What death doulas can teach us about dying

For Rita Ball there's nothing more meaningful than holding a person's hand in their final moments.

"It is absolutely raw," Ball says, "to witness this life that is leaving the world."

She's been there at someone's last breath multiple times.

For three years, Ball has worked as a trained "death doula" in London, and as a non-medical end-of-life companion she supports individual families and volunteers in care homes for the NHS.

Ball says people often ask her what they're "allowed to do" when their loved ones are in the process of dying.

"I hear a real sense of relief when I say it's OK to hold them, kiss them, play music, talk to them."

You may have heard of doulas who help mothers during pregnancy, childbirth and early parenthood. But death doulas, sometimes known as soul midwives, have been growing in popularity in the last 10 years.

Emma Clare, chief executive of End of Life Doula UK, says 114 doulas joined her organisation in 2025 - a big increase on previous years.

Recently celebrities including Nicole Kidman and Ruby Wax have announced they are training to become end-of-life doulas, and Davina McCall says she also plans to when she retires.

Sometimes "the silence after someone dies can be huge", Ball says, but doulas can sit with the bereaved and recount those last few days.

Depending on their level of training a doula can cost between £25-£45 an hour, according to Clare. However, some may offer their services free of charge.

Fanny Behrens who lives in Devon, first approached death doula Sarah Parker, 10 months before her husband died of cancer.

"Sarah was just amazing with me while I just sobbed and sobbed in her kitchen," Behrens says.

"It was incredible to be able to talk to someone who wasn't family, who wasn't involved, and who could just be there, while I let myself fall apart with the grief of it."

The doula encouraged Behrens to broach difficult questions with her dying husband - including where he wanted to be buried and what he wanted his funeral to be like.

And she helped her navigate the "death admin" of contacting undertakers and registering the death.

"She was good at reminding me to look after myself too and not just get lost in the other person's needs."

While Parker mostly ended up being a source of support for Behrens, she also supported her husband. And she remembers Parker carefully explaining the process of how the body begins to shut down during the final days of life.

"There's something about being with someone who's very familiar with the process, who is matter-of-fact and at home with it and compassionate - that really helps," Behrens says.

"Even though it doesn't take the pain of it away, it kind of normalises it."

Like the other doulas we spoke to, Clare believes people today have "lost a lot of knowledge about ordinary death". She says most people's idea of death comes from dramatic scenes in films or a sudden death.

By explaining the physical process of dying in as much detail as people want, doulas help remove fear, she adds, unlocking time that could be spent more meaningfully.

For example, Parker explains, when people are dying their body temperature and breathing changes.

"At the end there can be a death rattle - a sound of hard breathing that can be frightening for people in the room," she says.

"If you've already told them to expect it, it can feel easier."

Soul midwife Krista Hughes, who also works at cancer charity the Mulberry Centre, says developing a strong bond with the person who is dying is important to allow them to live out their final moments as they wish.

"When someone is born they are born into loving hands," Hughes says, "and we hope they are able to die into loving hands."

Hughes recalls a person who wanted to die in a garden but was unable to due to the medical intervention needed. She recreated an imaginary garden for them by bringing in pictures and lavender oil, playing the sound of birdsong and describing a walk through lavender fields.

End-of-life doulas often provide support even beyond death. Ball says she's visited funeral homes on behalf of families to relay messages and has helped organise memorial services.

Others spend time in the community raising awareness, including holding death cafes to "open up conversations" over tea and cake.

Marian Krawczyk, researcher in end-of-life care at the University of Glasgow and founder of the End-of-Life Doula International Research group, says end-of-life care has to evolve, because the way people die has changed, with fewer people having short infectious illnesses or accidental deaths and more instead living for many years with life-limiting diseases.

"There are also now expectations of lifestyle choices in every aspect of our life," she says, "including the ability to craft our own dying."

And while for some, death doulas could help with this, it's a complex issue with no regulation or mandatory training in the UK.

Some people believe death doulas should be incorporated into the health system, while others think the service they offer should remain separate.

There have also been questions around the costs of this role and concerns raised that there is space for "opportunism around vulnerable people."

But according to Krawczyk: "The reality is that, appropriate end-of-life care is a postcode lottery" and doulas can help to fill those gaps in care.

Meanwhile, Dr Paul Perkins, chief medical director at palliative care and bereavement charity Sue Ryder, says the healthcare system can be "hard to navigate for patients especially when they are going through all the emotions that a diagnosis can bring".

He believes those who are dying should be helped to "have the best quality of life possible", adding, "so they can spend time with the people who bring them joy."