not fall apart.
As a bereavement doula I am learning more and more about life, death, loss and everything in between every day. I have seen that parents feel guilty because they are experiencing deep grief over the death of their child. Statements made by well-meaning friends may cause them to question the validity of their deep feelings of sorrow – statements like the following: “Just be glad you didn’t get to know her. This way you won’t have to suffer the grief.” Or “The woman down the street lost all her children in a fire, you are lucky compared to her.”
The fact is that grief cannot be compared – not even between parents. Grief will not lessen just because the grief of another person is perceived to be greater. Also, they may have given birth to another child. But this will be another child, not a substitute for the one who has died. I always say babies aren’t puppies who can fulfill a general need. And to be honest, not even a dog can be replaced, how on earth can people expect parents to "replace" their baby who has passed on with another!
Although primarily my focus, I don’t just assist with baby loss but also with other losses. I have assisted a mother who gave birth via c-section to a healthy, beautiful little baby boy. The reason she needed me though, was because her husband was brutally shot and killed in front of her. This woman was shattered and tears jumped in my eyes when I looked into hers. It was almost unbearable to look at her. But she needed a calm, collected and professional person to assist her during the birth. In hindsight, I was none of the above. I may have appeared calm and collected, and yes, even professional to the untrained eye. But I was falling apart on the inside. The moment the doctor lifted that precious little boy from his mommy’s tummy I had such a huge lump in my throat I couldn’t breathe. The Great Sadness won that day…
Because there is such a huge need for bereavement birth workers in South Africa, I have written an Online Bereavement Training Program to enable as many people as possible in South Africa with a heart for bereavement to assist parents going through loss. Students are equipped with the right information, tools and coping skills to guide families in South Africa going through the unimaginable.
It is my dream that my profession will be formally recognized and acknowledged in South Africa and that bereavement doulas’ services will be covered by all medical aids. The motto of the bereavement doulas trained by Nicci.doula Bereavement is “to serve with love in loss” – I hope to be able to do this for a very long time to come.
Ever since the traumatic birth of her firstborn, the subsequent birth of his brothers, 6 infertility treatments, 3 miscarriages and 1 adoption, it has always been Nicci's dream to make a difference in the lives of bereaved parents. She is Birth and Perinatal Bereavement Doula, and a certified SBD Doula®. Passionate about ensuring families of all kinds have the unique support they need, she is the former director at Voice of the Unborn Baby, and Managing Director of Doulas of South Africa. Nicci is an avid writer and has written many short stories on her experiences as bereavement doula. Nicci also wrote a book about her infertility struggles. Besides being a doula, she is also a professional stillbirth photographer. Nicci believes in the power of encouragement, and in building confident and empowered doulas to make a difference in South Africa. She also believes in dreaming big and working hard. She is passionate about people in general and more specifically about the doula profession. If you would like more information on the work Nicci does, please visit www.niccidoula.com or visit her Facebook page. For international bereavement training please visit www.stillbirthday.com.
Nicci lives in a leafy suburb at the foot of the Magalies mountains, in the Pretoria area of Gauteng Province, South Africa.
When Nicci asked if she could share how the loss of a baby can be in South Africa, I said, sure -- if you have a story to tell, we want to read it. As I began reading, though, I realized I had more questions than answers -- when she said "here in South Africa," she really meant it -- her work as a bereavement doula is nothing like any bereavement doula I have heard about in the US. I needed more clarification to see how things are so different, and what can be done to help change these archaic, thoughtless laws and procedures -- I am pleased to see Nicci is helping to make that change happen.
Except for different room numbers, the two doors looked identical. If you could have peeked inside, you wouldn’t have been able to tell the stories apart. Except for their age difference and the gestational age of their pregnancies, they were just two women waiting to give birth. And they did give birth, almost simultaneously.
Behind Labour Room 1 an 18-year old teenager was unsuccessfully trying to take deep breaths to ease the pain that threatened to overcome her young body. She was experiencing severe discomfort with each contraction, and as I held her hand I could almost feel her pain. Annah (all names have been changed) looked at me and asked, “Is this going to get worse?” I had to be honest because this is the one thing I promise my clients: Honesty. I looked at her and told her that yes; unfortunately it was going to get worse.
Her big brown eyes followed me as I walked around the bed and straightened her IV line. She asked again in a strong, clear voice, “How much worse, Nicci?” I took her hand and assured her that it was going to be painful, but it doesn’t last forever and she will forget the pain. I couldn’t tell Annah that while the physical pain would go away, the pain of the memories never leaves. It would have been cruel in the moment, so I just squeezed her hand.
Annah was a normal teenager who had just finished Matric [final year of high school] and she was celebrating the New Year and the beginning of new things with her friends. What happened is still a blur to her, but she fell pregnant the first time she was ever intimate with someone. It was devastating news. But the news was not as devastating as what they learned around 20 weeks along: according to her doctor, Annah’s baby had severe health issues, his condition being incompatible with life. At 22 weeks, Annah’s baby was going to be born.
Lisa, Annah’s mother, is who I spoke with about this birth. “Lisa, it’s Nicci, I am a bereavement doula and I was told that you want to make use of my services?” With relief in her voice she asked me to come immediately, as they were about to break Annah’s water. I rushed to hospital. After reporting to the nurse’s station, I was taken to the Labour Rooms. That’s when I saw the two identical doors...
When I was first introduced to Annah she seemed a bit hostile, but within five minutes we were chatting like old friends. After a while she told me that she was pregnant with a little boy she was going to name Zach. I was so relieved that we clicked. It is extremely difficult to assist someone who doesn’t want you there! In fact, it’s virtually impossible.
