May 25, 2011

What To Expect


We don’t want to feel pain. For over a century, science and medicine have been devoted to the reduction of it. This movement can be tracked in the history of child birth practices, and a similar movement, bringing consciousness to the process of dying, is in its infancy. First a look at how we come in.

In 1900, 90% of birth was at home. Fifty years later, 90% of births were in a hospital under general anesthesia. As a result, babies boomed even though many of our mothers were asleep when we came into the world.

The sterility of unconscious childbirth created an emotional void but the “natural childbirth” movement and Lamaze urged mothers to awaken to the magic and mystery of this rite of passage. The epidural knocked out the pain but not the patient, and Cesarean section anesthesia allowed mothers to be awake for surgery.

In the 1990s a plethora of self-help books, most notably What to Expect When You’re Expecting allayed fears, myths and ignorance. With sales exceeding 10 million, the book continues to dymystify the process. Midwives, doulas and family members are now part of the mix, supporting and sharing the moment at birth, enabling all involved to be present for a magical and meaningful experience.

It is important to understand the enormity of the change in consciousness and practice that has transpired in the last half century. Today this consciousness has begun to inform the process of how we depart.

There is an emerging movement to heighten our awareness as we journey out of life. How we die is undergoing a change, much like the change we have seen in the evolution of the birth process. This analogy is not only theoretical. Google around and you will find pages on death midwives and doulas, contemplative end of life practices including meditation, visualization. breathwork and massage.

Palliative care services are available across the nation, medically reducing pain and suffering for the dying. Hospice care which treats both the emotional and physical pain of dying is utilized by 30% of Americans. The World Health Organization has written declarations calling for palliative care to be part of every country’s health care services. The International Hospice and Palliative Care organization’s manual includes this statement:

“….psychosocial components of suffering will not be treated successfully until the pain is relieved.”

Many of us want to die pain free, and in our homes. Morphine, in-home hospice care, Medicare coverage for hospice, and long term care insurance policies help to provide this option (though each are flawed). This movement not only educates caregivers on how to help us die without intense suffering, but is also involved in our emotional state around death. AfterThoughts blog reflects this movement. Here we approach the topic, eyes wide open.

Privacy remains highly valued, though denial around death is diminishing. As baby boomers age, we increasingly experience the death of our contemporaries and parents. We are becoming knowledgeable about the shortcomings of institutionalized death. We have begun to see that being present while a loved one is passing, can be a natural, meaningful experience.

There is a movement out of the silence. As seen in the range of posts here, we are thinking about how we want to live before we die and how we want to die. We are delivering ourselves out of the void, easing our pain and suffering about death, long before the need for morphine, long before we are ill, long before we are elderly. Even without a “due date” we are gathering information, making plans, preparing for this last rite of passage. We seek not only to eliminate the physical pain of death, but also the pain caused by our ignorance and our fear. Publishers take note: a new title? What to Expect When You’re Dying.

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