When I set out to be by my father’s side in 2012, I had no idea what to expect. My sister and I both lived in Colorado Springs, so naturally we caravaned to Oregon together. We talked about it a lot. What would we have to do? How would we help our mom? This was not a typical visit in any way. I felt ill-equipped and unprepared.

Once we arrived in Oregon, and we settled in, I began to discover just how similar labor and postpartum doula work is to supporting not only the dying man, but his family.

Here are 5 more ways I found that my doula work had prepared me for this in ways I did not expect.

1. Dying has a natural, typical process.
I will never forget the social worker who came to visit and explain the process of death to us as a family. It’s a lot like labor, where the signs of impending death get “longer, stronger, and closer together,” like contractions do. Like labor, the dying process is made up of stages, but they are not set in stone, and it looks different for everyone. No one can ever predict when or how the dying process starts, nor how or when it will end. You just have to wait and see. Like labor, when you are more familiar with the basic physiology of the dying process, caring for your loved one is a lot easier. It helps to have a general idea of what to expect.

2. The family needs support as much as the dying one.
Much like the expectant father, the dying man’s loved ones need education and support to help them navigate this painful, sometimes confusing journey. The social worker told us that we would all feel like we were going crazy, “but that’s okay–it’s normal crazy.” Pretty much everything we would experience would be typical of the dying process, but we would all feel as though it wasn’t. And that was normal. Dying is weird. So is birth. And for those who haven’t seen it, it helps to be able to hear an expert tell you that it’s all normal. This is a major role a doula plays. Supporting the father, partner, or family members through the birth process largely consists of smiling across the pregnant woman’s back and giving the thumbs-up to a dad who thinks the love of his life just might be dying based solely on the sounds she’s making. That calm professional presence meant so much to us as a family and enabled me to put on my own doula hat and love my family through the process.

3. Doulas are comfortable with bodily fluids and nudity.
My only regret in helping care for my dad is that I didn’t step up sooner to help my mom with the actual physical care. It took seeing my mom in tears, needing help to get Dad up off the floor for me to see the need for what it was. Dad was reluctant to let me help, because he didn’t want his daughter seeing him that way. However, Mom needed me. So, I gently insisted to Dad that he needed to let me do this for Mom’s sake. He agreed, and it didn’t take more than one trip to the bathroom together for him to feel okay about it. I happen to have a natural bent toward a clinical mindset, and I knew it wouldn’t bother me to help Dad get to the bathroom while he could, and when he couldn’t, to hold the portable urinal. It’s not much different than letting a pregnant woman lean on you while she’s on the toilet during labor, or hold her hair and an emesis bag while she throws up. It’s just part of life. And death.

4. Everyone involved has a vital role to play.
Part of a doula’s job is to understand the roles everyone involved in a labor and birth are going to fill, based on their gifts and what the mother needs. She assesses the expectations, then sees where she best fits in, and can enhance and help everyone’s roles. It’s the same at the deathbed of a loved one. Everyone has natural personality quirks and gifts and roles, and it is vital to let each play the part they are most comfortable with. Granted, we all have to step out of our roles once in awhile and make do, but generally, we each got to do what came naturally to us. Our kids even filled a role, keeping joy front and center even in the midst of our death watch. It was comfortable and seamless for the most part.

5. It’s not about me.
No birth I attend has anything to do with me. I am along for the ride, for better or worse. I am there to comfort, support, encourage, and anchor. I am not there to fight battles, rescue anyone, or to make a statement. My father’s death had nothing to do with me either. It was his journey, and I was there to comfort, support, encourage, and anchor as well as I could. I could have done a better job, I know, but I did the best I could with what I had, and I know that it was enough. It had to be, because I offered everything I had. We all did.

We each of us, my mother, sisters and I were utterly drained at the end of it all, but we had no regrets. Dad passed into his Father’s arms exactly the way he wished to: with minimal pain, at home in his own bed, surrounded by those he loved. We all of us were his doula team. And we didn’t even know it.

To read the first part, click HERE.

Grace & Peace,
Tiffany

Almost three years ago, I packed up my four children and drove to Oregon to help care for my father. His melanoma had metastasized to his spinal fluid, and everything that could be thrown at it to kill it, had been. There was nothing left, but to wait. Probably only weeks were left.

