Death Doulas Are In High Demand—But What Do They Do, Exactly?

Trigger warning: This story discusses death, grief, and the COVID-19 pandemic.

It goes without saying: The past year has been a tough one on many levels. We've been isolated, anxious, depressed, uncertain about the future—and we've experienced a lot of loss. Sadly, over 600,000 people in the United States have died from complications with COVID-19.

While many businesses have suffered under the weight of the pandemic, the death doula business has experienced a shift. "There has been a massive increase in demand," Suzanne O'Brien, wellness and oncology nurse and founder of Doulagivers, says. "People wanted help understanding; they wanted help taking care of their loved ones." A doula is typically associated with providers who help women bring life into the world (also known as birth doulas). Death doulas are on the other side of life's cycle, helping to close out the journey.

Still, you may be wondering what death doulas do and how they are different from other healthcare providers who deal with the end of life. Here's everything you need to know.

What Is a Death Doula?

O'Brien says to think of death doulas as a combination of a nurse, social worker, and chaplain. "The doula is the support system for mainstream medicine," she explains. "Doulas help reduce the fear and reinforce hospice teachings." She adds that one meaningful aspect of working as an end-of-life doula is that she can help people realize that death is a human experience versus a medical one.

"In the past 100 years, we've medicalized death and started to treat it like it's optional," O'Brien says. "We do everything we can as a society to avoid it, but death is part of life." According to O'Brien, doulas serve to stabilize the atmosphere and reduce stress to create an environment ripe for closure that people need at the end of life.

What Does a Death Doula Do?

"If you're in fight or flight mode or you're frightened, you can't have those beautiful, meaningful conversations," she explains. "You can't say thank you, or I love you." Part of O'Brien's work is creating a space for people to have safe, meaningful exchanges with loved ones. "I do my best to hold that space for a family to sit with their mom, dad, or anyone else, to express love," she says. "That's something the doula is instrumental in."

Death doulas help bring comfort to the person transitioning, but she support's the person's family, too, allowing everyone to find closure. And, while the demand for death doulas has been high over the past year, there's supply to meet it. "We just started a new semester, and we have 170 people training to become death doulas," O'Brien shares. "We already have 1600 people who are certified and hundreds who are in the process of getting there." According to O'Brien, the process takes up to six months and includes official training followed by an internship.

Death Doulas During the Pandemic

While it's been hard to find silver linings in such an emotional time, O'Brien has noticed a shift in perspective. "COVID showed us the reality of life's fragility," she says. "When you live with that awareness, you learn to live your life from a place of gratitude." For O'Brien, that realization occurred when she began her work in hospice care. "That's when I started to live my life fully," she says. "I have so much gratitude for the option to be able to go to the gym or the grocery store because you suddenly realize that it can change any day."

The unpredictable nature of life and death often means people don't get to have meaningful final conversations with loved ones—especially during the pandemic. Death doulas can help with that, too. "The idea general idea of grief is that you get two weeks, and then you're supposed to be over your loss," O'Brien says. "When you do it that way, you never get a chance to process, and that grief will pop up whenever it wants to." Because of this, O'Brien works to help people find peace and closure even if it's been a while since they lost someone.

"We can take someone back to a situation, help put it into perspective and find the healing moments in it," she explains. "Then we talk about the grief process going forward and forgiveness because often families have to forgive themselves." Life is a complex process of emotions and reality, especially in moments of transition. However, death doulas are doing the work to make sure that, ultimately, support is available when you and those you love need it most.