Perinatal Loss Doula Wellness Check Form

Supporting Those Who Support Grieving Families: Perinatal Loss Doula Wellness Check Form

Perinatal loss doulas perform some of the most emotionally demanding work in healthcare support—accompanying families through stillbirth, attending NICU vigils, creating precious memory photography, and providing ongoing bereavement care. This Perinatal Loss Doula Wellness Check Form offers a dedicated space for doulas to process their experiences, identify signs of compassion fatigue, and access the support they need to continue this vital work.

The Unique Emotional Landscape of Perinatal Loss Support

Unlike traditional birth doula work, perinatal loss doulas enter spaces filled with grief, medical trauma, and profound loss. They witness parents meeting and saying goodbye to their babies in the same breath, capture the only photographs families will ever have, and hold space for unimaginable pain. This work, while deeply meaningful, carries significant emotional weight that requires intentional wellness practices and organizational support.

Why Regular Wellness Checks Matter for Perinatal Loss Doulas

Compassion fatigue and secondary traumatic stress are occupational hazards for anyone working in bereavement support. Regular wellness checks help doulas and their organizations:

• Identify early warning signs of burnout, vicarious trauma, or emotional exhaustion before they become debilitating
• Create a culture of care where seeking support is normalized and encouraged
• Track patterns in what types of cases or circumstances create the most stress
• Allocate resources more effectively based on doula needs and case complexity
• Prevent turnover by addressing wellness concerns proactively
• Maintain quality of care for grieving families by ensuring doulas are emotionally resourced

This wellness check form serves as both a personal reflection tool and an organizational early-warning system, ensuring that those who care for others are themselves cared for.

Key Features of This Perinatal Loss Doula Wellness Check

This template is specifically designed around the unique stressors perinatal loss doulas face:

Stillbirth Support Assessment

Stillbirth cases carry particular emotional complexity—full-term babies, parents' shattered expectations, and medical interventions that can feel traumatic. The form explores how recent stillbirth support has affected the doula emotionally, what made specific cases particularly challenging, and whether the doula feels adequately supported in processing these experiences.

NICU Vigil Attendance Impact

Extended NICU vigils—sometimes lasting days or weeks—create sustained emotional exposure and unpredictable schedules. The wellness check addresses the physical exhaustion and emotional toll of maintaining presence during these uncertain, high-stakes situations, and identifies when vigil work is becoming unsustainable.

Memory Photography Stress Evaluation

Creating memory photography is both sacred and psychologically complex work. Photographing babies who have died or are dying requires technical skill under emotional pressure, awareness of medical equipment and family sensitivities, and the weight of knowing these images are irreplaceable. This section helps doulas process the unique stress of this responsibility.

Bereaved Family Follow-Up Load

Ongoing support for bereaved families—through anniversaries, subsequent pregnancies, and grief milestones—extends the emotional connection and can blur boundaries between professional support and personal grief. The form examines the cumulative impact of carrying multiple families' stories and the challenge of knowing when and how to conclude support relationships.

Self-Care and Boundary Assessment

The wellness check includes questions about current self-care practices, boundary maintenance, personal grief triggered by cases, and available support systems—both professional and personal.

Resource Needs and Organizational Support

Doulas can identify specific resources, training, or organizational changes that would better support their wellness, from clinical supervision to adjusted caseload limits to peer support groups.

How Healthcare Organizations and Doula Collectives Use This Form

Hospice and palliative care programs, hospital bereavement support teams, independent doula collectives, and nonprofit perinatal loss organizations can implement this wellness check form as part of comprehensive doula support:

• Monthly or quarterly check-ins following particularly difficult cases or as regular practice
• Post-case debriefing to process immediate reactions and identify needed support
• Supervision conversations where coordinators and doulas review wellness together
• Annual wellness reviews to identify trends and adjust support structures
• Confidential self-assessments that doulas can use for personal reflection, with the option to share with supervisors

Paperform: The Compassionate Platform for Sensitive Wellness Assessments

When collecting information about grief work, emotional exhaustion, and personal wellness, the form experience itself matters. Paperform offers the perfect balance of professionalism and warmth that this sensitive work requires.

Design That Honors the Work

Paperform's document-style editor lets you create a wellness check that feels more like a thoughtful conversation than a clinical assessment. Add gentle imagery, calming colors, and compassionate language that acknowledges the sacred nature of perinatal loss support work. Choose fonts and backgrounds that create a peaceful space for reflection.

Conditional Logic for Personalized Support

Use Paperform's powerful conditional logic to show follow-up questions only when needed. If a doula indicates high stress around memory photography, reveal specific questions about training needs or peer consultation. If they're experiencing symptoms of secondary trauma, automatically display crisis resources and encourage immediate supervisor contact.

Confidential and Secure Responses

Wellness assessments require trust. Paperform's SOC 2 Type II compliance ensures responses are securely stored, while role-based permissions let you control exactly who can access sensitive wellness data. Doulas need to know their honest reflections are protected.

Integration with Care Coordination Systems

Connect Paperform wellness checks to your case management software, HR systems, or Slack channels for appropriate escalation. Use Stepper to automatically route high-concern responses to clinical supervisors while maintaining confidentiality, or trigger follow-up appointment scheduling for doulas who request support.

AI Insights for Organizational Patterns

Use Paperform's AI Insights to analyze wellness check responses across your doula team, identifying common stressors, resource gaps, and support needs without compromising individual confidentiality. These insights can inform training programs, caseload policies, and wellness initiatives.

Mobile-Friendly for Flexible Completion

Doulas work irregular hours and may want to complete wellness checks during quiet moments. Paperform's mobile-optimized design ensures they can thoughtfully complete the form whenever and wherever they have emotional space to reflect.

Building a Culture of Care for Caregivers

Implementing regular wellness checks sends a powerful message to perinatal loss doulas: your emotional wellbeing matters as much as the families you serve. This proactive approach to doula support:

• Normalizes the emotional impact of grief work
• Provides language for doulas to articulate their experiences
• Creates data that justifies increased support resources
• Demonstrates organizational commitment to sustainable, ethical care
• Prevents crises by addressing concerns early

Organizations that prioritize doula wellness see lower turnover, higher quality care, and healthier, more resilient teams capable of sustaining this demanding and meaningful work over the long term.

Extend Your Wellness Program with Stepper Workflows

Stepper (stepper.io), Paperform's AI-native workflow builder, can transform wellness check submissions into coordinated care for your doula team:

• Route urgent concerns to clinical supervisors or program directors immediately
• Schedule follow-up conversations automatically based on stress indicators
• Track wellness trends over time for individual doulas
• Send resource compilations (articles, podcasts, exercises) tailored to reported challenges
• Create peer support matching based on similar experiences or case types
• Trigger check-in reminders when doulas haven't completed a wellness assessment in their designated timeframe

This automation ensures no doula falls through the cracks while maintaining the personal touch essential to wellness support.

Supporting the Supporters

Perinatal loss doulas hold some of the most sacred and heartbreaking spaces in healthcare. They deserve—and require—organizational systems that honor their emotional labor and proactively support their wellbeing. This Perinatal Loss Doula Wellness Check Form provides a structured, compassionate way to ensure those who care for grieving families receive the care they need.

Whether you're leading a hospital bereavement program, managing a doula collective, or coordinating hospice support services, implementing regular wellness checks is an investment in both your team and the families they serve. Paperform makes it simple to create, deploy, and manage these essential wellness assessments with the sensitivity and security this work demands.

Start supporting your doulas today—because sustainable compassion requires intentional care.