Recently, in a group of fellow Stillbirthday doulas, the leader of our organization brought up the topic of termination or, as we sometimes refer to it, duration of life in utero (DOLIU). She asked us to carefully and thoughtfully consider how we might support a family seeking to terminate their pregnancy, either as an elective termination (ET) or a termination for medical reasons (TFMR), and asked us to indicate whether we were "on the ledge" (providing support to help continue a pregnancy, and showing up after termination if appropriate) or "in the valley" (providing support throughout a difficult pregnancy decision, including ET/TFMR/DOLIU, if applicable). Both are valid stances within our training, but it's helpful to know which doulas provide which kind of support when making referrals.
This is something I've thoughtfully considered for a long time, even before I became a mom, but especially once I was faced with the possibility of needing to make this decision for my own family. While my son's condition proved to be fatal on its own, I still had to consider the possibility that termination might be the most loving and kind way for his life to end.
It is largely because of my son that I have decided to place myself in the valley.
Had Oliver not died on his own, TFMR was a choice we had to seriously consider--whether or not we should put him through the trauma of open fetal surgery, of kidney transplants and dialysis and basically living in a hospital for his earliest years, whether or not his quality of life would be decent, whether or not he was even likely to survive, whether or not I was likely to survive all the in utero interventions, and so on. This is what informed choice looks like--being able to consider all of the factors and make the best choice for a specific situation. This is how we honor the sanctity of human life, by recognizing that sometimes, it is more honoring to a person to allow them to die peacefully than to force them to live in agony.
I have had the honor of providing support through TFMRs before, and these have been some of the most honoring, beautiful births I have seen. This is, in no small part, due to the intense consideration families give to their choice before coming to this decision. I never encourage families to choose one path or another, but to make the best decision for their family and for their child.
If you are considering a TFMR, I am willing to walk with you through that valley.
Do not take this to assume that I will automatically be the best doula for you. There may be other reasons why someone else might be a better fit for you, and I will support you through making that choice as well. I certainly won't encourage you to terminate, nor will I encourage you to continue your pregnancy. I will encourage you to consider all of your options, consider your own heart, and make your choice based on what's best for you. If you choose DOLIU, we will work together to make it as honoring and comforting as possible.
My personal and political beliefs influence me, but they have no place in the support I provide. My choice to be "in the valley" isn't a political agenda, it comes from knowing that these decisions are impossibly hard and that the support of a doula throughout this decision can be so beneficial. It is, on my part, simply a choice to show up without conditions.
If you find yourself in the valley, you are not alone. I and so many others are here to walk with you, no matter which choices you make.