death

What It’s Like to Be a Death Midwife

In a recent article for Mic, I spoke with death midwives about what they do, how America handles death, and their thoughts on grief. Image courtesy of Getty/Mic. 

It’s a fact we’re all reminded of whenever tragedy strikes, or when we’re lying awake at 3 a.m. after waking up from a nightmare: At some point, everyone we love will die. When that moment comes, be it the loss of an aging parent, a beloved celebrity or a friend gone too soon, we’re struck with grief and often we don’t know how to deal with it.

There are, however, some people who deal with death on a daily basis — as funeral workers, grief counselors, or postmortem investigators. Curious about how to deal with grief in today’s society, Mic spoke to death midwives, or those who help usher dying people into the final stage of life.

Often hospice workers trained in caring for the dying, death midwives work with the dying individual and their loved ones to aid in the dying process. (According to this death midwife’s website, costs vary between approximately $1500 and $3000.)

Also sometimes called an end-of-life guide, the role changes depending on a family’s desires and needs: A death midwife can help with mundane tasks from sorting out medical bills, to helping wash a body should a family opt for an at-home-funeral, a term used to describe the rare practice of skipping the funeral home altogether and saying goodbye to a loved one at home. Death midwives and end-of-life guides pride themselves on being more “heart oriented” than funeral directors, which have been criticized for being more corporate-owned and clinical.

In addition to providing compassionate care in the form of, say, helping the dying create photo albums to honor memories, or helping with such practical matters as offering advice on handling medical bills, those in death work often answer blunt questions about the dying process— a natural part of life they feel is not openly discussed enough.

“You know how people say ‘You need to process your grief?’ I call bullshit on that. Have you ever heard anyone say, ‘You need to process that joy you felt Christmas morning?'” death midwife Terry Skovronek told Mic. Skovronek has been a self-identified death midwife for 19 years, and considers the process of death comparable to the natural process of birth — just at the other end of the spectrum.

Skovronek got into death work after giving birth to her children. “I gave birth to my kids at home,” Skovronek told Mic. “If something went wrong, if they died at birth or were born dead, I wanted to know what my legal responsibilities were.”

Betsy Trapasso, who uses the title “end-of-life guide and advocate,” told Mic that a death midwife can help “provide the vigil and post-death care, help the family and help folks wake up to and reconcile the fact that they are dying.”

A death midwife “can take many shapes and forms, from helping someone who is dying face the issues they need to face, any work they want to get done before they die, any relationships they want to heal,” Trapasso added.

Before transitioning into private practice and advocacy for the dying, Trapasso started out working in a hospice after obtaining a master’s in social work. She’s also worked as a psychotherapist, and says the frequency with which her clients brought up the subject of death let her know there was a professional void that needed to be filled.

“Before I did the death work I was a psychotherapist, and people would want to talk about death all the time. They’d want to know about what death was like,” Trapasso told Mic.

What is death going to be like? It’s a morbid question, but as Skovronek said, it’s a natural one.

“[The dying] will say, ‘What do you think is going to happen when I die? Explain to me what my breathing is going to be like, and do you think I’ll start to see things?'” Skovronek told Mic. She compared the family members’ hesitation to speaking about the death process to people’s unwillingness to speak openly about sex.

“What’s shocking is how little folks know. I [compare it to] the Victorian era, where a 17-year-old girl is married off never having had anyone explain anything to her about sexuality, or penises…imagine the terror [of] not knowing anything of the biology they were about to encounter of the experience. That’s how most people are with death. They have no bloody idea.”

Beyond the physical dying process, many people are unsure how to speak about the grief experienced by loved ones after a friend or relative has passed. When witnessing a friend or colleague dealing with a loss, the living can often find themselves at a loss for words.

People who are trained in grief counseling, like Trapasso and Skovronek, are well-equipped to deal with someone who has just lost a loved one. If someone in your office experiences a major loss, for instance, “sometimes your fellow coworkers are like, ‘What do we say?’ How do we act?’ That’s a huge thing,” Trapasso told Mic. “What mostly everyone [families I’ve worked with] has told me is [to] just say, ‘I’m sorry.’ That’s what people want to hear.”

A kind, one-size-fits-all response of “I’m sorry” works so well because there’s no one way to grieve. “Grief comes in all shapes and sizes and forms. People grieve differently, and that’s what’s important for people to realize,” Trapasso added.

Some mourn outwardly, from sobs to an abundance of shared Facebook posts. Others are too hit with shock to respond in a visibly mournful fashion. Others need to keep themselves busy – and all of those reactions are healthy and OK. It’s not everyday that we are faced with death up close and personal – so what can we learn about grieving from those who do daily as a profession? “Just say, ‘I’m sorry.’ That’s what people want to hear.”

