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The Business of Holding Space for Death

Updated: Apr 16, 2023

Should a bereaved parent(s) be expected to compensate you for your time, support, and service to them as an infant and pregnancy loss doula (IPLD)? This is an ethical business dilemma that IPLDs are going to have to work through if they are planning to evolve from IPLD volunteer to an IPLD with a personal practice, also known as a “business.” Some IPLDs receive a fee, many a non-specified monetary honorarium or donation, and some IPLDs choose not to be compensated at all.

It’s an ethical question that no one seems to want to discuss. There is the same thread of discussion in the death doula community, but when the deceased being is a baby and not an adult…that thread unravels. Even funeral homes/services are not in agreement as to whether a family should be charged for the services of disposition when there is a perinatal or infant death.

Many people have an opinion (and a strong one at that) on this topic:

  • “You would actually expect bereaved parents to pay you?”

  • “Obviously you volunteer all your services.”

  • “It’s not morally right to make money off of any human being who dies.”

  • “If you really cared, your service would be free.”

I have heard them all, and as an IPLD with my own practice, I had wrestled with this for at least a year before I was able to find a solution that felt right for me. Now, in my circumstances, I have another paid practice, and I am a retired person with a pension. These circumstances informed and impacted my decision making, but an IPLD who is serving their community fulltime and requires some modicum of compensation to survive & continue doing their work will have to rethink a business based on gifts of service and sliding scales.

Why is this such an ethical question? Why is this the “elephant in the room” even among IPLDs? Are there any other professions where there is such a sense of “uncomfortableness” around being fairly compensated for service dedicated to a client? Is the medical team assigned to the family being paid? How about the hospital chaplain? Does anyone gasp whether the florist who creates flower arrangements for an infant’s funeral charges for the flowers? Must the birth doula refund their fees if the family they are supporting experiences pregnancy or infant loss? Is the social worker or counsellor who is providing grief counselling for a family after a miscarriage getting compensated for their hours of support to a family? The answer is likely this…that in the time before, during, and after the experience of a pregnancy or infant loss, most of the professional circle of support around a bereaved family is being compensated in accordance with time spent and in consideration of fair compensation for services rendered.

So, I come back to this ethical conundrum for many people in the “business end of death”…are you entitled to be compensated in some form for the time, professionalism, expertise, and support you provide to a bereaved family? Is it that it is simply immoral to charge a fee or expect an honorarium from a family who has just lost a baby? Is it a money mindset issue for the IPLD themselves? Is it about personal worth? Is it an issue that the IPLD profession needs to explore? Is the issue of compensation one of the reasons why there are fewer active-serving IPLDs than death doulas? Does the self-worth mantra “I serve; I deserve” not apply to IPLDs? If IPLDS are not getting compensated, then are bereaved families at risk of not getting the most professional and supportive service they deserve? Is the fear of criticism the reason why an IPLD may not request some form of compensation for their services?

These are ethical questions that each IPLD will have to explore. There are no “professional standards” regarding compensation. There is no consistency within those persons who serve in this role. I found quite a few resources that helped me make an informed choice. Certainly, an area that I spent a great amount of time exploring was my own money mindset and how to serve my community in right livelihood.

Allan Cohen wrote a book called Spirit Means Business. You can take or leave the spiritual (universal not religious) related content, but the information on personal worth, and your relationship to service and money are worth exploring. There are many great thought leaders in the “money mindset” and right-livelihood arena that are focused on those who serve in helping/community service professions. If you need support to make these decisions in your practice, you may want to create a circle of IPLDs in your area who would like to explore the ethics of compensation.

Here are some statements from different thought leaders in this field who are interesting to engage with:

  • I serve, I deserve.

  • Just because it would be wonderful for all struggling families to have free services in their time of need, doesn’t mean you can’t be compensated as a professional.

  • Criticism of compensation is not a reason to volunteer your professional services. Many times, the criticism isn’t from people you serve; but from people outside looking in.

  • Remuneration for services does not only include money; there are so many sustainable ways for people to compensate you for your services. Think outside the box.

Questions to Consider

  • Are you feeling guilty, vulnerable, or waiting for permission from others to make decisions around IPLD fees/compensation?

  • How will you have your worth acknowledged in your practice?

  • Can you find a way to make passive income so you can serve your families for free?

  • How are you going to be compensated by right livelihood? Is nourishment of community and the capacity to express your gifts through your work enough for you?

  • Do you have the belief that you should rise above money?

  • Do you hold beliefs around money, abundance, and remuneration?

Each IPLD has a right to choose how they serve their families. There are no right or wrong answers. Trust your own inner guidance and act on that. Know that life finds ways to support those who support others—be that by money, exchange, recognition, appreciation, good Karma, opportunity, or spiritual, & soul prosperity.

Anyone interested in becoming an infant and pregnancy loss doula (IPLD) can register for HHA's IPLD certificate program here.


Kelly Hurley is a HHA graduate and has an infant and pregnancy loss doula (IPLD) practice in British Columbia. You can learn more about her at

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