Of Dying and Birthing, and of Midwives for Both

It may seem surprising at first thought, but there are startling similarities between the holy work of giving birth – especially when it is one’s first experience of birthing – and the holy work of dying. Both confront one with a journey that one only knows about from others. There is pain involved without knowing what it will feel like (and unless you have given birth yourself, you really cannot imagine, trust me), and how one will bear it (my cheerful vision of giving birth to the music of Mozart dissolved with the first contractions). There is the uncertainty of when exactly this will happen even when the general time frame is clear (“my due date is in six months.” “I have only four months to live”), and of what exactly this will feel like. What does it feel like when one’s waters break? What does it feel like when the process of active dying begins?

Given these similarities, I was intrigued by a recent newspaper article that described changes in our culture’s way of approaching death. Among several new trends in the so-called “positive death movement,” such as death cafés, there is also certified training available now for end-of-life doulas. I had known doulas only as birth and postpartum support persons, most of whom are women, who offer professional care to a mother before, during, and shortly after the birth of her child. Now, there are also certified doulas who offer support and care before, during, and right through the process of dying. Most of these end-of-life doulas also are women.

I could not help but think of Jesus’ death. The women stayed. Maybe the women who remained with Jesus in his end-of-life agony rendered present a knowledge born from within their own female bodies, namely this: that unimaginable pain searing through a body, and water breaking forth, and flesh being torn, and blood flowing profusely are not signs of death alone. They are also the signs of a woman laboring to birth new life.

The thought of Jesus’ death as a form of birthing is not as far-fetched as it might seem at first. Jesus himself evoked the image of a woman in childbirth on the night before he died: “When a woman is in labor, she has pain, because her hour has come. But when her child is born, she no longer remembers the anguish…” (John 16:21). Indeed, his approaching death came to be described with the very same words: “When Jesus knew that his hour had come…” (John 13:1). More poignantly, Jesus died with a psalm on his lips that images God as a mid-wife. Psalm 22, which begins with the haunting “My God, my God, why have you forsaken me?” sharpens the sense of Divine betrayal by reminding God of the midwifery God practiced at the psalmist’s birth:

Yet it was you who took me from the womb;
You kept me safe on my mother’s breast.
On you I was cast from my birth,
And since my mother bore me you have been my God.

It is precisely this contrast between “you are my God from my mother’s womb” (in the translation of the ICEL Psalter) and the sense of now having been forsaken that gives this psalm its bitter depth. For some medieval writers, it was this precisely this imagery of birthing in connection with Jesus’ agony on the cross that captured their imagination. Anselm of Canterbury (+ 1109), for example, prayed: “Truly, Lord, you are a mother; … It is by your death that they [your children] have been born”. And the Carthusian mystic, Marguerite d’Oingt (+ 1310) meditated in one of her prayers:

Are you not my mother and more than mother? … when the hour of the birth came you were placed on the hard bed of the cross where you could not move or turn around or stretch your limbs as someone who suffers such great pain should be able to do; … And surely it was no wonder that your veins were broken when you gave birth to the world all in one day.

More precisely, Jesus was seen to give birth to the church in his dying. Some medieval visual representations are very precise in rendering this birthing: a tiny ecclesia  enters the world through Jesus’ wide-open side wound, which resembles as a birthing canal.

Today, we are regaining some of the connections between birthing and dying, at least in the broader culture, think only of the doulas who support one in birthing and in dying. Why do I have the sinking feeling that the church is behind in this — although it could well be the mother of all doulas, in both the holy work of birthing and of dying.

Featured image: Cruxifixion by Martin Erspamer, OSB, Lutheran Church of the Ascension, Atlanta


  1. As I read the July 20 post “Wrestling with Words: Inclusive Language and the Difficulties of Prayer” by Deacon Bauerschmidt and the majority of the 12 responses that sounded to my ears so much like “mansplaining” for why the desire for inclusive language wasn’t necessary, I longed to hear some words of wisdom from you, Teresa. However, this post satisfies my wish and need much more wonderfully. It provides a very rich example of how the experiences of women give rise to different, yet equally valid, ways of praying and connecting with Christ. At the risk of sounding cynical, I note the lack of response to your reflection from the men who often reply to PrayTell blog posts and wonder why.

