This may be an unusual thing for a doula to write. But I think it matters.
Not everyone needs one.
As end-of-life doulas become more visible, people are starting to ask fair questions. What exactly are we adding? Palliative care already brings doctors, nurses, social workers, pastoral carers and volunteers. Isn't that enough?
For some families, it truly is. And I think doulas earn trust by saying so out loud.
When you may not need a doula
Some people are already surrounded. There's the sister who's a nurse. The neighbour who leaves soup on the doorstep without being asked. The friends who draw up a roster for the fridge and actually keep to it. A palliative team who knows everyone's name, including the dog's.
If you have that, hold onto it. Community is the oldest end-of-life care there is, and nothing I offer replaces it.
There are also things a doula isn't for, and a good one will tell you so plainly.
- Pain, symptoms and medication belong with your GP, nurses and palliative team.
- Wills, estates and legal documents belong with a lawyer.
- A mental health crisis needs your GP, a psychologist, or Lifeline on 13 11 14. In an emergency, call 000.
When a doula can make a real difference
Many people don't have a village. Families are spread across countries. Partners are exhausted. Friends mean well but don't know what to say, so they say nothing, or say the wrong thing and then disappear.
This is where a doula often helps.
- The main carer who hasn't slept properly in weeks and is running on adrenaline and toast
- The family who live far away and want to know someone steady is there
- The person who wants to talk honestly about dying, while everyone around them keeps changing the subject
- The family with old tensions that make the hard conversations harder
- The person who wants to plan ahead, but doesn't know where to begin
- Anyone worried about the after, when the professional support quietly ends
What I bring isn't a different service so much as a different kind of time. Unhurried. Without an agenda. And continuous, so the same familiar face can be there from the first conversation to the weeks after a death.
The shadow side of helping
Carl Jung wrote about the shadow, the parts of ourselves we prefer not to look at. He also wrote about the wounded healer, the idea that people often come to helping work through their own pain.
I think both are worth naming here. Many of us become doulas because of a loss that changed us. That can make us deeply compassionate. It can also, if we aren't careful, make us need to be needed.
A doula who isn't aware of their own shadow might create a gap rather than fill one. They might take over when they should step back, or bring their own grief into your room.
So I believe doulas should keep doing their own inner work, have supervision and support of their own, and always ask: is this about them, or is it about me?
Questions worth asking any doula
End-of-life doulas aren't regulated in Australia. Anyone can use the title. That makes it even more important to ask good questions.
- What is your background, and where did your training come from?
- What will you do, and what won't you do?
- How do you work alongside our doctors and palliative team?
- Do you have insurance and a current police check?
- Who supports you when the work is hard?
- How do you charge, and what happens if our needs change?
You are allowed to ask all of these. A good doula will welcome them.
What good support should feel like
In the end, I think you'll know more from how you feel than from anything written on a website.
The right person should make the room feel a little calmer, not busier. They should leave you feeling more capable, not more dependent. They should follow your lead, honour your family's way of doing things, and know when to quietly step back.
The goal of a good doula is not to become essential.
It's to help you feel less alone in something you were never meant to face alone.
If you're not sure whether you need this kind of support, that's a perfectly good reason to have a free conversation. Sometimes the honest answer is no, and I'll tell you so.
carolina x