(I Had a Miscarriage) And How To Support Your Doula Clients Through a Miscarriage with Arden Cartrette
Do you struggle to know the “right way” to support doula clients after they have experienced a miscarriage?
In Episode 39 of the Birthworker Podcast, I'm joined by Arden Catrette from The Miscarriage Doula, who is sharing her insight and experience from supporting women through the most challenging times in their lives.
In this interview with Arden, we chat about:
How to hold space for women and leave behind toxic positivity…
Understanding your role as a bereavement doula…
Navigating the many triggers of a successful birth after previous loss…
… and a whole lot more!
Arden Cartrette: Thanks for having me today. My name is Arden Cartrette. I'm a bereavement doula, and what led me here was my own personal journey with infertility and recurrent pregnancy loss, all at the age of 24, when generally doctors are telling you that you're young and healthy and you have regular cycles and you should have no problem getting or staying pregnant. But I found that to not be true in my case. I went through two really traumatic losses that have greatly shaped the way I handle everything, and then we conceived my son with the help of fertility treatment, and I always say fertility treatment, but I like to specify that it wasn't IVF because there are many options at creating life and a family, and so we used ovulation induction medication and got pregnant with him.
Pregnancy after loss was really hard. I thought that if I could just get and stay pregnant, that it would heal everything and I would be totally good to go in life, I would have everything that I wanted, but it was really hard. Then I gave birth to him and it was both a healing moment, but still fearful. I usually share whenever I talk about his birth that I had an induction with him because I was actually due on the same day that my second loss happened, and I was in the hospital for my second loss, so the date was really triggering. I was afraid to spontaneously see blood and I was battling PTSD that I was coping with and getting help with, so we did do an induction with him, and while I was pushing, I had my eyes closed the entire time because I was so afraid to see my baby not alive.
I know that sounds really morbid, but I had my eyes closed and then he was born and he didn't cry, which nobody told me that that happens a lot of the time. So I was threatening the nurse to tell me that he was okay before I would open my eyes and look at him. I think that really shows the trauma that I experienced up until that moment because what's supposed to be an anticipation of meeting your rainbow baby, I was still so fearful until I counted his fingers and toes and could feel him on my chest. So once he was born, I really could've used a bereavement doula. I wish that I would've had one, like a birth and bereavement doula, that way I would've had somebody who could help me through the triggers of birth after loss. I mean, there were so many triggers I could make a list, and I wish I had somebody, but I didn't.
The pandemic world shut down three weeks after my son was born, and while I was sitting on my couch with my cute new newborn, as he slept on my chest, I decided that I was going to become a birth and bereavement doula. Throughout the course, I realized that my passion is not so much with the birth of living rainbow babies. It was giving support when I really needed it, which was during loss, and if I had healed a lot of that grief and trauma, I wonder how different my experience would've been, so I started focusing on supporting women through miscarriage.
I actually uniquely did it before becoming a doula through my Instagram page. I would give out my phone number and women would text me as they were in the bathroom miscarrying. Once my son was born, I didn't have the time to give, so I had to find a way to make this work for my family, but also feed that passion and fulfill my goals there. So I am a birth and bereavement doula, but I focus on the bereavement aspect.
Kyleigh Banks: Mm-hmm. Are most of the people that you help virtually then, across the world?
Arden Cartrette: Everybody has been virtual so far. I've helped in births virtually, especially births whenever women have had recurrent pregnancy loss first, and so we focus a lot on the grief that comes up in birth. I am trained in birth, but I don't focus on the birth aspect of birth, if that makes sense, so a lot of my clients actually have birth doulas in addition to using my services.
Kyleigh Banks: Okay. I feel like when someone needs your services, it's kind of like, "I need them right now. This is happening right now." Is that true?
Arden Cartrette: A lot of the clients that I see, it's usually one or two times that we'll meet and it's right around the time of their miscarriage. Sometimes it's to prep for miscarriage and what to expect, and I kind of walk them through it. Other times to reflect on their miscarriage experience and have somebody holding a safe space for them to talk about the details that other people will cringe at, and not want to listen to. I do have quite a few ongoing clients where I meet with them as needed because with miscarriage, you learn that you're miscarrying, you physically miscarry, then you have your first period, and then you think about, "Should I get pregnant again?" You're fearful of that, and then you do get pregnant again, and you're fearful of that, and so a lot of my clients, I see them through the stages.
Kyleigh Banks: I didn't think about that, all the milestones that bring back that trauma.
Arden Cartrette: Yeah.
Kyleigh Banks: You said that people typically hire a birth doula and then separately a bereavement doula. Is that the case in general when we're talking about bereavement doulas, or is that different just for your business?