His decline was gradual, over the course of about three and a half months. During that time, I discovered another purpose to my doula training and work.

The end of life is much like the beginning. It is mainly about waiting, comfort and support. There isn’t anyone who can do the dying work, except the dying. Those in attendance find themselves with not much to do but wait. At the most, we bring comfort through physical touch, slow conversations, and just quietly being present. It is so much like waiting while a woman labors. The main difference being that we are on the wrong side of the veil. We do not get to see our loved one birthed into the next life. It is all darkness on this side.

I have never been so grateful for my training as a doula. Everything I learned is very nearly directly applicable to the dying process. Here are 5 things I learned while doulaing my dying father.

1. Pain can be a normal part of the process.
Granted, the pain of death was not something I believe that we were ever designed for. It is often pathological, but it is also a natural part of dying. As in labor, it is a signal that something needs to change. Perhaps a massage will alleviate it. Perhaps a dose of morphine will help the man laboring to die to rest a little easier. Pain also allows and invites loved ones to minister to the dying simply by being present, holding a hand, or stroking the hair.

2. The same comfort measures used in labor often work well for the dying.
Massage. Gate control. Supporting the five senses. Medication. Acupressure. Essential oils. Music. Bathing. Hydration. Light snacking to their level of hunger if it exists at all. The dying, much like the laboring woman, do not need much food if any. It’s important to follow their lead. All these techniques we learn in our doula training are applicable to the dying one. Of course, some causes of death render certain massage strokes unbearable, much like transition may do in a laboring woman. It’s all about trying different things, and allowing the dying to accept or refuse it without taking it personally.

3. Holding space is the foundation for dignity.
We know as doulas that a mother’s pain level, or even the kind of birth she has will have little bearing on how satisfied she is with her experience. What matters most to her is that she is the decision maker and that she feels supported throughout the process. We as doulas hold the space for that to happen. We are constantly directing attention back to the laboring mother: “How do you feel about adding Pitocin to the plan? Would you like time to talk about it?” It’s the same with the dying. They often struggle to decide, and just need the space to settle in with what they want. This gives them the dignity they deserve as a human being while they go through an undignified, and often painful process.

4. Writing an end-of-life plan is much like writing a birth plan.
It’s written before the active dying really begins, much like a birth plan is written prenatally. It outlines the dying person’s desires, wishes, and medical decisions ahead of time, so that if and when they become incapable of decision-making, those who are caring for him can use it as a guide to know what he would most likely want to do. Unlike a birth plan, it is a legal document, and only power-of-attorney can override it. The principle is the same, though. And as a doula, upholding these desires came naturally to me.

5. Dying doesn’t look at all like what is portrayed in the media.
Birth in the media is always an emergency, there is a lot of screaming and hating of husbands, and demanding of drugs. It’s almost never clinically accurate or true to life. It is the same with death in the media. Death in the movies is always grand or gory or like watching someone fall asleep. Watching my father die was none of those things. There is no way to portray the sights, smells, sounds, or the heaviness of the room where the dying man lies. There are as many ways to die as there are to give birth. As beautiful as Dad’s final moments were, as dignified and peaceful as it was, I found death itself to be ugly. Just as I find birth to be beautiful, in spite of the “mess” and the pain and the noise and the smells. Death and birth are studies in contradiction. They are each a paradox. And both are sacred.

I loved being with my dad while he lay dying. I felt honored, privileged, and blessed to witness a man’s leaving of this world to enter the next. For Dad, to live was Christ, and his death was gain. Every time I enter the sacred birthing space of another woman, I am reminded of the gravity of life, and how important it is to have dignity at both birth and death. As a doula, I now know that I have the skill and compassion I need for either. If I weren’t a doula, or pursuing midwifery, I think I would want to be a hospice nurse. But that is an entirely different post for a different day.

Thanks for sticking with me. I know this is a tough subject, but it’s close to my heart, and it was time to write about it. How have you experienced death or birth in your life? Have you seen both? Are there other parallels you noticed?

Grace & Peace,
Tiffany