“The important thing for people to know is that it’s different for everyone. You just have to be supportive for the person and really just being there and being present and let them express what they need,” Trapasso told Mic.

Generally speaking, our impulse as a society is to push away ugly and unwanted experiences such as dying and death as a way to alleviate the mourning process. But the death midwives Mic spoke with said that when dealing with loss, it can often be healthier to give your grief space to breathe, rather than race toward an unseen end point.

“It’s like when you have a quarter in your pocket, this little thing that you rub up against, and maybe you twirl it in your fingers. Wouldn’t it suit us if grief was like that, this little thing that we can carry in a small way close to our bodies? [Something] that doesn’t dominate our experience, but we revisit it now and again?,” Skovronek said. “I’m not saying one should live in discomfort, but one should feel appropriate to have room for [grief] … we are denying ourselves a significant part of our humanity if we are tolerant of only half of the range of human experience.”

Technology is also changing our relationship with death. Facebook, for instance has become a place where we can share memories and mourn loved ones; often the deceased’s page turns into a memorial, a place to share memories and grieve. According to Trapasso, technology’s new role in the grieving process is ultimately a good thing, in that it provides a venue for people to share their grief with each other.

“With [the loss of] a friend, you can all share their story, and honor their life, because we always want to feel like we’re part of something. I love it, because for so long I saw people suffering alone,” Trapasso told Mic.

Nowhere was that grieving process brought into sharper relief than in the week following the death of David Bowie. During the week of Jan. 10, social media seemed to take a momentary pause from political posts and New Year’s resolutions, instead becoming flooded with Bowie hair GIFs, thinkpieces on the icon’s impact on gender roles and music videos from the star’s career.

Aside from allowing us to join in the shared mourning process over the death of an icon, the response to Bowie’s death suggests that collective mourning might fill a crucial void in our society, Skovronek said.

“I think we bond to these experiences so strongly because we are so eager to have a communal experience of death and we don’t have it anymore,” she said. “So it’s almost like…it’s a gift when one of these things happen.”

Fertilizing Marijuana Plants, and Other Weird Ways to Decay After You Die

Read my latest for VICE.

When I die I want my body used as fertilizer for cannabis so my friends can smoke me. Please plant me in a calming Indica plant so I may reduce the anxiety I caused while I was alive: Sophie Saint Kush. Plus, it’d be good for the environment. Green funeralsare on the rise as an environmentally-conscious generation starts thinking about our wills. And with good reason: Traditional burial methods can take a serious toll on Mother Earth.

“Modern burial—by which I mean the burial of an embalmed body in a metal casket, which is then set into a concrete burial vault, essentially the standard funeral home send off—consumes vast amounts of resources and leaves a trail of environmental damage in its wake,” Mark Harris, former environmental columnist for the Los Angeles Times, author of the book on green burial Grave Matters, and co-founder of Green Meadow Natural Burial Ground, told VICE. “A typical 10-acre cemetery contains enough coffin wood to build more than 40 homes and enough toxic embalming fluid to fill a small backyard swimming pool. Additionally, every year we divert enough concrete to burial vaults to create a two-lane highway running halfway across the country, and enough metal for caskets to annually rebuild the Golden Gate Bridge. Given those statistics, I’ve come to see cemeteries less as bucolic resting grounds for the dead than as landfills of largely non-biodegradable and hazardous materials.”

“Green burials are a healthy start to nipping our pollution issues in the bud. Also, you save money on not purchasing a casket or a casket,” said Amber Carvaly, a mortician and family advocate who has spent the last year helping build Undertaking LA, an alternative funeral service in Los Angeles.

Not to mention, embalming is disgusting. “During the conventional embalming process that happens in the United States every day, spiked caps are placed in the eyes to keep them closed, mouths are wired shut, blood and abdominal cavities are vacuumed out and all (I mean ALL) holes get plugged up with cotton to prevent “leakage,” Theresa Purcell, natural burial advocate and former president of the Trust for Natural Legacies, told VICE. “People spend so much money on these air tight Tupperware-like caskets trying so hard to keep nature out, but in that type of environment you are trapping the body with anaerobic bacteria and as the body naturally decomposes, gasses are released. The body then bloats and putrefies, sometimes causing the coffin to explode!”

Yikes. In search of a better way of decaying, VICE sought out some more peaceful, planet-friendly alternatives to exploding in a toxin-filled casket. (Some of our ideas were better than others.)

