For mothers whose babies lived only briefly—or never took a breath —remembrance can be both agony and gift. Meet the women who enter silent delivery rooms to help these mothers create the few precious memories that must last a lifetime: a whispered word, a photograph, one final hug
The Call
It’s 1:15 in the morning when Andrea Chattah’s phone rings.
“Hello?” she whispers into the darkness.
It’s the woman she spoke to hours earlier. Nothing was happening then, so Andrea told her to try to sleep, to call when the birth was progressing. Now the young mother is on the phone, and her voice is eerily flat.
“The nurse says it’s almost time,” she says.
Andrea sits up, hearing only silence on the other line. There’s no beeping fetal monitor in the background, and she can almost taste the sadness through the phone.
“Do you want me to come?” she asks gently.
“Yes.”
Andrea’s up, dressed, and on her way in minutes.
She’s not the only one who answers calls like this.
Andrea Chattah and Chany Lebovits are some of the approximately 75 women on call across the New York Tristate area, with another 35 in Israel. They do this work through an organization called Knafayim, founded by Malkie Klaristenfeld, and they call themselves “emotional doulas.”
For them, there’s no coaching a laboring woman toward a healthy delivery. No breathing exercises or positioning techniques or ice chips in flimsy plastic cups.
The emotional doulas are there when labor ends, not with a beautiful cry… but with silence. And these women show up, night and day, because no mother should have to give her child one last hug alone.
The Doing
“When it comes to helping a mother who’s having a stillbirth, the first thing everyone asks me is, ‘What do you do? What do you say?’”
That question, Malkie Klaristenfeld explains, is a fundamental misunderstanding of the emotional doula’s role. An emotional doula’s work is not to do, but to be there. There’s no hard-and-fast script for them to follow. Every family has its own dynamic, and every situation involving a baby who isn’t compatible with life or a stillbirth is different. Every mother walks into that hospital room with their own beliefs, relationships, and dreams.
The emotional doula is a presence. Sometimes she’s right beside the mother, sometimes she stands outside the door of the hospital room. Sometimes she talks, and sometimes she doesn’t speak at all. The most important thing a mother has to feel is that she wasn’t abandoned.
This is because a stillbirth is not only heartbreaking, but also a trauma for the mother.
“Even a mother who’s lost a baby before doesn’t ‘get used to it.’ Every loss is different, so the trauma and the crisis is real, every single time,” Malkie says.
And that’s where the emotional doulas come in.
From Malkie’s experience, whether or not a mother is able to move forward largely depends on whether she was emotionally “there” for what happened to her. When a mother feels like she was part of that experience, as devastating as it is, and when she was able to make decisions about what was happening, she can recover.
It’s difficult to move forward from something you never faced.
Unfortunately, for years, hospitals and families followed the opposite instinct. They wanted to “protect” the mother and keep her from seeing her child or facing the sadness of her situation. The prevailing attitude was one of forgetting, sweeping the incident under the rug, and turning the entire subject into a conspiracy of silence. What was the point of remembering, anyway? But it was a choice that left countless grieving mothers awakening later and asking, “What happened to me? What happened to my baby?”
The role of the emotional doula is not to remove pain, but to help each woman be fully present in the moment, to immerse themselves in the pain so it doesn’t haunt them later… and to memorize the moments of motherhood that will have to carry them through a lifetime.
Even during the worst hours of the night, the grieving mother who was present at the birth can at least say to herself: I was there. I know what happened.
The Hello That Means Goodbye
How do emotional doulas prepare for the situations they face?
Many regular doulas take initial training seminars that last from two to six days. But while this gives them a basic grounding in regular birth, such a short timeframe can’t come close to preparing emotional doulas for a stillbirth. This is why Malkie built a six-week training seminar for emotional doulas. Not everyone who trains is already a doula. Malkie opens the program to anyone — social workers, therapists, or people who just want to help.
First, trainees learn about the emotions and language of the silent delivery room, how to talk… and how not to. They discuss what birth looks like in these situations and model the different types of conversations that might come up, as well as appropriate responses.
Malkie repeats one phrase to her cohorts each year: Saying hello means saying goodbye.
Our first instinct is to look away from a loss, to tell ourselves out of sight, out of mind. But the ostrich-head-in-the-sand attitude doesn’t spare anyone. Looking, processing, and greeting the baby helps parents eventually have closure.
One more thing every emotional doula has to learn (and for some, the hardest lesson of the entire six weeks) is that your story is not their story, and it never gets to enter the room.
“I come to every case with my losses behind me,” Malkie says. “But their story has nothing to do with mine. I will never bring my life into another person’s experience.”
