The afternoon of April 29, 2005, has been marked as a forever turning point for Nicole Alston and her husband, Paul. The couple was expecting their first child, but within minutes of arriving in the delivery room, their doctor delivered tragic news.

“He told us: ‘There is no heartbeat,’” Alston says.

When the Alston’s got pregnant, she described their life as “really coming together.” She was thriving in her career in the corporate relocation business, as was Paul in his role in the field of transportation.

“It was a happy time,” she says. Her doctor had told her, “you’re having a textbook pregnancy,” she says. “Once we got past that first trimester, I really wasn't thinking that anything bad could happen. … And then it did.”

After her doctor’s grim delivery-room news, Alston delivered her 7-pound, 1-ounce stillborn baby daughter. The couple named her Skye, which they had chosen months earlier. “In that moment, I felt like I had to push through,” Alston says. “I was overwhelmed with sadness, not really understanding how this could possibly have happened. My life changed forever.”

They spent a couple of hours holding their baby girl — time they were more than grateful to have with her.

In that moment, Nicole says, a flood of thoughts consumed her. She cycled through the memories of the years she and her husband had spent trying to get pregnant, her miscarriage in 2004, and then the many pivotal moments they would not be able to share with Skye, like her first birthday.

“It's like you’re speeding toward a brick wall,” says Alston, “and then everything gets demolished.”

Now, nearly 20 years later, Alston is a social worker who has served in many roles for the Center for Prolonged Grief at Columbia University in New York City. Currently, she’s an affiliate and field supervisor at the Center, which investigates and develops ways to help people deal with grief.

Alston says her loss has paved the way for her to pursue what she now considers her life’s work in supporting other bereaved mothers and families who have suffered a significant loss.

But the grief can still sting, just like it did in those early moments of her loss, she says. The lesson she’s learned: grief never goes away, and that’s okay, she says.

Condolences, Like ‘At Least, You Can Have Another Child,’ Didn’t Help

Coping with the loss wasn't easy in those early months, Alston says. Within nearly a month of burying Skye, Alston was laid off from her job of 11 years.

Comments from well-meaning friends, like “just be strong” and “at least, you can have another child” and “God doesn’t make mistakes” did not help.

She isolated herself from family and friends, as a way of protection. She says she didn’t know how to talk about what she felt were complex emotions with her social circles. In her subsequent work researching grief, she has learned that this was a common response following perinatal loss.

“Anything that starts with ‘at least’ is not helpful,” says Heidi Horsley, PsyD, a licensed psychologist, social worker, and adjunct professor at Columbia, whose work focuses on grief. “You need people to show up for you — witnessing, validating, and normalizing your grief.”

The grief of losing a child at birth is profound for parents, Dr. Horsley says. Preparations for, as well as expectations of, that child’s future are formed. “So when you lose a baby, you lose not only that child, but you lose the future you thought you were going to have,” she explains.

Alston and her husband turned to their faith and prayer to help cope. They also allowed one another room to grieve in their own way.

For the most part, Paul admits he held in his hurt and pain during the initial aftermath of his daughter’s passing. “I got through it. I was more focused on Nicole," he says.

“We both had to learn how to deal with the loss,” she says.

Finding a Lifeline

At times, Alston says she found herself in a tailspin because of her grief, and soon realized she had to bring that to a halt. “I was not in a good place. There was so much despair, and I wasn’t turning the corner,” she says.

She decided to go on a 21-day partial fast, only eating raw foods, including fruits and vegetables, which she says served as a sort of mental reset and helped her keep the focus on moving forward. She says she wanted to take a step that felt like something tangible she was doing to pay more attention to healing. She read as much as she could about stillbirths and the impact on women of color.

“This acute grief period was a defining moment,” she says.

She learned that Black women were twice as likely to lose a child at birth — a trend that persists today, according to a study from the Centers for Disease Control and Prevention (CDC). The staggering data made Alston realize she wasn’t alone, and it also led her to want to help other bereaved mothers and families, she says.

Within the four months of losing Skye, Alston established a foundation in Skye’s honor (The Skye Foundation), and she was invited to share her experience with nurses, social workers, physicians, and fellow grief advocates. She shared her story with national media outlets.

“I don’t want to give the impression that there was this magical thing that happened after 21 days of fasting,” she says. “I prayed. I turned to my faith. I cried a lot. I gave myself permission to be sad during this time.”

But, she also realized that supporting others who were grieving “was a lifeline” for her.

“You don’t get over a loss, you learn to live with it,” adds Horsley, who lost her brother in a car accident. “It changes us in profound ways.”

Having a Voice in the Space

Alston decided to work on a master’s degree in social work at Columbia University, which she completed in 2010. She studied under Horsley.

Since graduating, she’s worked with families, medical staff, and other advocates to better understand how to provide psychosocial support for families who lose a child at birth. She’s contributed to various blogs and major University textbooks — like Bereavement Care for Families, which covers perinatal loss among other types of family grief.

In her roles at Columbia, she has been a community liaison, recruitment coordinator, and independent evaluator for various major studies. One of these studies explored the treatment of complicated grief and life after loss among older adults.

In 2017, Alston founded OK2Grieve, an organization that provides online resources and services to support families after a loss. The mission of the organization, according to Alston, is to broaden people’s understanding of what it means to grieve by giving people space to share stories — be it the death of a loved one, an illness, a disappointment in life, or a divorce.

Currently, she’s part of the Columbia research team focused on studying COVID-19, the impact of the pandemic in Harlem, and the pervasive effects of grief on the Black community there. She’s also working with the Social Work Health Futures Lab (at Portland State University), which is exploring effective interventions to support those grieving in the aftermath of the pandemic.

“If we have not learned anything else during the pandemic, I believe that as a world, we are more grief-aware,” she says. “We have lost too many people to pretend that grief is not a thing.”

Alston also worked as an associate producer for the documentary The Color of Care, a joint effort by Oprah Winfrey and the Smithsonian Channel that premiered earlier this year that investigates the racial inequities within the U.S. healthcare system.

“I'm passionate about perinatal loss, but I wanted to talk about grief and loss from a broader perspective,” she says.

When Alston’s grief resurfaces, she says she leans on her faith. She also doesn’t ignore those feelings or the losses she continues to experience.

Skye would be 17 this year, enjoying her final year in high school, she says. As a family, the Alstons celebrate Skye’s birthday each passing year. “Being intentional about that has been really healing for us,” she says.

Being able to help others with grief and loss, helps, too, Alston says.

Alston says at her lowest point a close friend prayed with her. Her prayer was that one day Skye’s death, and the grief that followed, would make sense, she says.

Her current work can be challenging, and bring mixed emotions, she says. “But to have a voice in this space feels validating,” she says. “As opportunities have unfolded — for stronger academic credentials, to speak internationally, to publish with some of the thought leaders in grief and loss, to participate in research projects — Skye’s short life birthed purpose in me.”