SIOUX CITY | Jolie Vega remembers the first time she heard her son Judah's heartbeat.
The sound was music to the Sioux City native's ears. She was instantly in love with the baby growing inside her and her eyes filled with tears of joy.
"The whole pregnancy was just about him and our new lives with having a child and all the plans we had," she recalled. "When we lost him it was devastating, to say the least."
Vega's son was stillborn at 41 weeks gestation in September 2014, and then in January 2015 she had a miscarriage. She said she and her husband, Charlie, felt "blindsided."
"It was very hard on my husband and myself. We were each other's support system," she said. "It was a daily struggle to get up for the day and get going."
Eventually, the couple sought counseling to help them cope. Vega said they also found comfort in confiding in other couples who had similar experiences.
Hoping to help others, Vega founded No Footprint Too Small, a nonprofit organization in Lincoln, Nebraska, where she now lives. The organization supports mothers and families who have experienced pregnancy and/or infant loss.
Miscarriage is the most common type of pregnancy loss, according to the American College of Obstetricians and Gynecologists. Studies reveal between 10 and 25 percent of all clinically recognized pregnancies end in miscarriage, while the Centers for Disease Control and Prevention says stillbirth effects about 1 percent of all pregnancies. Each year about 24,000 babies are stillborn in the United States.
One of the most important services No Footprint Too Small offers is birth and bereavement doula support, something Vega said she wishes she would've had when she delivered her son.
Trained birth and bereavement doulas provide both physical and emotional support to mothers during labor and gently facilitate bonding -- holding the baby, bathing the baby or reading to the baby -- afterward. Vega said a stillbirth can be a very traumatic experience for mothers and families.
"You have all of the normal events in labor occurring, but then you have the loss on top of it. It just makes it very emotional," she said. "We basically allow the family the opportunity to say hello to their baby before they have to say goodbye -- that's very important."
No Footprint Too Small, which has about 15 regular volunteers on average, also connects mothers and families to counseling services and support groups in their communities, provides care packages filled with reading materials and mementos, and fashions weighted memory bears -- teddy bears filled with sand to match the exact birth weight of the baby they lost. Vega said the teddy bears are a therapeutic tool for mothers, many of whom report an aching in their arms and chest to hold their baby.
"We create those out of onesies or blankets or any other type of sentimental material the mother would provide or we can provide it for her if she doesn't have materials or doesn't want to let them go," she said.
Vega said her organization has sent memory bears and care packages to families living in Iowa, including Sioux City, as well as Nebraska. In the near future, she said she would like to establish a location for No Footprint Too Small to operate in her home state.
"We're looking into what that would entail and what steps we'd have to take," she said.
As a society, Vega said Americans are uncomfortable dealing with death, especially when it involves a child. She said pregnancy and infant loss can be a "pretty lonely grief journey."
When a stillbirth or miscarriage occurs, she said people often falsely assume something was wrong with the baby or the mother's body or that the mother was doing something harmful during her pregnancy.
She said the best thing you can do for a grieving family is spend time with them. She recommends avoiding saying, "They're in a better place," or "You can just have another baby," which can be particularly hurtful.
"That baby had a unique personality. It was an individual life," she said. "You can simply say, 'I don't know what you're going through and I can't imagine, but I'm here.'"
She said three to six months after the loss of a child is often the most difficult time because the shock has worn off. Mothers and fathers have gone back to work and visits from family members and friends have dropped off.
"Not only be there for them initially, but be sure to follow up and be there down the road for that family," she said.
Many mothers and couples, Vega said are grieving alone because they didn't announce their pregnancy. She said most people wait to go public with a pregnancy until after 12 weeks gestation, because most miscarriages occur in the first trimester. She said these mothers and couples may return to daily life feeling isolated and adopt unhealthy coping methods.
"You not only lose the baby, but you also lose all the hopes and dreams that are associated with that pregnancy," she said. "The outside world didn't have those memories and that common bond, so I think people kind of underestimate the value of that relationship between parents and an unborn child."