The training is designed to put a trainee into the delivery room, into the mind of a family that isn’t hers, while keeping her own past separate. Nothing she carries should ever become something a newly grieving mother has to carry, too.
Three Doorways
Most emotional doulas don’t come into this job by default.
Some suffered loss, or even multiple losses. Others watched loved ones face loss. Some women simply love to give to others. Every woman who becomes an emotional doula can point to the exact doorway she took on her way to this calling.
Malkie’s doorway was her own life. Nineteen losses — some early, some late. After suffering the agony of her tenth loss, she came to a realization. “I had two choices: bury myself in my pain, or do something with it.” She chose to “do something,” first working with another organization, and then building Knafayim to support mothers and families facing pregnancy and infant loss.
Andrea’s doorway opened seemingly by accident.
“My daughter was due in the middle of Covid, back when hospitals had begun letting certified doulas into delivery rooms. So I got certified in four days so I could be there for my daughter,” she explains.
Andrea was already a psychotherapist and a consultant for Sephardic Bikur Cholim’s fertility division, which helps families trying to have healthy babies. She trained with PSI (Postpartum Support International) to earn a Perinatal Mental Health Certification, and continues to learn through her supervision with Devorah Enten, one of her initial teachers, and who is the same supervisor Malkie uses to train Knafayim’s clinical doulas. This connection led her on the road to helping mothers during the pain of a stillbirth.
“I felt like I was doing Hashem’s work,” she says. “I still feel that way.”
Chany Lebovits’s doorway was her son, who saw an advertisement in a magazine about doula classes and sent it to her. Chany signed up, then learned about Knafayim’s course. For someone who loves giving to others, it wasn’t much of a choice. Terrified but game, Chany jumped into the unknown.
And this network of women doesn’t stop at the edge of the Tristate area or Israel.
When a woman in a small town in the Midwest was carrying a baby with a life-limiting diagnosis, Malkie didn’t have anyone nearby to send. Instead, she found a Chabad doula through a parallel network and made sure the young mother wouldn’t have to walk into labor alone.
Anywhere a mother faces loss, that’s where the emotional doula will stand by her side.
“We reach wherever we’re needed.”
The Hello
“By nine in the morning, I was screaming,” Baila begins. It was her third birth, but two healthy children hadn’t prepared her for the roller coaster of a pregnancy marked by medical complications… and then the shattering moment when the doctor told her the baby’s heart had stopped beating.
“People who know me could tell you I never scream or yell. Even when I was having my first, I never cried out.” But two days earlier, Baila learned her baby had already died, and the emotional doula who was supposed to meet her wasn’t there when the contractions suddenly became intense.
“I kept screaming that I wasn’t going to deliver this baby alone,” she remembers.
It’s the fear an emotional doula races against every time she gets the call. The hospital staff can manage the medical side of things, but no one wants a woman to go through the worst hour of her life with no one beside her.
Every story like Baila’s begins before a doula leaves her house. There’s a group chat for many of these emotional doulas, and usually Malkie posts the barest outline: 34 weeks, getting induced tonight, third pregnancy, or sixth pregnancy, should go quickly. Hands go up, and whoever’s closest or free or the best fit responds to the call.
Chany remembers the first time she responded, agreeing to be an emotional doula for a grieving couple. “I was terrified,” she says candidly. “I called Malkie in a panic and asked her, ‘What do I even say to these people?’ She told me, ‘Just be yourself.’”
Most of the doulas don’t need to rush to the hospital the moment a pregnancy loss is confirmed. One of the reasons for this is that the doulas aren’t needed for pain-management techniques through a grueling labor. In these births, an epidural is common, since the goal is to keep the mother as comfortable as possible.
“I was on an epidural the entire time,” Baila says. “But they warned me the labor could be very long, because a baby who isn’t alive can’t help the birth progress properly.”
If a woman just started labor, there’s little reason, most of the time, for an emotional doula to sit in the waiting room for eight hours.
“We usually don’t go in until labor is more active,” Andrea says.
When she does walk into a hospital room, she assesses the situation. What’s happening? Who’s present in the room? What emotions does she sense? Her first step is to address both the mother and father, validating their pain. She connects with them by asking if they have questions, tries to make them comfortable, and gently builds a relationship. Andrea tells them a little about herself and asks if it’s okay for her to sit down.
Often, the doula is the first person the family’s talked to since the devastating news.
“My role is to help them not feel so alone,” Andrea says. “There’s often a sense that people don’t want anyone to know, so in most cases, the couple comes into the hospital very alone.”
