Death Doulas in Mainstream Media: (Let’s Be Honest Here.)
9 minute read
In June of 2021, an article in the New York Times regarding Death Doulas was circulating around the death worker community, landing on my desk several times. The title of the article read like this, “‘Death Doulas’ Provide Aid at the End of Life: End-of-Life doulas support people emotionally, physically, spiritually and practically: sitting vigil, giving hand massages, making snacks.”
Before this article, there was an article in USA Today about Death Doulas that included descriptions of Death Doula work like this: “When people are nearing the end of their lives, a doula will visit and often sit vigil with them as they are dying. They also help patients with their will and other advance directives. They help people do legacy projects such as quilts, art projects, scrapbooks or writing letters to leave behind to their relatives.”
While mainstream media is getting the word out about the work of Death Doulas, it isn’t quite telling the public the truth about all the ways Death Doulas work. Are these articles telling the general public (and Death Doulas) that this work is just an adjunct service to hospice, that it’s an upgrade on your death care? Are these articles describing a service solely focused on the person dying and not the caregivers?
Over the past several years, as I watch the holistic death care movement grow, I’ve noticed the portrayal of Death Doulas and Midwives in the media continue to repeat this pattern. Are these articles serving or hindering the Death Doulas’ work? They may possibly be doing both. While they are making the Death Doulas’ presence palatable, they are leaving out the fact that oftentimes, the Death Doulas are essential workers.
Death Midwifery – my term for this work - is a missing piece in the fabric of American humanity. If we lived in multi-generational living situations or in cooperative communities, we would possibly have designs for thoroughly holistic death care spaces. My work falls under the umbrella of Death Doulas, yet the style of Death Midwifery I and several other death workers practice is rarely described in articles. Nobody asked for my opinion, so I’ve taken it upon myself to write this article and set my opinion out there to be read. After so many years serving families and individuals as a Death Midwife, educating hundreds of people about death, teaching nursing students in universities, and training Death Midwives through my Nine Keys Death Midwifery Apprenticeship, I’d say I have a right to have an opinion on what is being told to the general public about Death Doulas.
While Death Midwifery does include creating legacy projects, helping people get their affairs in order, offering therapeutic touch, and caring for our clients with nourishing meals and spiritual support, it also includes crisis management. That is a part of the work that not many of these articles address. I’d like to give some examples of how Death Midwifery, as a movement of compassion, serves these cases as well.
A few years ago, a young woman in Atlanta reached out to me, through my website contact page, a few hours after she found her father’s body in his bedroom. He died by suicide after suffering for several years with multiple sclerosis. I called her immediately, assessing the crisis over the phone and giving her directions for immediate care as they waited for my arrival. I was at their house shortly after the call. By the time I arrived, the body had been removed by the medical examiner. Upon my arrival I began to triage the different articulations of this trauma among the suddenly bereaved. I knew what was ahead of them, and I wanted to slow things down for them before they would be rushed into the throes of after-loss plans. It was a few hours later, when everyone was sitting on the sofa—and I on the floor—that we were able to find a moment for holistic death care on this devastating day.
All deaths are holy passages.
In February of 2020, I was serving a gentleman whose mother was dying of congestive heart failure. This woman expressed to me that she did not want to burden her family with caring for her. She wanted her dying process to speed up. Her resistance to care from her family and hospice made things very difficult for all involved. My weekly visits with this woman looked like what the New York Times and USA Today said Death Doulas do. We sat together, had tea, listened to oldies music, and held hands. I did lead her through guided meditations, and we did have conversations that drew her closer to accepting her situation. A few days after what would be my last visit with this family, I received a shocking phone call from her son. His mother tried to end her life by suicide and the method she chose did not work completely. She was in intensive care with serious injuries. This is exactly what she didn’t want for her death. My Death Midwifery went from making tea, to managing the family crisis.
She died the next day. Death brought mercy, as it often times will do.
In May of 2020 I was called by a gentleman who got my name and number from a health food store clerk who knew of my services. The gentleman was in the store seeking homeopathic pain relief for his condition. He was dying of pulmonary fibrosis. In our phone call, I could hear that he was struggling to breathe. I arranged a visit for us for later that day, as speaking in person would not be as taxing as speaking over the phone. I found him in his front room, sitting upright in his Eames lounge chair, ringing his hands in anxiety. His oxygen tank was humming, but the nasal cannulas were pulled down under his chin.
