It Is a Matter of Life and Death — Getting Support from Doulas
by Ryan Hook | September 16, 2020, updated about 1 month ago
“The states of birth, suffering, love and death, are extreme states: extreme, universal, and inescapable. We all know this, but we would rather not know it.”
– James Baldwin
Folk use the phrase “It’s not life and death,” all the time. Mostly they're correct, but in reference to doulas, they would be incorrect.
Arguably, the beginning of life, and the end of life are the most important events in human experience. Culturally and historically, birth and death have been sacred events. Informed leaders guide the dying or pregnant individual, assist and shepherd family members through complex emotions, and most importantly they provide comfort and insight for the person who is the focus of the life or death event. That’s not really how we approach these experiences anymore—at least, not in North American dominant culture.
While we have funerals, and palliative care, many of us are left lost and grieving with no one to look to for guidance when a loved one passes. Parents bringing life into the world have hospitals to turn to, and sometimes midwives, but once the baby’s out, the support may dwindle down to check ups and vaccination follow ups. The processes, in short, have become highly medicalized.
There are individuals who can assist with the emotional, spiritual, and complex processes of life and death, operating within our dominant culture—they are called doulas.
What is a Doula?
Doulas are trained professionals who act as guides, counsellors, and emotional support. Birth and End-of-life doulas offer philosophies and condolences that contextualizes life and death into a holistic experience.
I spoke with a birth doula and an end-of-life doula to get their perspective on their work.
Why Engage a Birth Doula?
While in the role of birth-doula Marie Steiner has just experienced her twenty-fifth birth and pragmatically notes, “Our bodies are created to have babies—it's a natural, normal process, and we’re created for it,” but, despite its commonality, very few formerly pregnant people can say the birthing process was the same for each of their children. There seem to be curve balls thrown in most birthing stories. No birthing process will line up exactly with another.
And that’s why doulas make themselves available—to support, and troubleshoot. Birth Doula, Marie Steiner says, “It takes a lot of character to have a baby and be a mother. So it’s important that I get to know [a clients’] personality, their sensitivities and even their allergies.”
When you engage a doula, you are engaging a person to learn about you, and to tailor the birthing process to what you, specifically, need.
What Do Doulas Do?
Steiner is, in her words, a “Mommy servant.” She gets to know the personality of the parent-to-be and to understand their specific needs because, “Comfort is different for everyone.”
Some pregnant people have morning sickness—some don’t. Some pregnant people become sensitive to smells—some don’t. Some pregnant people become irritable—some don’t. Helping you be more comfortable during your pregnancy is what doulas do.
Some doulas have knowledge of different foods and herbs to support pregnancy, or to stimulate birth if a child is hanging out in-utero for too long, or to promote lactation. Some doulas help you create a birth plan, and act as coaches and emotional support during the labour process. This is all in service to the primary objective of supporting the person who will be giving birth before, during, and after the process.
Steiner says, “In one case, a woman preferred being around her cat, [rather] than her husband. Sometimes, we just need to accept people’s needs.” Doulas help tailor the experience. They take in what you’re communicating so as to remedy what it is you’re struggling with.
Birth Doulas and Cultural Sensitivity
Birth is a common, world-wide miracle, handled differently culture to culture.
A birth doula may work with women from various cultures, looking for someone to support them in a culturally sensitive way. Steiner says she’s dealt with mothers from many backgrounds.
Steiner has integrated a variety of cultures’ practices into her own in the past. She says, “With so many philosophies on life, it’s important to understand different cultures—some prefer to keep the placenta or circumcise, and some don’t.” Not being culturally sensitive could be a huge oversight.
Take the following example—the Balinese believe the placenta is alive after birth, and it is considered a living twin. The placenta is cleaned and buried outside the home where the baby was born.
While birth is commonplace, the rites and rituals surrounding it aren't. Helping people living in modern North America to hang on to the important parts of their culture’s birth traditions is another way that doulas support, and tailor.
Separating the Living From the Dead & De-Medicalizing Death
Dying happens to everyone, eventually. No one gets out alive, you know, that old chestnut.
Frequently, in the west, death is a medical event, despite other cultures treating death as a journey. End-of-life Doula, Adrian Allotey, says, “death is a spiritual event—not a medical event.”
In Allotey’s mind there is “no good or bad death.” For those going through the death process, Allotey says, “they’re not dying, they’re still living. We live unto our last breath.”
Often we treat the dying person as something other than the person we loved. A death doula helps those surrounding the dying person see that that person is still there. Allotey says, “A death doula journeys with you, and accepts you for who you are while explaining to you the phases of death.”
Doulas Take Care of Business, and Family
Death doulas are also mediators. They may for instance, facilitate conversations about memorial services, and the administrative side of dying in the west. They often know what documents are required to get estates in order, or can direct you to resources that do, and help you keep track of the status of those documents.
They might also help you translate what medical professionals are trying to communicate, particularly to loved ones who may not be able to process information at that time it's being offered. Doulas do not give medical advice. They may also help ensure that you’re never alone while in the hospital—something many fear.
Death affects anyone who is close to it, and Allotey says she provides emotional and spiritual support to family members, partners, and friends of the soon-to-be departed. Allotey calls this, “The circle of care.”
She says, “Once a patient is taken care of, I begin to look at who is closest to the patient, and then I work outward.” Allotey facilitates end-of-life discussions, because death is often a community event.
Allotey believes, “People hold on for different reasons at the end of life, it could be their own fears, or the worry on the faces of the people they love.”
Allotey mitigates that end-of-life anxiety for patients by creating “Living-Well Plans.”
Living Well Plans are designed to give clients a voice in the last 24 to 48 hours of their life. She says she guides them “through deciding what they want to happen, who they want to be there, and how they want the sacred environment to be.”
Living-Well plans help them feel alive until their last breath. Allotey also discusses their medical wishes, and who they want advocating for them in case they aren’t able to do so themselves. Her objective is to help the patients, “Leave their story behind,” and to support them in defining what that looks like.
Extra Support to Assist the Living
Religions, customs, beliefs and cultures guide our interpretations of death. Allotey understands this and has taken part in chaplaincy courses. She also practices Reiki on patients and family members.
She says, “When I do energy around a person, it holds space for them to have a remarkable transition without being attached to any outcome.”
The point of Doulas isn’t to tell you everything will be ok. The point is for them to act as guides through the complex realities of death...and life.
Ryan Hook is a writer, photographer, musician, and spoken word poet. Born in St.Albert and living in Edmonton, Alberta, his mission is to bring Sound and Story. He has worked as a music journalist for Vue Weekly, BeatRoute, and Exclaim! as well as been a published short story writer. When he's not writing he is an accomplished songwriter and recording artist for his band, Baby Boy and the Earthly Delights. Whether it's writing, music, or travelling, he bides by the philosophy that life is a playground and nothing is off limits.