Midwives or Doulas Help to Ease the Way

The first moments of life are often filled with heightened emotions, confusing paperwork and plentiful reactions from those surrounding the new mother and baby.  Life’s final moments are very much the same.  Providing emotional, spiritual and psychological support for women during childbirth has been extended these days to providing very similar services at death.  Birth doulas guide souls into life; death doulas guide souls out.

In recent decades, there is a sweeping movement happening and we see a growing number of doulas (the term is Greek for “woman who serves”) helping in many ways to ease the process of dying, grieving, and acknowledging both death and birth as sacred acts.  Like birth doulas, death doulas don’t play a medical role.  They work collaboratively with doctors, nurses, hospice teams and other caregivers to provide practical support to families and individuals at the end of life.  Their roles are often seen as end-of-life guides, soul midwives, death coaches, or “death doulas” among others.

The role itself isn’t always well-defined.  Death doulas can work in a healthcare setting, in the home, or in senior living centers.  They are often called upon by medical professionals, by the family, or the client themselves.  An end of life doula may be likely to step in early in the process, helping both the healthy and the terminally ill make sure their medical care, their paperwork and end of life wishes are in place in the way they prefer.

Among midwives and doulas, there’s a belief that no one should feel alone during life’s mystifying, sometimes terrifying beginnings or endings.  The Death Doula philosophy focuses on the idea of a “conscious death,” where “people have the death they really want.”  Of course, this means different things to different people.  Some want to tell their life stories, some want to simply hang out and play cards, while others want to hear beautiful soft music.  Many doulas say their greatest offering is sometimes to simply be a compassionate presence.

A “death doula” often becomes engaged closer to the act of dying itself, helping those at the end spend their final moments in the way they choose—perhaps helping to shape their legacy, doing a life review, making sense of their own story or in a ritual of their own creation.  Their primary role is to simply to be fully present to the person dying and/or the family to ensure compassionate and caring companionship at the end.  In the dying process, a Death Doula may provide a vigil for the dying person, holding their hand, singing, reading, simply being a compassionate, caring witness.  “Grieving Doulas” support families after a loved one has died.

The first organized Doula service has its roots in New York City in the late 1990s with a woman named Phyllis Farley.  She says, “It occurred to me that you need the same qualities at the end of life as you do at the beginning—helping people in the labor process.”  She knew that a disturbing number of people die alone, or in hospitals plugged into machines and didn’t want this to be the case.  80% of people report that they want to die at home, surrounded by a loving presence of supportive family or caregivers, while only 27% actually experience this.  In a world where doctors and nurses are pressed for time, family and friends are often upset or anxious during death, death doulas willingly walk into a void that would otherwise see many facing life’s inevitable end without the best kind of help.  There is a growing recognition that the spirit must be attended to as much as the body.  And the soon-to-be-bereaved need help along with the dying to facilitate meaningful interactions between them.  As a doula, it is important to encourage people to say everything they need to say so that they don’t look back with regrets.

An increasing number of hospitals and hospices offer end-of-life doula programs.  Doula services are tailored to meet the specific needs of each patient and his/her family.  They can include plans for their advanced directives, celebrations for their end of life, and how their wishes will be carried out.  In Coachella Valley, doulas are available and one can connect with those varying services through local Hospices and/or Graceful Passages at www.gracefulpassages.org.

Dr. Elaine Millam
Graceful Passages