Arden Cartrette: I think it's different for my business. I didn't really create this business model after anything. I've just figured it out as I go, and I didn't really know what I was doing or what I wanted to do with it, so it seems that I'm a lot more of emotional support on the grief side than I am physically during birth. There are birth and bereavement doulas that do in-person services, and so if people do find something like that, then that's great, I think if I build a relationship with somebody, then they trust me to talk them through the triggers of birth. But generally, I think most people would get the same person. I think my services are a little unique where people feel attached after they've talked to me and had an ongoing relationship to where they also use me in addition.
Kyleigh Banks: Yeah. Talking specifically about supporting people through miscarriage, what would a doula's role look like in that?
Arden Cartrette: That's a really great question. I can tell you what my role is, and that is usually telling them what to expect. It's all things that you don't want to have to tell somebody, but it's things that they need to know. It's not as pretty and full of happy moments as I feel like other doulas' jobs are. It's a lot of holding space and not saying the wrong thing and just being there and being somebody who can validate that what they're sharing and feeling is real and it's worthy of being felt, and it's a lot of mental and emotional support.
Kyleigh Banks: Mm-hmm, and in your program to help doulas support clients through miscarriage, do you walk doulas through what to expect?
Arden Cartrette: The course, I've listed out all different types of loss, like the terminology that you'll see, what it means, what treatment might look like, what miscarriage might look like. We walk through the three options that most women are given, which is to miscarry at home, to take a medication, or to have a procedure. I walk through the differences. I also share notes of my experiences and experiences of others. It's pretty in-depth because there are so many types of loss that it's not a one size fits all, which makes it really difficult in birth. You kind of know what is generally going to happen, and so you know how to prepare somebody. But with loss, until you get the full picture, you don't really know how to guide them through it, and so listing out all those things and teaching other doulas different types of losses and maybe what's perceived about that loss is really important.
Kyleigh Banks: It seems like there are so many different types of loss, especially when we're talking about the trimester that they happen in. It's really hard to categorize it as just loss because they're all so different, I feel.
Arden Cartrette: Yeah, and it's different for every client too. They might feel different. I usually wait and see how somebody talks about their loss, because sometimes you'll hear them say that they lost a pregnancy and some people will say they lost a baby, and so people also attach different emotions to different terms in miscarriage. The term "miscarriage" itself really sucks.
I tried whenever I first started this work to only refer to it as "first-trimester birth" and "second-trimester birth," but nobody could find my support because nobody refers to it as that. So I always am very clear that even though miscarriage is in my business title, I hate the term, and I will never say a woman miscarried. I will always say that she had a miscarriage because it happened to her, it didn't happen because of her, and so I think that changing language can also be really helpful.
Kyleigh Banks: Yeah. Let's talk about language for a second because I feel like doulas want to be the cheerleader, and that's something that I hope to help people step out of. A lot of times we want to be the savior, we want to be the cheerleader, we want to say, "You're going to be fine, you're doing great, Everything's fine. This is normal." But in terms of loss or in terms if a loss is imminent and hasn't happened yet, being that toxic positivity cheerleader person can be really hurtful.
Arden Cartrette: Yeah, really hurtful. I don't use any of that language with my clients. A lot of times the best thing you can do is say, "This really sucks. Let's talk about how you feel about it. Let's talk about what you're struggling with." I've worked with clients who have birth doulas and they are getting ready for birth and they have these affirmations, and a lot of affirmations around birth are, "My body is capable. I trust my body," and language like that.
But when you've experienced loss, you don't trust your body. You don't have that trust, so instead, one thing that you can do with language there, instead of putting a blanket statement of, "I trust my body," since a lot of women might not, is saying, "I trust my baby," or, "I believe I can do this," or kind of making it not a definite statement. It's changing the language around some of the affirmations that we see, because there is a lot of toxic positivity.
Or it's like, “Just keep going. If you slow down, it's the same as giving up.” I see a lot of things like that, which I think four years ago, I would've been like, "Yeah, if I slow down, that's the same as giving up. I got to keep going. I got to work really hard." But sometimes slowing down is needed and sometimes stopping isn't a failure, it's not giving up. Some women might experience pregnancy loss and then not want to get pregnant again, and that's not failing their partner, or their family, that's unfortunately science in a way failing them, but they aren't failing anybody. So I think that terms like, "Do it," or, "Stay positive," or, "Positive vibes only." Yeah, it's just not... Sometimes we need to be negative because that's how we feel.
