How to Become a Death Doula

Dear Barbara, How do you start training in becoming a death midwife?

1. Examine why you want to be a Death Midwife. What is bringing you to this area? If it is because you want to share your religious beliefs with others then this is not the area for you. People as they approach the end of their life generally bring with them the beliefs they have spent a lifetime believing. If you have had a recent death of someone close to you, wait at least a year. Your personal wound is too fresh and each death you experience will stir your own pain. If you are frustrated with the current way end of life is being addressed--welcome. You will have found a place to help us grow.

2. Explore your personal belief system and your life challenges that have made you who you are. What do you think happens when death occurs? Do you believe in a life after death? Is death a failure, the enemy, or a natural part of living? What was your first experience with death? You bring your personal beliefs, true and false, to the bedside. Unless you understand your personal experiences and how they have affected who you are that part of your personality will taint and possibly affect your work with others.

3. Explore all religious beliefs. Get a basic understanding of world religions so you can support all beliefs as you guide a person and their family through their end of life experience. Read the Tibetan Book of the Dead to give yourself an esoteric prospective.

4. Educate yourself in as much information about the dying process as you can find. Explore what physically happens as death approaches, the signs of approaching death. What are the emotional aspects that surface as death nears? Learn about the natural way people die. You need to know how the body and mind unfolds as it approaches death from disease or old age. You need to understand the basics of pain and comfort management, nutrition, bowel/urine care and skin care.

5. More education, this time about communication skills, active listening, problem solving techniques, and people skills. Just because we can’t heal a physical body doesn’t mean that healing isn’t done. We have the opportunity to heal the emotional, mental, and spiritual parts of a person (using their spiritual beliefs, not ours).

6. Learn about your city and state laws and regulations regarding a death at home, funerals, cremation. Do you need to call a coroner? What are funeral home protocols? Learn about cremation procedures, burying in cemeteries, in the ground, in vaults, in mausoleums, home funerals? Families will use you as a resource for information they do not have.

7. You need to be a person who is comfortable improvising, thinking on your feet, making impromptu decisions, a quiet leader, a good listener, comfortable with silence, able to not have an answer, to be able to say “I don’t know”. You need to be invisible yet be the conductor that guides all the occupants of a room in a gentle rhythm. You need to have a life style that allows you to leave what you are doing at a moments notice (day or night), and to stay hours and hours. This is not a 9 to 5 job.

8. You need to create ways of taking care of yourself, to keep yourself balanced in work, play, sleep and eating. Find a ‘buddy”. Someone in this field who you can talk with at a moments notice. Someone who will help you debrief after a particularly hard experience. Create a closure ritual for yourself with each family and patient so you can move on to the next. Learn how to set limits.

These are a few of my thoughts on being a Death Midwife. There are several classes available for Death Midwives and End of Life Doulas. Just use our wonderful Google to search for and explore classes and what each offers.

Something More about How to Become a Death Doula: My work with end of life has been about education. All of my materials are aimed at showing the normal, natural way death comes to us all and how to live through that experience for ourselves or with someone else. I recently added You Need Care Too because we, professional caregivers face different challenges than many who work in the healthcare arena.

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Hi Vivian, in response to your asking about end of life doula certification and more information: there are groups that offer training and their own certifications. Google would be the best bet to find them. Do your research as to which one best meets your needs. I have worked with Deanna Cochran of Quality of Life Care. Check her out. She also collaborates with the National Hospice and Palliative Care Organization for her program. A good recommendation. My blessings are with you as you pursue this new service. Barbara

Vivian Luong

I recently retired after 29 yrs working as social wofker (bilingual English and vietnamese) . I like helping families during the time of passing. I am wondering if there is a certificate program or what the requirements would be to be able to offer this type of care. Thanks

Barbara Karnes

Claudia, I’m afraid I have to disagree with you. Here is why: Dying is not a medical event. It is a social, communal event. We need people trained in end of life skills, not necessarily medical skills. In our academia, which is where all those with letters after their name come from, there is NOT extensive end of life skills taught. Someone training to be an End of Life Doula or EOL Midwife is specifically studying end of life—-not just the medical aspects of dying but all components. Working independently they have the time window to “be there” where RN’s working on the clock do not.


In my opinion I don’t see the need for yet another health care professional to be added to the arena. I would encourage any RN to get further education in this area since they have a license & can care for the dying within their scope of practice. Assignment to a Palliative Care unit, Hospice place, or Hospice at home would be a match that would be paid.
The public is I think, confused enough, with AD, BSN, MSN, ND, DNP, PhD, EdD, DNS, DSN that an RN might have without confusing them more. The term ‘midwife’ is known for ages & now includes advanced practice registered nurses (APRN). They also use the word ‘doula’.
I recommend business cards for ALL nurses, & information on checks since we are one of the most trusted professions there are. Lets keep that opinion by informing the public in the best way possible.

Pastor Betty Czubay, ELCA (my Lutheran denomination)

I recently retired after working as a nursing home chaplain for 20
years, and 8 years as a parish pastor. When I heard the term “death
doula”, I thought, “Why didn’t I think of that?” I have always looked
at death as the birth to eternal life, and every bit as joyful as our
human birth. Thank you for your wonderful material. I, my staff,
and families of residents have benefited greatly from them.

Best wishes to all death doulas.

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