Mic

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.”

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Why Do So Many Women Feel Sad After Sex?

Repost of an article I originally wrote for Mic Connections. Photo courtesy of Mic/Getty Images.

The last time I cried after sex was during a summer fling I wasn’t totally into, about a year and a half ago. The sex was consensual, but all of a sudden, while he was on top of me, my flight-or-flight instinct kicked in. I had to ask him to stop before tears came.

This wasn’t a first-time experience. I live with post-traumatic stress disorder brought on by sexual assault, which means I sometimes have panic attacks during sex, which can sometimes end in tears. But according to a paper recently published in the journal Sexual Medicine, I’m not alone.

According to the study, nearly 46% of the more than 230 women polled have felt depressed after sex at some point during their lives. These women reported feeling symptoms of PCD, or postcoital dysphoria, which is marked by “tearfulness, anxiety, agitation, a sense of melancholy or depression or aggression,” according to the Independent. Of those women, 2% said they felt that way after every time they had sex. And although 20% of the women polled said they had experienced sexual abuse in the past, which led to them developing mental health issues down the road, many of those surveyed didn’t report having a preexisting condition like PTSD to explain their symptoms. 

Why the hell are so many women feeling sad after sex? The PCD study had some obvious flaws. For instance, the results were collected through an online survey, and the sample size included predominantly heterosexual women. But this is not the first time researchers have tried to link sex to sadness in women. A 2011 study published in the International Journal of Sexual Health found one-third of women said they felt depressed even after satisfactory sex.

Jerilyn, 27, is one of them. “Even when I was single, the post-sex depression morphed into a different shade of empty. I always attributed it to the fear of being abandoned,” she told Mic. “I started to wonder if something was being taken from me every time I had sex, even though I enjoyed the act itself.”

Researchers theorized this post-sex dysphoria was caused by hormonal shifts after orgasm. But according to sex and relationship expert Logan Levkoff, the reason might have less to do with biology and more to do with how women’s sexuality is viewed in modern society.

“I think it’s important to remember that if you grow up not feeling empowered by your body, if you feel guilt and shame about sex, if you’ve been taught that your needs are less important than a man’s needs … [it’s not a] surprise that some people wouldn’t feel great after sex,” Levkoff told Mic.

According to Levkoff, part of why women might feel down after getting laid is that their needs weren’t met in bed, a phenomenon linked to how our culture teaches women about their sexual desires. While many men believe that women can achieve orgasm via penetration alone, according to one study, about 75% of women need some form of clitoral stimulation to achieve orgasm.

If their partners aren’t interested in paying attention to their desires, it’s no surprise that women would feel frustrated or emotionally drained after sex. “I think that the take-home message has a lot to do with how we learned about sex [and] how we feel about our bodies,” Levkoff said.

Playing into stereotypes: Possible causes of PCD aside, it’s worth noting that the study could be interpreted as perpetuating the idea that women are more biologically predisposed than men to becoming emotionally attachedto their partners after sex. (That notion was quickly debunked by a study from Concordia University, which found men and women process both love and sexual attraction in pretty much the same way.)

The idea that women are more likely than men to become sad or depressed after sex also inherently endorses the stereotype that women just aren’t really into sex at all. While numerous publications have said otherwise — in fact, a fertility app survey from earlier this year determined that many women would prefer to be having more sex than they’re currently having — the stereotype of the sexless housewife in a frumpy nightgown snapping, “Not tonight, honey,” at her poor, neglected husband still persists.

For this reason, many women don’t buy into the PCD study, insisting that they feel just fine after sex. “The only time I ever feel negative emotions after sex is if it was a one-night stand and I didn’t practice safe sex,” Meredith*, 24, explained. “Maybe guilt the next day, but no, I’m never sad. I love sex.”

Ehris, 22, is also skeptical that women have a biological predisposition toward post-sex depression. “I’ve experienced [sadness after sex] before. But I don’t think that it needs to be pathologized as a problem experienced predominantly by women,” she explained. “I’ve had and heard of partners of both sexes and a variety of genders who have felt melancholic after sex.”

Ehris brings up an important point: PCD isn’t exclusive to women. Men too don’t always feel awesome after sex. “We certainly don’t talk about it as much,” Levkoff said of PCD in men. “And that’s the one thing — this study sort of stereotypes, ‘Yeah, women really aren’t interested in sex.’ I don’t want this to become a self-fulfilling prophecy. I think that’s a bad paradigm to put out there.”

hormonal quirk or a sign that something’s not quite right: An orgasm can be one of nature’s most powerful drugs. When you have sex, the release of hormones in your brain can cause some funny reactions, from making you want to snuggle into your partner’s armpit to making you cry uncontrollably for no apparent reason. The occasional bout of post-sex sadness might be a sign that something isn’t right in the relationship, but it might also just be an odd quirk of nature and nothing more than that.

That said, if you consistently feel sad and depressed after having sex, it’s worth asking yourself why and reevaluating your partner selection. While it might sound obvious, who you’re having sex with plays a major role in how you feel about it afterward. Levkoff said it’s wise to check in with yourself and make sure you are comfortable with your partner and that there are no unaddressed, underlying issues preventing you from enjoying the encounter to the fullest, even if you’re just looking for a one-night stand.

Ultimately, it’s important to have sex with someone with whom you feel safe, “and by safe I mean respected, trusted, cared for,” Levkoff said. “It might not even be a monogamous romantic relationship. If you feel like this is someone you are connected to and who respects you, that certainly impacts [your feelings afterward].”

Jerilyn experienced PCD for years before she started dating her current partner, a longtime friend of hers. They’ve been together five months, and Jerilyn said she is finally enjoying sex in the way she thought she was meant to.

“This is the first time in my life that I have not had some form of postcoital depression. The only reason I get sad is if he falls asleep and I want more,” she explained. “Sex is finally what it should be for me, which is primal and passionate, and no longer something that provokes that overhanging, ambiguous sensation that something isn’t right.”

I’ve dealt with a lot of my PTSD-related issues, and like Jerilyn, I am now with a partner with whom I feel safe. I no longer feel sadness or anxiety after sex. Instead, I feel a lovely, Ativan-esque sense of calmness.

*Some names have been changed and last names have been withheld to allow subjects to speak freely on private matters.