Kyleigh Banks: Yeah. It's almost like the best way to go about it is to just let yourself feel what you're feeling rather than trying to fit, perform in some way, and for doulas, let your client feel what they're feeling instead of trying to push your thoughts onto them or push your beliefs onto them, and it's interesting because it could probably go both ways. I'm thinking someone could experience a very early loss and say, "Oh, that was just a pregnancy loss. No big deal." Let's try again, and if a doula is bringing onto them, "I'm so sorry, that shouldn't happen to you," potentially, that client is like, "Why are you making this a bigger deal than it needs to be?"
Arden Cartrette: That's a great point. I think that we should follow the women's lead. I mean, I have clients who believe everything happens for a reason and that makes them feel better. I don't personally believe in that. I don't ever say those words to one of my clients, but if they express to me that that's what they believe and that's what makes them feel better, I will support them through it, and I will not say anything that contradicts that. Our role as a doula is to be a support person. Support doesn't just look one way. It should be unique to the person.
I mean, we talk about the medical field a lot and how doctors don't personalize their care a lot of the time and it's just a blanket way to go about things. They say most pregnant women do X, Y, and Z, so you're going to do X, Y, and Z instead of looking at your medical history, mental health, or things like that, and we have to flip that if we're going to preach it. Sometimes you might not be able to prepare a hundred percent for a client because you have to get to know them and you have to ask them questions and follow their lead. But I feel like I've learned the most about people from doing that, from just listening.
Kyleigh Banks: Yeah, exactly. I remember looking back a couple of years ago when I was a new doula, I was like, "Can someone just tell me what to do? Give me a list of things to do and we're going to be good." But that's just not how it works. Even something as simple as a prenatal appointment, you can't just go through the same 20 questions with everybody, it just doesn't work that way, and that's something you learn, the more and more you support people, you learn how to just read the energy of the room. That's what being a doula is. It's reading the energy and offering support very specific to what's going on in that room and with your one client at that one time.
Arden Cartrette: Yeah. In my course, I add what my intake form questions are. There are only a few of them and they give me an idea of how this person might want to be supported, so it helps me a little bit going in. One of my questions is, it's most helpful when my support person, and then it's three options, it's 1: listens and doesn't share relative information, 2: asks before sharing, or 3: shares relative information if they have it. That question alone tells me so much about somebody. It's been really helpful for me to connect with others because I know if they're looking for a conversation back and forth to feel community and feel close to somebody, or if they just want somebody to listen to them, or if they're not sure and they want you to ask first, and so I think getting to know specific people is key in providing care.
Kyleigh Banks: I really like that one. I don't use that one, but I'm putting it in there. That one's really good.
Arden Cartrette: It's really helpful. I've seen a difference in how people react if I share relative information when I know that they want it because I never want to be that person that gives unsolicited advice. Just because they're hiring you doesn't mean that they want you to respond to everything with something that they could buy that will help, or some exercise to do. Sometimes they just need a friend that also has professional experience to help them through what they're going through.
Kyleigh Banks: Mm-hmm. Absolutely. I see that in birth, too. Because I'm on the birth side, I rarely work with people who have had loss before, which is interesting knowing how frequent it happens. But I use that in birth work by saying, "Do you want me to be hands-on? Do you want me to ask before I touch you? Or do you want me to just sit by you until you ask me to support you hands-on?" I know when I was starting my doula role, I would be really scared to touch people because I didn't want to be touched. But not everyone is like me and it's really important to know that not everyone is like us and to follow their lead.
Arden Cartrette: Yeah, I was that way in birth where I didn't hire a doula because every time it was brought up to me, I was like, "I don't want somebody touching me.” My husband knows me so well to where he knows not to be putting his hands on me while I'm in labor and things like that. I'm one of those people where if I'm stressed, or in pain, I clamp up, and I just need to figure it out myself. But I want people nearby in case I decide to change my mind. That's actually the thing that scared me away from hiring a doula was because I thought it was all essential oils and exercises, and it's not that way. I wish that I would've realized that everybody is different and you find somebody that works for you.
I don't like birth plans, mainly because I work in loss, and so whenever I work with somebody who's pregnant after loss and they're preparing for childbirth after loss, I don't like the term "birth plan." I guess it's just a personal thing, so I call it "birth prep," so I'm like, "Let's talk about what you want birth to look like," but I have a document that I give them to fill out. That way, if they do have a doula, they can give this to them to also help them out. It lists triggers that they're afraid of or that will come up in birth. That way, somebody can be hyperaware of those things, or when I'm in pain, I do X, Y, and Z, and I want you to do this or ask me first, and things like that can be really helpful.