Use your body as plant fertilizer

“I think this is a great idea,” said Carvaly. “If you cremate your body all that is left is dry calcium phosphates, salts of sodium and potassium. It’s not really much in the way of nutrients. Once you are cremated you burn off most of what would be beneficial. However, you can choose a green burial and your body will absolutely benefit the surrounding plants and animals.” Some environmentally-friendly companies are already capitalizing on this idea. “I would definitely use a “tree urn” a new way that your body can literally help grow a forest,” said Albe Zakes, Global VP of Communications for recycling company TerraCycle and co-author of Make Garbage Great: The Terracycle Family Guide to a Zero-Waste Lifestyle. “It’s much greener than being pumped full of formaldehyde and stuffed into a wood box treated with even more chemicals,” he told VICE. “Plus who knows if reincarnation actually exists, but you know for sure you will live on as a tree, providing shade, purifying the air and water, and maybe even making a home for a nice bird family!” Of my weed idea, Theresa reminds me: “How dank your death gets depends on if you can legally grow weed in your area.”

Get cremated and mixed into tattoo ink

What if your “I heart Mom” tattoo could actually contain your dead mom? “It’s been requested before. It’s a symbolic gesture,” tattoo artist JK5 told VICE. Some tattoo-lovers hope to have their cremated ashes mixed with tattoo ink so their loved ones can be tattooed with their body. “I’ve heard of this and it sounds awesome! I don’t personally know if this increases the risk of infection or anything like that, but if you can find an artist that can do it safely I say go for it,” says Purcell. Unfortunately, cremation may not actually be so green after all. “Cremation is a valuable option and absolutely better for the environment than modern burial practices, but the process of cremation requires a significant amount of non-renewable energy and emits toxins, like mercury, into our atmosphere. Still, it’s a good choice for you and yours. Just not as great for the environment as sometimes portrayed.”

Freeze-dry yourself like astronaut food

A choice better than cremation is promession. I learned about this method from my friend Grant, who once took me on a date in a cemetery. Promession is freeze drying—you more or less turn your body into astronaut food. “Promession rules,” agreed Purcell. “I first found out about this idea by reading STIFF by Mary Roach. Promession is the process of freeze-drying a body with liquid nitrogen and exposing it to ultrasonic vibrations until it disintegrates into particles and you are left with a dry powder about 30% of the original weight. Basically a form of compost that’s way more environmentally friendly than conventional burial.” Unfortunately, promession is not yet legal in the United States.

Use yourself as kitty litter

My friend Brooke wants to be cremated and used as kitty litter. “To achieve this you would need to fill out a Disposition of Cremated Remains form with your funeral home/crematory that says you plan on taking the cremated remains home and then doing NOTHING with them,” advises Carvaly. “Then you can do whatever you want with them after that. Wink wink. Legally you cannot put the remains in the litter, but… I doubt you’ll ever get caught.”

Get turned into a nice piece of jewelry

If human bones are already being made into art, why not make a cameo in the afterlife as bone jewelry? “My dream would be that when my time was drawing to a close I could go out into the woods, curl up under the trees, and let nature take it from there,” says bone jeweler Kaya Tinsman. “If I could find an artist or jeweler familiar with cleaning bones whose work I felt a connection to, I would love to have my bones used as art as a memento mori for loved ones left behind. Unfortunately, all of this is highly illegal right now.” The idea of “mourning jewelry” is one that goes back centuries. “For hundreds of years now the hair of deceased loved ones have been woven, twirled, and set behind a clear stone, such as quartz. I’ve thought about using my final living years making jewelry incorporating my own hair for the people I love,” Tinsman said.

Mourning jewelry is similar to Aboriginal mortuary rites, Purcell’s personal favorite burial ritual. “Bodies were placed on a raised platform, covered with leaves and branches, to decompose for months until just bones remained,” Purcell explained. “Those bones were then painted with red ochre and placed in a cave or worn by their family members.”

Get broken down into chemicals

One of the newest and coolest ways of body decomposition is alkaline hydrolysis. “This is where the body is placed in a chamber that is then filled with a mixture of water and lye. It is then heated to 160 °C, but at a high pressure, which prevents boiling,” explained Carvaly. “The body is broken down into its chemical components (amino acids, peptides, salt, sugar) in liquid form. The process takes about three hours. This is not legal in all states yet but I am sure that one day it will be.”

Donate your body to necrophilia…?

Some people would rather go out with a bang. My friend Marty says he wants his body donated to a necrophiliac. Would that work? “Oddly enough this would be the only one that would be difficult in accomplishing,” said Carvaly. “You could temporarily donate it, but you would really need to make sure that whoever has control over your body at the end of your life is onboard with it. It’s likely they could temporarily let your favorite necrophiliac have a go and then give the body back. Because at some point the state needs to know where that dead body went. I don’t really know of any bodies that slipped through the cracks and were never buried, cremated, or donated to science.” None of the death babes were into this idea. “Yeah, no. Sorry, Marty,” says Purcell. “Gonna have to try and visit the bone zone while you’re still alive.”

For more information about funeral rights and options visit the Funeral Consumers Alliance and the Green Burial Council.