Let’s face it: No one is dying to die. But we all know it’s coming, and what could be more life-affirming than knowing you’ll have a “good death?” Death doulas are prominent figures now at the center of the death positivity movement, and their job is to help support those who are dying or preparing to die. 

In the same way that birth doulas help prepare clients for delivery, death doulas help the dying plan for the inevitable. 

Alua Arthur is a well-known death doula. She helps her clients and their families become more comfortable with the idea of death.  

“Death meditation is an opportunity for people that are struggling with some fears around death and dying to confront those fears head-on,” Arthur told Refinery29. “It’s not for the faint of heart. It’s an opportunity to really think about the body’s eventual decline, and to go there to see what the discomfort is, so that we can then talk about that and process that. It’s intended to soften the fear around death.”

The word “doula” comes from the Greek term “women who serve.” Arthur supports people in the final chapters of their lives, helping to make sure clients have the ends they want: what will be done with their remains, what their funerals will be like, what they’ll wear when they’re buried or cremated, or whether they want friends and family to party or quietly pay homage. 

Although death doulas have seen a wave of popularity of late, particularly due to the COVID-19 pandemic, the truth is that death—as in life—is not equal for everyone. 

Many people might equate a good ending to a good life with top-notch medical care, meaning a pain-free ending. But disparities exist even in death, and Black and brown people notoriously don’t receive the same levels of medical intervention that white people do. 

Black Americans have experienced the highest overall mortality rates as a result of COVID-19. In California, Black people are dying at twice the rate of white people.

According to the Association of American Medical Colleges, a 2016 study found that “half of white medical trainees believe such myths as Black people have thicker skin or less sensitive nerve endings than white people.” These relic notions often leave Black patients less likely to get their pain needs appropriately met. 

Oceana Sawyer is a death doula based in the Bay Area of California. She tells the Los Angeles Times her job is not only to support the dying but also push back on racial disparities and fight for her clients. 

“I was working with a woman who was dying,” she said, and “I had to convince the hospice nurse to give her [more] morphine, they were giving her these small bits of morphine.” Her client, she added, was in severe discomfort. “I didn’t want her to be fighting for air. That doesn’t happen when I work with white people.”

Since its founding in 2018, the National Endo-of-Life Doula Alliance, an organization comprising death doulas and trainers, has grown to 800 members, according to The New York Times. The interest has come from both a necessity—folks who found themselves out of a job due to the pandemic—and a passion from people wanting to help their communities in unprecedented times. 

“People were reaching out from a variety of different ages, younger than we would normally see because they realized that people were dying in their age category, which doesn’t usually happen,” Diane Button, 62, of San Francisco, a doula facilitator at the University of Vermont and a member of the Bay Area End-of-Life Doula Alliance, a collective of death workers, tells the Times. “It made them more aware of their own mortality and really made them want to plan and get their documents and advance directives in order.”

Most death doulas charge by the hour, and rates can range anywhere from $25 to $100 an hour. They’re able to fill in and assist with hospice. They also help families cope with and address the reality of the death of their loved ones. 

“I think people don’t talk about death because we’re not really comfortable with it,” Arthur tells Refinery29. “Yet, whenever I talk about my work, people always talk to me about death … I think my work gives people permission to talk about this thing that we all want to talk about anyway, yet we’re just not doing.”

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