I did that for myself in birth where every nurse that came onto the rotation, I said, "Look, I've been through loss. These are my triggers. I need you to keep blood away from me if you possibly can," and the nurse that I had, I'll never forget her. Her name was Sam and she has five kids, I'll never see her again, but she was a blessing. Whenever they got me up after giving birth and I had to use the bathroom, and so there's a lot of blood, she was helping me breathe through it because that was my trigger was the clots and the bleeding and seeing blood in the toilet, and so we had a plan of showing me my healthy baby when that happened. I made everybody my doula by communicating.
Those are all things that I didn't think of until they were happening in real-time, and so sometimes I'll work with people where we go over that, but I give them the tools to use when they have a doula, that way they can give it to them. Some birth doulas might not see a lot of loss at all, so if I can pass along some information, I usually try to.
Kyleigh Banks: I love that. Yeah, that's really needed. Absolutely. Before we talk about the course that you have for doulas, can we talk a little bit about what your support looks like for moms? What kind of packages do you offer on the practical side. What does that look like on the business side?
Arden Cartrette: Everything about my business looks so different I feel like than other doula businesses. I don't have packages at this time because like I said, it's unique to everyone. I don't want people to feel roped into seeing me every month for six months or having to hear from me more often than they want to or anything like that, so people pay as they go. They book sessions with me and it's affordable rates. I charge $65 for the first session and then only $35 for the follow-up.
The reason I do that is that I am in a lot of medical debt for miscarriage and it really sucks to pay a lot of money and see a bill on your statement that you know booked because of miscarriage and that stops a lot of people from doing therapy because it sucks to pay even more towards a child you didn't get to bring home. So my goal is always to make miscarriage support affordable and attainable, and so it means I'm not making a killing doing this, but it helps a lot of women not worry about the financial aspect of finding support. I do virtual sessions, group programs and digital e-books and things for people who aren't ready to meet face-to-face, but want the information in their hands.
Kyleigh Banks: Can you tell us a little bit about what kind of workshops you run in the 12-week programs?
Arden Cartrette: Yeah, so that's something I've played around with for a while and I'm still figuring out how I want it to go. They're small groups, they're 10 to 13 women. 15 seems to be too much, but 10 seems to be not enough for people, so I'm figuring out the numbers. I've broken it into miscarriage and grief or pregnancy after loss, and recently we've broken it up a little bit more where we're doing first-trimester loss, second-trimester loss and pregnancy after loss.
Then we're also going to do women who experience loss and have a living child because everybody relates on different levels based on their miscarriage. I'm trying to group people together where they make friendships out of it, and so I recently brought on a couple of doulas who are leading the groups, which is really awesome. What we do in the groups is like people share what they're going through. It's a really grim place a lot of the times, but it's really cool because you watch people grow throughout the 12 weeks of the program, and so you see them crying every time they talk about their loss to feeling hopeful that they will experience a healthy pregnancy in the future.
I've had a ton of girls who have been with me for about a year. They've jumped from group to group. They went from miscarriage group to miscarriage group and then finally to pregnancy after loss and they are all starting to give birth to their rainbow babies, which is really cool. It's just a judgment-free place to sit and share. We meet weekly, I provide custom content where we talk about different topics and I give them professional advice and I'll do workbooks and things like that I create for them.
Kyleigh Banks: How much do those 12-week group programs cost?
Arden Cartrette: They range from $130 to $150, just depending, sometimes I've gone to 20 weeks, so it's usually in that range.
Kyleigh Banks: That's awesome. What an amazing thing that not a lot of people are offering. That's really cool.
Arden Cartrette: Yeah, and I like to say I'm creating the support that I really needed. I don't know if I would've been ready for virtual group support, but I would've liked the option. I think before the pandemic, I don't know if anybody else feels this way, but I didn't even know that virtual services really existed. I thought that everything had to be in-person, so I think that's one thing out of the pandemic that I was like, Well, I can meet with people over Zoom and help them. I don't have to be in their bathroom with them. That's a little private, but I'm not opposed to that. If somebody were to reach out to me and be in my area and they're like, "I'm having a miscarriage, I would really like to have somebody here with me," I would drive over in a heartbeat, so it depends on how people want support for sure.
Kyleigh Banks: Yeah, I feel like for me it took away a little bit of a barrier because I love being home, and I don't like leaving my home very often. It would take a lot to get me to go to an in-person support group, so yeah, for me, it would take away that barrier of leaving my house.
