Midlife Midwife Musings

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On death; Heather/Alison, revisited in May 2017.

Lately it feels like all our friends are dying. It’s just a few – three, maybe; but that’s enough when you’re only 55. Since I wrote this piece below on 27/09/01, my partner and I have also lost both our fathers, to good old age, and her nephew, at a tender 25 years, to the February 22nd 2011 Christchurch earthquake. So I’ve been thinking about death a bit. At the start of my academic journey as a sociologist 25 years ago, I was more interested in birth. I had just trained as a midwife, had a five year old daughter, and was convinced that childbirth was a field the potentially feminist profession of midwifery might reclaim some lost ground over. That was a while ago – indeed, a lifetime ago; and now it seems I’m faced with more death than life. Can there be a re-death? I’m very familiar with re-birth as a metaphor, but re-death? Never heard of it. I’ll keep thinking. In the meantime, this is what I wrote back then.

Heather and Alison

Alison invites me silently with a smile, a nod and raised eyebrows to enter the room. I follow her, trying to be silent and almost invisible, as she indicates a seat for me beside the bed that Heather lies in. I reach out and take one of Heather’s hands in mine, after feeling momentarily unsure about whether I should do so at this time; I don’t want to disturb what she is doing. She seems so incredibly inside herself, oblivious, almost, to the presence of Alison and me in the room with her. Her belly is huge. I wonder if she is in transition. Her breathing seems quite laboured now, but she seems to have found a certain rhythm to go with. There is some soft music playing; an Indian meditation piece with some very quiet and slow chanting. It provides a feeling of absolute peace and serenity in the room. Alison is completely in tune with Heather’s rhythms; she follows her lead in everything. She watches Heather’s face continually from the other side of the bed. If Heather licks her lips, Alison holds a glass of water out for her to sip from, before watching Heather sink back into the pillows. She seems to be comfortable; what pain there is seems to be manageable.

Alison whispers to me: ‘she’s just going with the flow so well, isn’t she…’ and I feel my tears well over at the enormity of being part of this. I am in awe of Alison, who seems to be in a perfect partnership with Heather; they are symbiotic. No one comes to disturb us. There are no noises from outside. It almost feels as if we are in a womb of sorts, ourselves. The lighting is soft and dim and I can see the contours of Heather’s face changing as she breathes, and at times hums, and sometimes moans.

Heather’s daughter, Celia, who had been born nine years earlier by caesarean, comes in to the room with Heather’s mother, ponders Heather’s face for a while, and then goes back out to play. She appears unconcerned at what her mother is experiencing, and slips in and out of the room from time to time thereafter. There are three generations of the women in this family present; their connection to and knowingness of each other is tangible. Heather’s mother asks Alison quietly if there is anything she can do, but Alison shakes her head, and so her mother sits back down and returns to her reading. It seems a perfect way to give birth; surrounded by women related by blood and by friendship, with no need for words, communicating silently and often with eye contact and facial expressions. There is a sense of incredible peace and acceptance, of going with the flow, accepting the process, and not hurrying the forces of nature. There are no clocks on the wall. I still wish that more women could, or would choose, to give birth like this, with no hurrying, no time limits, surrounded only by people who love them and will follow their lead in the process. Going through this experience now was the closest Heather had felt to her family in her life, she had told me a few days earlier.

Heather isn’t giving birth this time, though; she is dying, of lymphoma. The cancer has swollen her belly to bizarre proportions; the rest of her body is excruciatingly thin. Alison and I have had a whole month of getting used to this moment; for a long time we haven’t known whether Heather was ‘living’ or ‘dying’, and realized we would have to accept a limbo state, a grey zone of not-knowing, that no one could tell us one way or the other, after treatment stopped, what would happen. So we approached it now almost like a birth, as Heather herself did by that stage. She considered her impending death to be a spiritual transition, and at times talked to me about how this felt. She wasn’t afraid of the transition; she had finally let go of her earthly concerns and surrendered herself to the process as it was unfolding. Her sister, Alison, was being with, midwifing, Heather, through this transition.

Spiritual care for the dying has been described as “midwifery for souls …keeping the body comfortable, passage peaceful, soul triumphant, and family present” (in Paine, 2000:367). Perhaps the needs of those dying, and of those birthing, are more similar, and much simpler, than we realize. Perhaps there is not much difference between being-with in birth, or being-with in death, for nomad midwives….

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Now being a ‘Death Doula’ is a thing (in America, so far). I worked as a nurse in palliative care for a while, well before, and in fact leading to, my interest in home birth. I thought home-death was lovely, and home-birth would be even more compelling. I’ve come a long way, baby, but have much less direction, now. Maybe I’ll figure some things out in the course of these musings. Maybe not. But I am going to try a bit more writing, just for company, along the next leg of the journey.