And if there are other relatives or people in the room, that can help… or make everything dramatically more complicated, especially if there are strong opinions about what the couple should do next. Sometimes Andrea will ask to speak with the couple alone to hear what they really want.
The family’s community, culture, and background often have a lot to do with how events play out. Couples from certain places or backgrounds often go through the loss by themselves. For them, this is a private moment of pain. For others, birth is often a time when the mother and mother-in-law are present, so there are more people in the hospital room. This could lead to more support or more arguing… and then the emotional doula’s job expands to navigating the family.
The emotional doula prepares parents for what comes next, for the unfamiliar moments after the baby is born, and for decisions the parents may never have imagined making.
And then there’s the birth itself.
Some of the mothers don’t even want to push, and the doula will validate her feelings and cry with her.
There’s a visceral fear that comes with picturing a baby — supposed to be at the beginning of life — together with death. But when a stillborn baby is delivered, Andrea doesn’t see what others might imagine.
“For me, it’s not scary, because I don’t see a baby who died. I see a baby who passed away,” she says. “I feel like there’s kedushah in the room, and a pure neshamah. It’s more spiritual than scary.” When she can, she holds the baby and says a perek of Tehillim into the stillness.
After that, the family is often moved to a separate room, usually at the end of a corridor, away from the maternity ward. And on the door of that room, in most hospitals, there’s a small, discreet marking — a butterfly or a wave — so that passing hospital staff knows what room this is.
“When I was there,” says Baila, “even the cleaning crew said to me, ‘I’m sorry for your loss.’”
The Hardest Goodbye
The hardest conversation when there’s a stillbirth or a baby who lives for only a short time after birth is whether or not the parents should see the baby.
Malkie remembers when an entire family arrived at the hospital together — the couple, both sets of parents, everyone walking into the delivery room at once. They found out together that there was no heartbeat. The devastation was total, and the family’s unanimous, immediate verdict was, “There’s no way she’s going to see the baby.”
That was when Malkie noticed the husband hadn’t said much, and she realized he wanted to see his son. She started talking, very gently, about the possibility of spending time with the baby when he was born.
After the birth was over, Malkie made sure the bereaved father was able to hold his baby and say his own private goodbye. The mother wasn’t ready, so Malkie asked her if she could take a picture of the baby.
“I’ll hold on to the photo,” she told the exhausted mother. “You don’t have to look at it now.”
A few weeks later, Malkie received a call.
“Can I have my baby’s picture?”
It was the only piece of her baby the mother would ever have.
When it comes to seeing the newborn, Malkie teaches that it’s important for emotional doulas to never force a mother into one enormous, irreversible decision. Instead, they give her a series of small ones, letting her take control in an accepting, nonjudgmental way.
First, the baby is cleaned and wrapped in the same blanket and hat every newborn receives. The emotional doula pauses behind the curtain in the room before bringing a baby in, gently saying out loud exactly what the parents can expect.
“I prepare them for what they might see,” Andrea says. “And parents can decide if they want to see the baby’s face… or not. When even a face feels like too much, there are less frightening connections for the mother — a footprint, a photograph of just the feet, even a single toe uncovered. And I always ask it as a question. Do you want to see his little foot? Do you want to stroke his hand?”
Chany’s learned to ease mothers into interacting with their babies in a comforting, nonthreatening way. One baby was born with a deformity, and instead of asking the mother to make a yes-or-no decision about whether to look at her, she started talking about the baby.
“I covered her and said, ‘Look at the baby, isn’t she tiny?’ The mother leaned in, kissed her, and held her little wrapped bundle.” When the baby was treated like a person, the whole process became easier. Chany always tells the mothers, “You don’t want to look back without closure. Hold the baby, even just for a few minutes.”
But it’s always a suggestion. Nothing is ever forced.
Andrea has watched this decision play out in every possible way. One mother chose not to hold her son. When that happens, Andrea gives the mother options, that Andrea can hold the baby, or look at the baby and report back. The mother wanted her to look at the baby for her.
“When I came back into the room, she asked me right away, ‘What color hair does he have? What does he look like?’ Maybe she didn’t want to hold him, but I remember thinking, That’s a mother!”
Some families choose the opposite, trying to make the time they have together as full and tender as possible. They sing to their baby, rock the tiny body gently, talk, and cry, trying to compress years of parenting into mere hours.
Andrea recalls a mother who wanted her stillborn daughter dressed in pink for photographs, “like a little photo shoot.” The nurses helped change the baby so they could take all the pictures she needed, granting a heartbroken mother the opportunity to acknowledge the loss of her daughter in a way that gave her comfort.
