July 29th, 2008

Filed under:
Mixed Bag, The Long View
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Who are the Doulas of Death?

Lately I’ve being thinking a bit about doulas, and their re-emergence as a profession in our culture. In case you’re unfamiliar with the term, here’s the Wikipedia entry:

A doula is a non-medical assistant who provides various forms of non-medical support (physical, emotional and informed choice) in the childbirth process. Based on a particular doulas training and background, the doula may offer support during prenatal care, during childbirth and/or during the postpartum period. A birth doula is a continuous care provider for labor in many settings. Thus a labor doula may attend a home birth or might attend the parturient woman during labor at home and continue while in transport and then complete supporting the birth at a hospital or a birth center.

I hadn’t seen the word ‘parturient’ before, so here’s a definition of that term:

1. About to bring forth young; being in labor.
2. Of or relating to giving birth.
3. About to produce or come forth with something, such as an idea or a discovery.

It’s kind of an awful looking word–it reminds me both of ‘prurient’ and ‘nutrient’.

Profound Moments in Life

We employ a doula at what is, presumably, one of the most profound moments of our lives. It’s interesting, I think, that a similar role hasn’t emerged to guide us through another profound moment of our life–our death. This was a role traditionally filled by a priest or pastor, but in North America we live in significantly post-God nations. Who are the doulas of death?

I have some semi-formed thoughts around the association of doulas with New Ageism. In my experience, New Age movements tend to emerge where a receding Christianity has left gaps.

Beyond the comfort of faith, I’m not sure what role the Christian church served in pregnancy and birth, so that thesis doesn’t seem to hold much water. Mind you, speaking of water, we shouldn’t forget baptisms and christenings. So, I’m left with these incomplete statements:

Christianity: As x are to birth, priests and pastors are to death.
New Ageism: As doulas are to birth, x are to death.

If the terms ‘Christianity’ and ‘New Ageism’ are too charged, we could just replace them with, say, ‘100 Years Ago’ and ‘Today’.

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Comments: 9 Responses so far

Richard Akerman
July 29th, 2008
12:42 pm

Hospice care workers the first thing that comes to mind in terms of doulas of death.

[Reply]

Jen
July 29th, 2008
1:13 pm

I was thinking the same way as Richard - just as doulas are there to support women giving birth and their families and navigate the medical part of things (should the woman give birth in a hospital), so are hospice workers around to support the dying and their families in the variety of situations where death takes place in a predictable manner (so not for car accidents, etc.).

[Reply]

Leanne Palmerston
July 30th, 2008
5:53 am

Just to clarify, I am sure that you will find that at leat half, if not more, doulas who currently practice identify as Christians and offer services that encompass their faith for other believers.

As a non-Christian, it really freaked me out when I became a doula - me coming from a feminist, rights for women position - that so many birth workers were pretty hardcore Christians.

And, yes, of course, hospice workers are the doulas of dying. When my MIL died a cancer a few year ago, we were assigned a social worker (in Ontario, Canada) to help make sense of what was going on.

That person did not remain with us as we kept vigil, however, like a doula would remain with a couple throughout the entire birth process. And, she didn’t really do anything for my MIL, being there mostly for our benefit or to walk us through any administration we needed to do on our MILs behalf.

The staff at the hospital couldn’t stop long enough to provide meaningful emotional/comfort support to my MIL during her last days much the same way that L&D nurses come in and out of a labour room, unable to provide labour support outside of pain medication.

I imagine there is a gap at this time of life, too, for someone to be with the dying for their specific comfort. Though, doulas have been shown in research to improve birth outcomes. What would the benefit to hiring a doula for the dying?

[Reply]

Adriana
July 30th, 2008
9:29 am

My mother is a hospice volunteer here in Victoria. She defines her role as one of support for the dying and their loved ones. Unfortunatly the volunteer program is one of discrete assigned hours and she rarely sees the same patients from week to week.
Although there are probably some volunteers who would be willing and have the time to be matched full-time to a patient, for most, the variables extent of the time commitment would be too much. It would probably take a professional commitment.

I also suspect that there is a certain discomfort around for-fee-support/guidance for the dying & their families. People are more willing to pay to ensure a smooth & supported joyous occasion, than a smooth & supported sad occasion. As much as it is a fact of life, society expects support to come from friends & family who have already been there and done that.

[Reply]

The Other Heather
July 30th, 2008
10:42 am

In addition to hospice workers, there are palliative care teams that include doctors, nurses, and home health care aids.

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The Other Heather
July 30th, 2008
10:43 am

Err…home health care aides. Pardon the typo.

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darren
July 30th, 2008
11:09 am

Indeed, hospice care workers and home health care aides do seem like a fairly good fit. I don’t know how much of their work is intended to be coaching-oriented. Any thoughts?

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TheRogueMama
September 23rd, 2008
9:39 am

I am an MA student for Holistic Counseling and I am a doula and childbirth educator. I think a ThanaDoula is something different from palliative nursing or hospice care. Doulas, in birthing, are independant support persons, helping women advocate for the birth experience they would like to have and assisting them in navigating what comes up unexpectedly. A ThanaDoula would do the same thing, for the dying. This type of support person would navigate the waters between priest or priestess and healthcare provider, with no other agenda than to assist the person at the end stage of their life to navigate, comfort, soothe and love a person through this new and often scary process. ThanaDoulas would not be bound by someone else’s agenda, policies, procedures, except that they would operate within the boundaries of the laws of state and country where they serve and work, exactly as it is for birth doulas. We are companions through the process, allowing our clients to let go in their own way, to transition through their own dying and to feel loved and cared for, the center of attention, tending to the dying.

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Doula of Death by Another Name: Death Midwife
December 28th, 2008
9:04 am

[...] in July, I wondered why we didn’t have doulas for the process of dying. Several commenters suggested that hospice and careworkers filled this niche, and I thought thought [...]

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