Annah starting talking about Zach’s funeral -- she said she wanted a particular casket and elaborated on her plans. Lisa and I both listened as Annah told us about Zach’s name, his casket and a few other details about saying goodbye to him. Annah was complaining about her contractions again and I demonstrated to her how to breath to make things a little bit easier for her.
I left the room to give Lisa and Annah a moment alone, and as I was waiting in the corridor, I couldn’t help to hear the familiar sound of a baby’s heartbeat in the other room. I could hear the nurse telling the mom in Afrikaans “Dit is nou amper tyd” (It is almost time now), and I could hear the laughter and buzzing excitement. The contrast to Annah’s situation was so stark, my breath caught in my throat for a second and I had to concentrate very hard to not let the sadness overcome me.
Lisa came out and we went around the corner to have a quick private conversation regarding the situation, but after five minutes she received a frantic phone call: Annah was ready to push! I was astonished that this woman went from 3cm dilation to full dilation within a matter of not even 20 minutes. We both ran to the room. We were just in time. The doctor arrived as we got there and the next moment Annah’s agonizing screams could be heard echoing down the labour ward’s corridors, surely made worse by the realization of her situation. Between her pauses to take a breath, I could hear a mini commotion next door as well. Unbelievably, both women were giving birth at the same time. Oh, the irony!
The next moment Annah was screaming so loud my ears were ringing, and with a soft push, little Zach was born. But contrary to the celebrations and exuberant exclamations next door celebrating the birth of a healthy baby boy, in this room there was silence as tears streamed down Annah’s face, Lisa barely coping herself. If pain were a picture, I saw it in that room.
The nurse delivered the placenta after the doctor cut the umbilical cord (and subsequently left straight away) and was gently cleaning Annah up. Lisa was standing with little Zach wrapped in a soft white blanket that was embroidered with a white silk bow. Lisa took the baby boy to his young mommy and I quickly grabbed my camera to snap a few photos. Lisa gently handed the baby over to his mom and I could see a thousand thoughts running through Annah’s brain.
“He’s beautiful. He’s so tiny. Look at his perfect little nose. He is so, so beautiful!” exclaimed Annah. I could feel the pesky lump in my throat returning to torture me, and I swallowed very hard to keep my composure. I took a few photos of him, especially his tiny little hands and feet. I wrapped the baby again and gave him to his grandma. Annah insisted to hold him and she stroked her baby’s forehead.
In South Africa, babies born before 26 weeks without taking a single breath, are considered medical waste and treated as such (incinerated with amputated limbs and used needles.) It is something the Voice of the Unborn Baby are trying hard to change. It is the greatest insult to families, during a time of such great loss, to not have their babies legally recognized. Because of this, a doula like me, who is Still Birth Day accredited and trained in perinatal bereavement, has to complete an affidavit (or assist a parent to do so), basically stating that a placenta is being removed from hospital – we just fail to mention that the baby is attached to the placenta...
The nurse motioned me outside and when I closed the door behind me she asked me when I was going to the police station to have the affidavit completed. I told her that the commissioner of oaths was actually coming to the hospital herself -- there was no need for anyone to go to a police station. She looked unsure of herself and then she asked me where the casket was. I told her it was in my car, but if she wanted to see it I would go and fetch it. She indicated that this was indeed what she wanted, so I quickly ran to my car. Our caskets are beautiful little woven baskets that look like a Moses basket and not like a casket at all, so luckily I didn’t upset anyone with it.
When I got back, Annah was sleeping and the nurse had taken the baby. Lisa’s eyes were red from crying, but she was calm and asked me a few questions, which I patiently answered. Luckily the commissioner of oaths showed up and we finalized the paperwork and chatted a bit about Zach’s funeral. Annah knew exactly what she wanted for the funeral -- I was impressed with how composed she was. I had to fill out a report for the hospital stating that I take full responsibility for the “remains,” and that I will dispose of it lawfully.
We put little Zach in a carry cot, and after saying goodbye to Lisa and Annah, we left. They both confirmed that they had said their goodbyes and that they didn’t need to see him again. In these situations we are absolutely led by what our clients want and we respect and carry out their wishes as far as humanly possible. Little Zach was snugly tucked into a comfy carry cot, covered with his embroidered blanket. He looked peaceful at last.
I so wished those two doors held the same thing inside: beautiful, lively little newborn baby boys. But we don’t always get what we wish for, and that is precisely why I do what I do. Because there is a family facing the unfaceable, because the government makes this even more painful by not recognizing these so-called ‘fetuses’ as babies, because someone needs to comfort, answer questions, and hold the hands of the people going through this excruciating pain – this is why I do what I do…because no one should have to walk through that door alone.
Ever since the traumatic birth of her firstborn, the subsequent birth of his brothers, 6 infertiliy treatments, 3 miscarriages and 1 adoption, it has always been Nicci's dream to make a difference in the lives of bereaved parents. She is Birth and Perinatal Bereavement Doula, and a certified SBD Doula®. Passionate about ensuring families of all kinds have the unique support they need, she is a director at Voice of the Unborn Baby, and also Doulas of South Africa. Nicci is an avid writer and has written many short stories on her experiences as bereavement doula. Nicci also wrote a book about her infertility struggles. Besides being a doula, she is also a professional stillbirth photographer. Nicci believes in the power of encouragement, and in building confident and empowered doulas to make a difference in South Africa. She also believes in dreaming big and working hard. She is passionate about people in general and more specifically about the doula profession.
Nicci lives in a leafy suburb at the foot of the Magalies mountains, in the Pretoria area of Gauteng Province, South Africa.
♥ four young boys and a boy dog (offspring)