And when a young mother chose not to see her stillborn, Andrea asked the mother if Andrea herself could hold him. At least this mother would always know that someone held her child lovingly before he had to be taken away.
This time together matters because many parents are more connected to the baby than they realize. Mothers have already bonded with kicks and fluttery movements throughout the pregnancy. For them especially, holding the baby can be very therapeutic.
It’s also agony.
“When I had my stillborn son, I was very torn,” Baila admits. “I loved my baby and wanted to see him and hold him. But I was terrified of being haunted by some frightening image instead of picturing my baby the way I imagined him, adorable and angelic.”
While the baby was being taken care of, Baila’s emotional doula held her hand and talked to her softly. Then she went to see the baby for them.
“It’s a boy, and he’s so sweet,” she told them, then asked if they wanted her to bring him in.
“My husband looked at the baby first, and said he didn’t think I should look at the face, but he did think I should hold him. So that’s what I did. I held my baby with his face covered. Then my doula asked gently, ‘Should I uncover a little foot for you? Would you like that?’ I saw his precious toes, I cried, I talked to him, and I felt a sense of closure, even though I never saw his face.”
But not every baby is stillborn. Some of Chany’s most difficult calls are for babies who can’t live long.
“We go in for sick babies also, not just stillbirths,” she says. “Some babies only live for an hour, and we support those families, too.”
Most parents facing this situation already know before labor that this is where things are headed. There’s been a diagnosis and weeks of preparing for the inevitable. That doesn’t make the end any easier. The baby might be breathing normally one moment, and then suddenly, things change.
“It’s very hard,” Chany says.
The choice of having a healthy baby was taken away, so emotional doulas give the parents as many other options as possible. Because at the end of the day, what matters most isn’t whether a mother wants to hold her baby or not. It’s that nobody else makes the decision for her.
The Making of a Mother
All three women agree — grief goes looking for someone to blame.
There was a couple Chany helped out over Succos. They were staying at his parents when the wife realized she wasn’t feeling any movement. She called the doctor, who didn’t answer. She decided to wait until the next day before contacting him again. When she went into the office, there was no heartbeat.
Chany stayed with her during the long labor. When the stillborn baby girl was delivered, there was a tremendous feeling of grief in the room — and self-reproach. “Maybe I should have tried calling the doctor again, and the doctor should have answered…”“It’s very common for the mother to turn the blame on herself,” Chany says, “even though you can’t blame yourself for what’s only in Hashem’s Hands.” But self-blame takes something away from a woman. If it’s her fault that her baby died, what kind of mother is she? Is she considered a real mother? Maybe she didn’t take her vitamins, or she exercised too strenuously, or… the blame game can be an endless loop. A traumatized woman, one who can’t bring herself to hold the baby she feels she harmed, is often left wondering if she’s even allowed to grieve.
Making her a mother to the child gives something back.
“My fundamental belief, my passion, is to support the mother and make her a mother to this child, because when Mashiach comes, this is her child. However it happens, whatever form it takes. Becoming a mother and a father to this child, in whatever way is right for them, will validate their pain,” Malkie says.
As a psychotherapist, Andrea sees mothers who suffered through these traumatic births alone. She knows that some of those who don’t have the opportunity to process the loss can possibly develop symptoms of depression or anxiety later on. With acceptance of the child, the pain, and the circumstances — without any blame — comes a certain amount of comfort.
The Costs… and the Dividends
Being an emotional doula is not something Andrea or Chany blithely set down at the end of a shift.
For Andrea, being an emotional doula transformed her relationship with pregnancy. What she used to think of as a more “natural” occurrence has turned into profound reverence for the neis that is the creation of a child.
“Every cell dividing, every heartbeat starting, every toe and nail forming — a million things have to go right. And most of the time, amazingly, it does.” For her, Hashem is so clearly a partner in having a baby. “It’s a miracle every single time.”
For Chany, the change is subtle. “I’ve always loved helping people, but being an emotional doula has given me so much more sensitivity, and the ability to really see what another person needs.” When visiting a relative recovering from surgery, she realized intuitively that the woman needed a gentle touch, so she massaged the woman’s neck and shoulders.
“It was worth a million dollars to her,” Chany says. “Being an emotional doula helps cultivate that feeling, because I’m completely there for the mother — emotionally, mentally, and physically, for whatever she needs. I’m focused on her.”
And both women keep one foot planted in ordinary doula work. “Baruch Hashem, I get plenty of healthy births, too,” Chany says, “and that balance really helps.”
Sometimes, what carries an emotional doula through the pain is a note… which Chany has plenty of.
