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Remembering My First Doula Case

For me birth has always been present in death. When I’m with a dying person I imagine them being born, taking their first breath and crying out to the world. That moment is filled with unlimited possibility. How precious and beautiful each person is at birth. Then the river of life takes them on a journey with millions of twists and turns leading finally to their death. Perhaps that first cry is not only a protest against getting pushed out of the dark, warm safety of the world they have been floating in, but also a deep psychic recognition that birth brings death.


These thoughts came to me with my very first doula case. I think of it often, almost 20 years later. I remember vividly entering the railroad-style Harlem, NY apartment where a man in his late forties was dying. The first person I was introduced to was the dying man’s mother. She had come recently from out of town to help care for her son through his death, which would occur only several weeks later.


A dear friend of the dying man was sitting with her on the couch. I immediately noticed how pregnant the young woman was. As introductions were made and I explained the purpose of my visit, she kept caressing her belly. Every pregnant woman does this, but given the circumstances I wondered if she wasn’t also reassuring herself it was okay to bring her baby into the world even though he or she would die one day like the man down the hall.


As it turned out, this young woman and her husband had also come from out of town. They had moved from New York City six months before and hadn’t been able to visit since. They came that day because they knew the dying man was close to the end of his struggle. She told me it was very important that her friend knew her child. She wanted him to place his hands on her bare belly and feel the kick of life within. To give him a chance to feel the body of her baby and to be able to tell her child someday that he or she had met her friend and been touched by him.


I thought that bringing birth to death in this way was so beautiful. It was particularly meaningful to me since the end-of-life doula program I had only just launched at my hospice was based on what I learned from birth doulas.


And of course, sitting next to this young woman on the couch was a mother whose child was dying. For the rest of my time supporting and guiding the man who was dying and his mother the intermingling of birth and death became a prominent theme of the work.

Perhaps it was the first visit and the pregnant woman that led me to suggest two weeks later that the dying man’s mother consider washing his body after he died. There seemed something so right about caring for the body of her son by cleansing it after he died—as long as that made sense to her and she wanted to do it. It would be a last act of mothering; a way to honor not only the body that had carried his life, but also her role in giving him life and caring for him as a baby.

When he died, on the fourth day of his vigil, I was coming to take the midnight to eight in the morning shift. I arrived just 10 minutes after he died. I held his mother in my arms while she cried. Then I asked if she wanted to wash his body. She nodded yes and the doula who I was coming to replace helped me set up what we needed. The three of us washed his body in silence. The only sounds came from us wringing out the washcloths and our breath as we gently washed his body—birth and death so clearly together. It was one of the most beautiful and meaningful experiences I could remember and has remained that way for me through all the years and doula experiences since.

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