It was just after 9:00 on a gentle Thursday morning. We had rain overnight, and the air was crisp, with a slight breeze. I stood with a mother, Sonja, about my age, sorting through her son’s clothes, neatly packed in our wardrobe.
Her son had just died.
He was 19.
We chose soft, comfortable sweatpants and a white T-shirt for him to wear when the funeral parlour picked him up.
Sonja and I didn’t talk while we did this. We did not want to disturb the beautiful peace that was so tangible in the room. Without knowing why, we felt it was a ritual to be performed. Dressing him for the last time would be sacred. It would be the last thing we could physically do for him… a final sacred send-off.
I thought of how recently she must have chosen his first outfit to wear just after he was born, and now, here she was again, choosing clothes for another profoundly hallowed occasion. Sonja was there when this beautiful soul arrived in the world. She was also there when he left.
What a horrible and cruel privilege.
The similarities between birth and death often surprise me. We assume these bookends of our lives would be polar opposites, but instead of a linear birth-to-death progression, I often wonder whether it is not a circular journey? Our bodies know how to be born, to push through the birth canal, to take those first breaths, to cry, to nurse. Our bodies also know how to die. They grow weaker, they stop needing hydration or food, the heart rate slows, the extremities grow cold, and the pulse races.
In the doorways of both birth and death, stand the doulas. On these days when we arrive and depart, the dates etched on our tombstones, we need guidance and wisdom – guides to help us on the way.
Doulas have always been around, and have been known by many different names. It is an ancient role fulfilled by a skilled and experienced person, whose job is to care for you. In the past decades, both birth and death have become so medical and clinical, and I believe we have suffered because we’ve ignored the fact that these two major life events are so much more than just medical occurences Birth and death, beginnings and endings, are also spiritual, psychological, and cultural. These milestones bring about huge changes, and we need people to hold space for whatever this transition brings. It can be anger, joy, hope, or fear, but whatever it is, we need someone to navigate this for us… someone who knows the way.
Birth doulas support during pregnancy, labour, and the early postpartum days, like settling at home, breastfeeding, and caring for other siblings. A death doula supports in the months and weeks leading up to the last breath, working with the patient and loved ones, and then carries on being present during the early bereavement.
A birth doula focuses on the safe arrival of the baby, but also an empowered start for parenthood for mom and dad. She/He will advocate for you and make sure the process is one you want and understand. The soul midwife (death doula) places their attention on a dignified and meaningful end of life, making sure the patient and the loved ones are informed and promises are kept, goodbyes are said, forgiveness is offered, and an intact legacy is left behind.
It is important to know that both doulas work with and not against medical teams. In many cases, the doulas are integral to supporting and caring for the clinical teams too. The continuous presence of the doulas has been shown to result in better outcomes – fewer interventions, much fewer emergencies and overall greater family satisfaction in both birth and death situations. In fact, a common saying is that people never know how much they need a doula until they have one. Both at the start and the finish of your race, it is the doulas who provide continuous, compassionate presence, offering informed guidance, and deep respect for the person’s values and choices. They make these paramount milestones safe for us.
Sonja’s son had a death doula named Carl. He lovingly guided the family through this last phase of his life. As uncomfortable as our society has made it, death happens to all of us. None of us is going to get out of here alive, yet we hide the death process from our society.
Imagine falling pregnant and not talking about it. Not planning or preparing a nursery. Not buying maternity clothes. Instead saying, “I’ll fight the pregnancy” rather than embracing it. What if we kept insisting, “I’m not ready to be pregnant—it should wait,” and decided to work with a dietician instead of a gynaecologist? Or took up endurance sport rather than slowing down.
People would never avoid telling their other children that a baby was on the way. And even if they did, none of these attempts at avoidance would stop the baby from coming. It would simply mean that when the baby arrived, no one would be ready.
This avoidance and lack of preparation seldom happens with birth, but it happens with death all the time.
I went to see Carl the doula at his home to ask him about what he does, what he believes, sees and experiences. He has guided many souls out of this world, has helped families come to terms with death, helped build legacies, and planned funerals. We talked for an hour and a half. I laughed when he told me he was once asked by an Afrikaans dominee to come and talk through his fears at the end of his life. When the church elders arrived unannounced, suddenly he had to be hurried out of the back door in case the church thought he’d joined a cult when he reached death’s door.
Carl told me that once at a hospice, a patient’s family had left a crazy number of Buddha statues in one room. As hospices are usually multi-faith, the Buddhas were discarded in a private little garden of the hospice and forgotten about. After some renovations, a patient arrived, and upon his death, the hospice received a million Rand donation. Apparently, the new room looked out over the forgotten garden filled with 25 Buddhas. The patient was a committed Buddhist and assumed the garden was put together by the hospice to honour his beliefs.
Carl also entertained me with stories of his travels. He has an incredible knowledge of all religions, beliefs and faith traditions. He has walked pilgrimages with Catholics through the Vatican, studied at ashrams in India, chanted with Buddhists in remote mountain temples, shared tea with sheikhs in the desert, and attended Hindu festivals.
But what he found the most profound – a truth present in most beliefs – was something written in the Egyptian book of the dead, written 2400 BC: “Your heart must be light”.
A light heart is not weighed down by anger, grudges, hate, greed, pride or guilt. Christians might call it a clean or pure heart.
Sonja dressing her son that morning reminded me that death is not the opposite of birth. It is its companion. Just as she once dressed him for his first journey into the world, she was now dressing him for his last. At both thresholds, birth and death, we are fragile, uncertain, helpless and deeply human, and at both doorways, it helps to have someone steady and wise beside us – someone who knows the path, someone who can guide us gently through the sacred. Perhaps we should prepare for death the way we prepare for birth: with honesty, courage, tenderness, and the quiet wisdom of those who know how to walk with us to the edge.