Podcast #89 Doulas… from the First Breath to the Last: A Conversation with a Birth Doula and an End-of-Life Doula – Gabby Jimenez and Claudia Peñate

This week on the Best Life Best Death podcast, I talk with two doulas, Gabby Jimenez and Claudia Penate. Both of them:

  • work with individuals and families
  • offer guidance, support and education
  • are available before, during and after the experience
  • bring expertise to common yet not-widely-known human events!

Find Gabby at: thehospiceheart.net

Find Claudia at: ⁠https://www.claudiapenate.com/⁠


Diane Hullet: Hi, I’m Diane Hullett and you’re listening to the Best Life Best Death podcast. Today I’ve got a really fun and unusual podcast because I actually have two guests and these women are at either ends of the doula spectrum. One is a death doula, and one is a birth doula. And we’re gonna talk today. What does that term mean?

What do they do in their jobs? Why would a family hire a doula? So welcome to both of you and I. I’m just gonna let you both introduce 

Gabby Jimenez: yourselves. So thank you Diane, for having both Claudia and I here today. What, this is such a great topic and something that I personally ha, ha, have to address quite frequently actually, because you hear doula and it immediately people think birthing doula.

So there’s a lot of education. My name’s Gabby. I’m a hospice nurse, an end of life doula, and a cine educator. You and I have met several. And I’m just really glad to be here, to be able to talk about this work, what we do, and super excited to have a personal friend here and someone who I have watched grow and just is doing such beautiful work.

And having said that, Claudia, take the floor. 

Claudia Penate: Thanks Gabby, and thank you Diane. This is amazing. My name is Claudia Ante and I’m a birth doula. I know Gabby because we both. In hospice. I, I did work as a hospice nurse as well, so but we’re here to talk about birth. Well, at least my side is here to talk about birth, and I’m really excited to be 

Diane Hullet: here.

Well, thanks. I, I love this. I just think it’s such a great combo, you know, because we’re really talking about these sacred passages at both ends of life and how they are similar and how they are different. And so let, let’s just talk about this term doula. Do either of, you know, kind of the history of that?

What is, what the heck is a do. 

Claudia Penate: So I know that it was Greek derived right? And it means either female, sort of like a female caregiver, someone who preps and helps women in labor. That’s really like the origin of doula. But I think that term has really grown because when when I say I need to doula somebody, even my doula sisters, that means I want to emotionally help.

I wanna hold space for you. I wanna care for you. I’m gonna prep, prep with you. So I think that term has really grown and flourished in many different ways. As you know, as the term doula, for me means caring for somebody, helping guide and teach 

Diane Hullet: and take care. I love that I’ve, I’ve, because, because I’ve heard of like a birthing doula or a birth doula, and then I hear of a postpartum doula, and when people ask me like, well, wait, what is that?

I think, well, it’s, it’s about a person who’s not the midwife, not the doctor, not the nurse, but actually they’re caring for the whole family system, the new baby and the mother and labor, and the father. If there’s a father in the room, all, all the people who are part of that birth. Mm-hmm. That’s 

Claudia Penate: exactly what it is, and you’re right, it it’s a very special role because I tell my families all the time, my support is more emotional than anything.

I’m there to emotionally help you get through this, whatever this 

Diane Hullet: is. Beautiful. And how does that play out for you then, Gabby, at the other end? 

Gabby Jimenez: Well, okay, you guys, I’m crying like my eyes are filled with tears because I love what you just said, Claudia, because you’re right. Like there is a, you know where I am, a nurse, but when I’m a doula, I’m a doula.

And the way I look at it is I walk alongside someone else on their journey. It’s not about. This is about them and for me, while it is emotionally based as well, for me, it’s also educational as a hospice nurse and an as an end of life doula, I am educating them in such a way that they are prepared for what could and would.

Might happen, but also to not, not have so much fear or uncertainty to answer the, the curious questions to sort of take their hand and not walk in front of ’em, not walk in back of ’em, but really, truly walk alongside them on the most intimate, most sacred personal time of their lives. And quite frankly, I think the same as birthing, right?

This is what we’re doing is we are, we’re just being a companion. Thankfully, right. What a gift. We are being honored to be alongside someone else on this really beautifully sacred. 

Diane Hullet: And, and do you think, you know, is the history of some of this, did this role used to be filled by extended family in the household or you know, people in the community that cared for people at these stages of life?

Like, why now? Is this a profession? How have these, how has it moved out of the home and into this professional role that, you know, families have to kind of seek? 

Claudia Penate: Do you wanna take that or should I, 

Gabby Jimenez: well, you know what? If you have a better answer, I’m gonna let you, because my brain goes to a whole different place.

Like I’m going to, the place of grandmas must have been doulas, right? Yeah. And, and our elders must have been doulas. I look at hospice volunteers and I think of them as doulas. So was it already there? And we’ve just coined the term because is it a profession? Well, yes, because it’s more popular now, but this has been going on for a very long time.

Where someone sat and was present for someone who was about to have a baby or about to take their 

Claudia Penate: last breath. Exactly. I agree with you on that. It’s, I feel like for, for birth doula, I feel it’s, it was mothers and grandmothers and sisters and aunts and, and really women overall were the ones helping care for the other woman in labor.

