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’.
Hospice care workers the first thing that comes to mind in terms of doulas of death.
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.).
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?
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.
Hi Adrianne, I came across your note while researching ‘doula for the dying.’ i worked at Vic Hospice for 18 months in spiritual care. Similar to your mother’s experience, I’m troubled by the fragmented relationship between volunteers and the dying. Looking for ways to provide a seamless service to accompany people from diagnosis right through death. If you read this comment and would like to explore further, kindly contact me at renner”at”gulfislands.com.
I’d like to talk with you if you’d like about the fragmented relationship you touch on between volunteers and the dying. I’m trying very hard to make my services seamless and any insight would be helpful. deanna(at)agentleguide(dot)com
In addition to hospice workers, there are palliative care teams that include doctors, nurses, and home health care aids.
Err…home health care aides. Pardon the typo.
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?
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.
I am a thanadoula student studying at ITM through the Contemplative End of Life Care Program. This is a new program being offered here in Toronto, Canada, though there are a few in other countries. As part of our studies we cover a wide range of topics involving the physical, psychological, social, spiritual care for those dying. Many of us are volunteers, professionals or those interested in death and dying, in the palliative/hospice profession. Most of the students have had their own personal experiences with death, but it is also a great course to examine our own thoughts of our own deaths. The course incorporates a number of spiritual beliefs around death, along with traditional rituals – it is a lovely way to see how various cultures approach death and dying. As a thanadoula, I hope to be able to help demystify the death and dying process/transition. As a Buddhist I have my own beliefs and rituals to help other Buddhists, but as a volunteer, my offerings will be non-sectarian, or cultural unless requested. As a doula, you are there to support, provide care as part of the interdisciplinary team, both to the one dying as well as his/her family/friends.
I look forward to spreading death education through technological means whether it be through a website, social media, networking to bring forth more OPEN discussion of something as natural as DEATH and DYING. If you were doing research via the Internet, what areas of topics would you be looking for with respect to support of the death or dying of your loved one?
Jemma, thank you for describing your interests and questions. Three of us, all experienced in instuitutional settings (spiritual care, palliative medicine, volunteering) are exploring ways to offer services as companions to the dying (“Sterbebegleiter” in succing German).
If you’d like to share web- and other research findings, please write to me at renner”at”gulfislands.com.
ps: I’m a 2006 graduate of the Metta Institute in San Francisco, an outgrowth of Zen Hospice there, with Frank Ostaseski.
for Jemma: we live in Victoria, BC … and you?
CINDEA — Canadian Integrative Network for Death Education and Alternatives is a new organization. We just put the first pages up on the website, but are still working on more. We have a resource page for pre-death and another for post-death: we really didn’t want to split them (as one of our concerns is the lack of continuum between pre and post death services); but had to because there was too much material, and I have a long list of more to put up.
We are presently looking for the various alternative pan-death service providers in Canada to list*, but there doesn’t seem to be much that is accessible on the web. So if you know of people who are publicly offering these services, please let me know.
* we have chosen to retain the term ‘death midwife’ for someone who support the Death Journeyer and family throughout the pan-death process — as, by choice, Death Doulas, Thanadoulas, Home Funeral Guides, and Funeral Celebrants focus on a particular facets of the process.
P.S. Peter — I live here in Victoria, B.C. as well.
I have just finished assisting the end of life with a lovely lady and her family. I had assisted at many deaths in a nursing home setting but never at home. It was an experience I will never forget and at some point will write about it.
I thank you for your info on Doulas of Death… never knew there was such a thing but had b een thinking of becoming one also consulting on keeping loved ones at home. Thank you again.
I have just happened upon this thread, as it was recommended to me by a friend in Hamilton, Ontario that I consider the field of thana doula. I am a healer and reflexologist. I also live in Victoria. I would love to get training in this remarkable gift. Any suggestions? Who would one approach to offer this service? Hospices? Families? Government Health organizations?
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