I noticed a silk ascot peeking up over his collar and his neatly pressed trousers. His wife was sitting on the sofa next to him, her legs curled up underneath her and there were dark circles under her eyes. I often can gauge a death and dying situation by the countenance of the caregiver’s face. After introductions, I sat on the floor, at this man’s feet.
“What would you like to ask me?” I said. “I see that you are having a difficult time.”
He went on to explain that he was on hospice care, though he refused their help and medications. He explained that he saw his father die of the same disease. He said, “I understand that you’re a Death Midwife. I assume that you help people die. I want to die soon.”
My heart went out to this man and his wife. I could tell that they’d been in a constant state of stress for some time. I asked him if I could speak plainly. I am good at speaking plainly, and I can see when someone, nearing death, has lost all patience with death euphemisms and false-hope-speak. What I struggle to do is to beat around the bush, though I’ll manage it when necessary. He was appreciative of plain speech.
“You are going to die soon, we both know this,” I said. “Going about it with anxiety and hurry like this will make it even more unbearable. I see you here, you are sitting upright, fully dressed, ringing your hands. I sense that death would like for you to find relaxation and surrender, sir.”
He leaned back in his chair, putting his head on the headrest. “Okay. How do I do that?”
I looked around his shoulder at the wet-bar on the wall behind him. I knew that getting this man to practice long, deep breathing for relaxation was out of the question. He could barely breathe. So, I asked him if he’d like a cocktail. He said yes. The look on his wife's face went from bewilderment to a sort of comfortability. She jumped at the opportunity for normalcy and made three martinis, one for each of us. As we sipped our drinks, and the evening went on, he began to relax. He told me stories about his travels around the world and his great affinity for art and for natural medicine.
After we finished our drinks, I explained to him that it was time to rest. I went so far as to ask him if he had a lovely set of pajamas, which he did. He promised me he’d go upstairs and climb into bed and relax.
We said our goodbyes. Three weeks later his wife sent a text message to me. He died in his bed, relaxed and at peace.
Death Midwifery, at times, manages crises. It shepherds families who may fall to pieces in their loved one’s dying process. It holds things together when heart strings are breaking. Death Midwifery midwives a dying person through their caregivers. It’s whole-family focused. It aims to get everyone on the same page. When the caregivers are dangerously exhausted, or are feeling lost, or are unable to let go, their lack of well-being impacts the one they are caring for. In my experience, Death Midwifery does more than sit bedside; it sits beside the family as they sit bedside.
As I tell my apprentices, it is an anomaly to be called to serve a family by holding vigil, lighting candles, and playing music. We’re not there yet as a culture. Most people don’t know how the body dies. My apprentices can hold space for someone who is dying, but they know this may not occur as often as they hope. They are inspired to be death-educators. They are taught to consider the caregivers as highly as they do the one who is dying. And they are taught how to arrive to traumatic death and dying spaces, without consternation. I tell them the truth: Death Midwifery is sometimes crisis management.
To make quilts, work on legacy projects, and write letters to leave behind would require a dying person to admit that they are dying. To invite a Death Midwife into the home is to admit that there is dying happening in the home. There’s a certain level of acceptance that must be reached before a Death Midwife is called upon. Many times, that acceptance doesn’t come until they are close to the end, when acceptance is one of the last remaining options. Death Midwives are rarely called by a person who is dying. They are called by the dying person’s caregiver, yet so much of the mainstream media is reporting something that points to the opposite.
If mainstream media continues to only tell the palatable narrative about this work, telling the general public that Death Doulas provide emotional support, give hand massages, and make snacks— without telling the stories of Death Doulas and Midwives who are also managing family crises, supporting caregivers who have reached burnout levels that are dangerous to their health, sitting with people who are dying who don’t want anything to do with a Death Midwife - their adrenal fatigued caregiver in the other room - being on-call for families who feel lost in the medical death care systems, available for sudden death situations— then how will this movement be able to truly grow? Goodness grows well through truth. It’s radical, compassionate community care. It’s not just an add-on to the current death-care status quo.
It's important to the work of Death Doulas and Midwives that the many sides of our stories be told. Death Midwifery is not an upgrade on the death-care for a financially privileged person who is dying. Death Midwifery is an ever-evolving mission that is returning holistic death care, death literacy, and person-centered care to communities. In its current incarnation, it is often times essential crisis management.
With all due respect, this work reaches far beyond hand massages and making snacks.
Narinder Elizabeth Bazen
(C) 2016 Narinder Bazen Death Midwifery, LLC All rights reserved
*Details of stories have been changed to protect the privacy of my clients.
