Losing a loved one is one of the most difficult experiences we can go through. The emotional impact can be devastating.  But, confusion about what the options are or even that there are options for managing the physical aspects of dying can make a hard time much worse.

In this article, Deanna Cochran, a skilled hospice and palliative care RN, helps us understand the invaluable supportive role of midwives and doulas when we are facing the death of a loved one. 

Have you heard of this before?

Most of us understand the midwife and doula role in the birthing process. Along with being an emotional and spiritual support for the family, the midwife is a skilled, trained practitioner who attends the birth of a baby. The doula provides emotional, spiritual comfort and logistical assistance.

In the death and dying field, we have borrowed ‘midwife*’ and ‘doula*’ to describe the compassionate and knowledgeable care by specially trained people who serve a person and their family as they die. Midwives and doulas through the dying process are entering the mainstream. This practice is referred to in many ways—‘doula for the dying,’ ‘death midwifery,’ ‘midwife to the dying,’—all describing the physical, emotional and spiritual support, companionship and advocacy during the end of life.

In the dying realm, I look at the concept of midwife in the following way. I see midwives to the dying as those who, along with spiritual and emotional support, are thoroughly trained and skilled in the physical processes of dying as well, much as is the hospice nurse. There may be times when you will want a medically skilled midwife.

My view of the doula I liken to the hospice volunteer. They don’t need to be knowledgeable like the midwife for their presence to be invaluable. The doula may or may not know much about the physical processes, but often it is not necessary that she needs to.

The website I developed to inform about this practice I chose to name Doula for the Dying, not Midwife for the Dying. Doula captures the essence, the heart of this concept of being with a family during the final days and hours. Doula is the soul of walking with a family during these days. And doula is the core of the midwife.

The comforting presence of the midwife or doula is becoming known slowly. Services from hospices like “11th hour” volunteering and “continuous care nursing services” acknowledge the importance of having more support during these hours. The only problem with this is that the hospice determines who needs it and how long it will last, not the family.

It’s the best we have so far and thankfully these services are here. Just know that midwives and doulas for the dying are growing in number. My hope is one day this kind of support is available to whoever wants it.
When most people tell of the death of someone they loved, they usually recall this time with incredible detail. In attending to the needs of the dying and their family, a midwife and doula can enable these memories to be as positive and peaceful as possible, providing compassionate presence–many hearts joining to care for a person and their family during this tender and sacred time.

*The term doula was first used in this context by Phyllis Farley, a proponent of natural childbirth in New York in 1998.

Deanna Cochran first sat with a family and their dying loved one when she was 13.  It turned out to be her calling.  Deanna is a skilled RN whose first love is providing hospice and palliative services to families with a dying loved one.  She is an extremely valuable resource for end of life issues.  Please go to her websites www.doulaforthedying.com and www.qualityoflifecare.com to learn more.   

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