Arden Cartrette: I mean, who wants to leave their house to go to a support group and sit in a chair with strangers that you're getting to know? I tell people they can eat their dinner. It's very casual. I have a little lap desk and I do it from my bed, that way, I'm casual with them. While I've brought on doulas, and talking about training and all of that stuff, people do have to get to know how to give support with miscarriage, all of my doulas have experience with miscarriage, personal experience, but they still have to learn how other people want support. So with groups, I tell them, I say, "Don't be afraid to sit in silence for 10 to 20 seconds."
I don't know, sometimes I will sit there and we'll all look at each other and I find it nice. I think that a lot of people, you can see people's minds working to where they want to share something but they don't want to interrupt, so they're waiting for that moment, and so my advice is just always don't be afraid to sit in silence. Sometimes you make it light and you're just saying, "It's okay if nobody wants to share anything today, I can sit here and talk all night." It's about being a friendly, consistent person in their journey.
Kyleigh Banks: Mm-hmm. I love that. I love that. I am one of those people that as soon as I'm ready to talk and I unmute myself, the group leader starts talking again 'cause it was only a three-second break, so I really appreciate for someone who it takes a minute to speak up. I really appreciate that and I know a lot of women do.
Arden Cartrette: Yeah.
Kyleigh Banks: Let's dive into when did you start creating resources for doulas? Why did you start creating resources for doulas? Then I would just want to hear about the course that you created for us.
Arden Cartrette: I started creating resources maybe within the last six months and the reason is my DMs and my email are filled with doulas and mental health professionals asking me for advice and how they could support and it takes a lot of time to individually respond to all of these people and I want to help, but I thought, I'm just going to create something that I can just, 'Here, this gives you everything that you need. It also provides, even though we know how certifications work to where it's not backed by a license, but I added the capability to get a certification from the miscarriage doula code. That way, you can show clients that you've done the work to be able to support them, and so I thought that that was a big reason for me to create something because if somebody was going to email me and ask me for advice, what are they going to say? "Well, I emailed a bereavement doula and she said , 'X, Y, and Z.'"
I want to help other people be better support people, not even just in business, but that's kind of how we change how people approach miscarriage in general at all, is if we continue to teach people. It started with teaching other professionals that wanted to learn how to support women through miscarriage with 30-minute calls to chat about it, but that also takes a lot of time, and so it's a lot of the same information over and over again. Then I created the course, and I put a lot of time into it, I've added to it, I mean, as I've thought of things, yeah, so I made it a course thing where it's in webinar view for a lot of it. It's audio format and the transcript, so any way that you receive information, it's there.
Kyleigh Banks: Awesome. Then you also do one-on-one business coaching for anyone who wants to add bereavement support to their portfolio, right?
Arden Cartrette: Yeah. I have a couple of clients I'm working with now who are doulas, one's in Germany, which I think is really cool, but we go over how adding bereavement to their services looks like. One is starting from the ground up, so I'm helping her build her services list and helping her get confident with pricing. I'm going into this because I get the inquiry so much, but I'm learning as I go, too, and I think that's my best piece of advice is that you have to be willing to learn as you go and see what your clientele can afford and what they're looking for because you don't want to waste your time whenever you could be putting out things that are really helpful. I help people add it to their services, and what that looks like, I'll talk to them about what a Zoom call could look like and walk them through my process and help create and take questions, so anything that somebody needs help with.
Kyleigh Banks: Amazing. And you have a podcast, too?
Arden Cartrette: I do. I do. I don't know how all of these things come out of me.
Kyleigh Banks: It's a lot. I'm right there with you. I'm like, "We do this to ourselves." But hey, it's fun.
Arden Cartrette: Yes, and sometimes I wonder, I'm like, "Why do I feel like I'm so tired?" Then I do these talks to where I'm like, "Oh, yeah, because I have a lot going on, I do have a podcast.” It's mainly revolving around women's stories. Women will sign up to share their stories for the podcast. I have some experts on there and it's just another outlet for people to get support because some people find support in hearing other stories. I put in the podcast episode title if it includes a rainbow baby, that way they know it's a success story at the end, or if it doesn't, they know that maybe it's one that they don’t feel comfortable listening to now. It's just another avenue for people to receive support.
Kyleigh Banks: I love that. Where can people find you? Where can they buy your courses? Tell us everything.
Arden Cartrette: I'm on Instagram at @TheMiscarriageDoula. My website is themiscarriagedoula.co, and if you go to my website, you can find links to everything. I have a page specifically for loss moms and a page for professionals, too.
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Meet your host, Kyleigh Banks, a side-gig doula turned CEO of a multi-six-figure birth-focused business. Her passion? Teaching birth nerds, like you, how to build an incredibly successful doula business that allows you to quit your day job, stay home with your kids, and most importantly, make a lasting impact on the world.