“Here’s one,” she says: “‘Your selflessness, coming to the hospital in the middle of the night to help people you didn’t even know, made our difficult situation so much easier. May Hashem shower you and your family with tremendous nachas, simchah, and all good things.’”
Still, emotional doulas are also human, and many of them also need to process their experiences. For this, Knafayim models peer-to-peer debriefing (not necessarily with a professional), totally centered on the doula herself. She can’t focus on what her clients went through, but on how she needs to find closure with what she saw and did.
The most beautiful moment? For Chany, that’s when the phone rings again, months or years later, with a different kind of news.
“I’m expecting, and I’d like you to be my doula at the birth.”
The privilege of bringing life into the world for a mother who once faced death is a wonderful, healing experience. And having an emotional doula at a live birth after loss is rewarding for the mother as well.
When Baila had her next child (another boy), she made sure to hire a doula who knew about loss.
“She understood my trauma. When it came time for labor and delivery, I kept asking her obsessively, ‘Is the baby okay? Is it really okay?’ And she told me, ‘Don’t worry, I’ll make sure this baby is going to cry so loudly when he’s born that you’ll want to cover your ears!’”
She knew that Baila couldn’t bear the sound of silence.
And Andrea, after helping too many grieving mothers, wants them to know: “You don’t have to go through this alone. Whether you have to terminate a pregnancy or your baby died in utero and you need to deliver… there’s help. I wish more people knew to reach out to organizations like Knafayim. We’re Klal Yisrael, we help one another. There’s always someone to call.”
The Last Hug
The last hug is the hardest.
Baila recalls how her emotional doula gave her and her husband space, stepping out of the hospital room and letting the two of them be alone with their baby.
“Even then, she peeked in to make sure we were okay,” Baila says. “My husband and I were crying and talking to the baby the whole time. Eventually, I felt like I would never stop crying as long as he was in my arms, and I let my doula know I was ready to send him back. She made sure I calmed down, that I ate and drank something — she literally brought me food! My husband had to step away to make phone calls, arranging for the chevra kaddisha, so she just sat with me.
“It might sound like, just an hour or two, is that really such a big deal? But for someone going through the trauma of a stillbirth, having someone really there for you, making sure you’re as okay as you can possibly be through the whole experience… it was everything.”
And then Baila and her husband had to face the journey home, arms achingly empty and hearts filled with grief.
“I davened that I should be the last Yiddishe Mama to go through this,” Baila says, and there’s a catch in her voice. Because her tefillah hasn’t been answered… yet.
Because during the day, and sometimes at night, the phones in the emotional doula group chat still buzz. There’s the information about a date, a hospital, a number of weeks. Then virtual hands fly up and a woman will go, because someone is about to become the mother to a child she’ll only hold once, and she needs someone to be there.
So they go. And they daven.
Let this be the last time. Let this be the last time a stillborn baby is held. Let this be the last time we hold a mother in her grief. And let this be the last time a mother has to give her child one last hug to carry her love into eternity.
Dos and Don’ts
Don’t say: “Baruch Hashem, you have a beautiful family at home.” “B’ezras Hashem, you’ll have another baby.” “You’re young, you’ll have more.” Andrea calls these her “top three least helpful comments.” Nobody grieving for one specific child wants to hear about the children they already have or the ones that might come down the line. Andrea’s started warning families in advance, before they leave the hospital: “People are going to say dumb things, and I want you to just say, ‘Baruch Hashem’ back, because Baruch Hashem, they don’t understand what you’re going through.”
Don’t forget the physical: After one woman’s third loss, Chany didn’t wait to be asked to do things. She brought the woman a blanket, slippers, water, and helped her get dressed after her procedure, down to her shoes and socks. After birth or a procedure, women need physical care just as much as emotional support.
Do open the conversation: This is the piece of advice Chany is proudest of. “After the birth, I tell the women to tell one trusted friend what happened, and let that friend tell everyone else so things don’t get awkward. Otherwise, people just avoid you.” It’s not out of cruelty, but because nobody knows what to say.
Do encourage something tangible: Andrea tells families they can buy or make something to honor the memory of their baby. She has her own memory piece, a necklace with a butterfly charm and a heart charm, bought years ago for a family member’s two losses.
Do let them write it down: Andrea suggests writing down what happened. “A mother who writes her story is able to put her thoughts into a story that is concrete and organized, and this can be very helpful in processing her loss and helping her heal.”
Do keep the photographs (even the ones nobody’s ready to see): Knafayim’s team keeps every photo on file indefinitely. “One family couldn’t look at their baby’s picture when I took it, but they called asking for it now, months after their loss,” says Malkie.
Shoshana Gross
https://mishpacha.com/the-last-hug-2/
