The Death Doula Profession: Background information when reading The Collected Regrets of Clover

The Death Doula Profession

This article relates to The Collected Regrets of Clover

The protagonist of Mikki Brammer's The Collected Regrets of Clover is a death doula. Just as a doula (or midwife) helps in childbirth, a death doula helps people who are approaching death. The profession has grown remarkably since 2000, when a New York City program co-funded by NYU Medical Center and the Shira Ruskay Center of the Jewish Board of Family and Children's Services first paired volunteer doulas with patients. In 2003, again in NYC, social worker Henry Fersko-Weiss (author of Caring for the Dying) created the country's first hospice-based end-of-life doula program. In 2015, he co-founded the International End-of-Life Doula Association, which hosts online or in-person training sessions for doulas and hospice workers, as well as for caregivers.

While some doulas work on a volunteer basis, most are hired privately for an hourly ($25-$100) or flat rate. This is not a clinical role, as death doulas do not prescribe or administer any medications, so the field is unregulated. One does not need a license or traditional education to practice it. However, the University of Vermont does offer an End-of-Life Doula Professional Certificate. The course is fully online, eight weeks long, and costs $800. It soared in popularity due to the Covid-19 pandemic, with annual enrollment tripling between 2017 (its first year) and 2021. Other organizations offer in-house certification programs for roughly the same cost.

Many doulas come from the healthcare field, particularly hospice care (a field dedicated to ensuring comfort and pain relief for terminally ill patients who are expected to die within six months and who are no longer pursuing active treatment). Others start off as independent funeral officiants. A doula may help with errands, getting one's affairs in order, or making the practical preparations for a memorial service, but is mostly concerned with emotional support: being there for the patient and their loved ones, to talk about what they expect, fear, or hope for from the final days of life. They may discuss regrets, write letters, or decide on rituals to be performed just before and after death. A doula's work is generally secular, but they may work in partnership with any faith leaders the patient wishes to have present. The primary goal is to help ensure an atmosphere of calm and peace.

Filed under Cultural Curiosities

This "beyond the book article" relates to The Collected Regrets of Clover. It originally ran in July 2023 and has been updated for the May 2024 paperback edition. Go to magazine.