    1. Ah yes, I had been pondering the very same thing, so thank you for pointing to it in writing, Juliana. I think I set that silence from ‘the boys’ — to put it succinctly if irreverently — in place in my post with insisting that unless you had given birth, you simply could not imagine what it was like [and therefore maybe better not start pontificating on it?]. At the same time, that also silences a good number of women, who for manifold reasons have not given birth. Still, I think women are closer, from within their own female bodies and its rhythms, to experiences of birthing, and thus less uncomfortable with birthing being invoked.

      1. .Perhaps I was hoping for more of an “ah-ha” moment, rather than one more attempt to explain it away. “Yes, now I can begin to see why women feel the need to hear scripture proclaimed and interpreted in their own voices,” would have done nicely. Even just a response that indicated the reflection was read and pondered would have been worthwhile instead of dead silence. Such seems to be all too often the response to many of the posts by women on this blog.

      2. Juliana, I think you might be overreading into the intentions of those (us men in particular) who choose to respond or not to this blog. Teresa’s piece was beautiful and intriguing, and I’m willing to bet the other male contributors were moved as well. But I don’t think I’m alone in not posting unless I feel I have something of value to contribute to the conversation; in this case, I didn’t initially feel like I did. Everyone who follows PT has slightly different areas of interest or experience, which will inform what conversations they choose to join (or not). I don’t think it has any more to do with gender per se than, say, what form of the Roman Rite they worship in.

      3. I want to take a moment to thank Patrick for posting. Even just taking time to do this — on a post where he feels he has nothing much to contribute as such — deserves recognition. Plus, Patrick single-handedly rendered the group of respondents more gender-inclusive than it had been. That, too, is not nothing. So, thank you, Patrick.

  2. Thank you Teresa – about 10 years ago this started to come up in my course on sick, death & dying – particularly among the women students. A group of them went on to create an informal group called the “midwives of death”. Many of these women went on to become Anglican priests, and I know for a number of years they kept in touch regarding this midwifing through death to life that formed a part of their ongoing ministry. I had actually forgotten their claiming and shaping of the conversation until reading your lovely reflection.

    1. Fascinating, Liz. Thank you for this. This makes me remember a male student I had in my “In the Face of Death: Worship, Music, Art” class a couple of years ago, you wanted to write his final paper on the similarities of midwifery for birthing and for dying. He and his wife had lost their unborn child not too long ago, and this student — who had already been present at two other births of children of his — had a keen sense that being there for birth and being there for death demanded similar things of him. Which of course becomes very acute when the “womb” becomes a “tomb”.

  3. I loved this reflection. During my second year after college, I spent a year living and volunteering at a hospice home run by a Sister of Mercy in southern Texas. My nearest friends lived 20 minutes away, and they spent their year volunteering at a birthing center that served a largely undocumented population of women. I remember evenings spent at their compound, hearing about women in labor at that very moment. On those evenings, I would drive back home to work third shift at the hospice, and I would sometimes find myself sitting at the bedside of someone who was actively dying. For a 24 year old, it was an amazing experience to witness the process into life and then into death, sometimes on the same night. (After I started medical school, I realized how special and unique those experiences were.) Teresa – both the hospice and the birthing center were run by women religious, and the Catholic influence was felt in such a beautiful way.

    1. Thank you for this story and information. There is hope!
      I suddenly wondered what a place might look like that centers on the presence of doulas, whether for birthing or for dying, but doesn’t divide those two processes…

      1. There were days when I felt like I had one foot in the land of the living, and one foot in a less physical, more spiritual place. I’m sure there’s a theological way of saying this, but it felt sacred and beyond our physical world.

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