And the husbands and men were all outside. Like, that’s how I envision it. Right. And the same with death. I think, and I, and I go back and forth because my role when I worked as an, as a hospice nurse, that was our primary role, was to doula the families, educate the families. And I do the same thing in birth, just like Gabby said.

I educate, I normalize because this is, these are natural processes. We, we, we are, we are born and, and then we. 

Diane Hullet: Right. I was just talking the other day to hospice nurse Julie, who’s kind of this, you know, oh, Julie. Fabulous person. And, and she said, you know, the birthing mother, the body knows how to birth and the baby knows how to be born and the dying body knows how to die.

So the less we can complicate that and get in the way, the better. But, you know, easier said than done. Right. And I think education is so, so key. So, so what’s your role with. 

Claudia Penate: So my role with families is to educate and prepare. For the labor and childbirth, and I also let the partners know that I’m there to support them.

I need them to be supported in order for them to support the birthing person. Same thing goes. In the dying process, we were there to support the families to help facilitate the death process for the dying person. Same thing goes here. I prep my families for giving birth in this country in a hospital system.

You really do not have many choices unless you do your due diligence and attend childbirth education courses. Have a doula come in with a birth plan. Know your options. Know your choices. Know your rights. Know that you have a voice that I definitely make sure that I prep my family’s for, and I’m there.

Just as a reminder, I’ll put a hand on a shoulder. I think we discussed this. Do you remember? Or, I give them that, that empowerment that they need. But it’s very much supporting, educating, and making sure that I hold space for the birthing person because it’s such a natural process that. The less amount of people and the less distractions and the more that we normalize, yes, this is gonna be a very extreme part of labor, but just know that it’s extreme, but very short.

And that tells us we’re getting much closer. And so when we get to that point, we remind that person and we remind the support person. And then that way she looks to her partner and says, okay, he’s not freaked out, so I’m not gonna freak. 

Diane Hullet: Right. So we’re all in this together. We’re all in this together. But I love the word normalize.

I think that really, you really nailed it with that. And, and how, like what, at what point do people typically engage you? You know, how far, how long are they along in their pregnancy before they say it’s time to line up the do luck? 

Claudia Penate: So I have. I’m booked through August right now, so I have even signed clients at nine or 12 weeks of gestation.

I have also started working with clients in the third trimester at 32 weeks or 36 weeks. So it really just depends. A lot of people don’t know what a doula is. Un a birth doula, that is until they’re pregnant. You know, they start talking to other moms and families and like, you have to get a doula or do you know what a doula is?

So it just really depends. Ones that know and know that that’s what they want, we get ’em really early. I 

Diane Hullet: love that. How, how about you Gabby? What’s your, what’s your role with families and how, what’s stage in the process? Do people typically reach out? Well, 

Gabby Jimenez: I much like what Claudia said, which was awesome.

Because that makes so much sense. And I too, I feel like it’s super important that families understand that the body knows what to do. We have gotten involved in everybody’s stuff like we do with everything else, and, and start to kind of redirect and change and add, and subtract and move. You know, we have to take control of everything, but at the end of the day, the body knows what to do and the family, those who are preparing to say goodbye, have to trust.

And so as putting aside my nursing skills experience just as a doula, I want to get them at diagnosis. I want them to sign on so that I can start them on this process by letting them know what to expect, what, what could happen, what this might be like. Also, the whole other side of it, which is one of my favorite things to do as a doula, is to create, I, I say choreograph a beautiful death on their.

I like to sit with them. I like to ask them what it is most important to them. Where do they wanna be? Who do they want there, you know? And, and I also, I have this thing called the This is Me list, and so I’ll sit with them and I’ll ask them questions, you know, who is your favorite teacher and why? What was your favorite Halloween costume?

You know if, if you could do any job, if you were given the luxury of time and could just do another job, what would it be? What was your favorite job? Who are you? Because one of the things that happens at the end of life is we sit at the bedside, right? And they’ll share a little snapshot of this person’s life and we’ll say, wow.

And then they’ll, they’ll say something else about how he was a professional ballroom dancer, and one of the family members will say, I had no. And what I realize at death is how very little we know about the people we love, because all of a sudden with death, it takes time, takes on a whole new meaning, right?

Because all of a sudden there’s less left. And so we sort of dig in and dive deep into who that person was. And so what I like to do is early on is sit down with them and find out who they are so that I can create a, this is me list, and then after he has died, I’ll sit with the family. If there’s time with Rich, they’re open to it.

Otherwise I’ll save it for later and send it to them. But I will write this beautiful sort of description of who he was to. And what that does is it also opens up like things that I can say like, what kind of music do you wanna hear? Mm-hmm. You know, is there, is there a favorite window you wanna look out of?

Do you wanna hear the beach? Do you want sense? Is there a candle you enjoy? Mostly? For me, it’s always about music, because music for me is a diary of my life, right? If you love music, and Claudia loves music so she can appreciate this. My whole life is a playlist. And so I have created a 12 hour playlist of my life because it will take me back to those places.

So sitting with family members and, and creating a playlist with the person who is preparing to die early on allows for conversations. Mm-hmm. So, yes, of course I wanna remove fear, I wanna educate, I wanna support, I wanna walk alongside them on this journey, but I also want to choreograph it in such a way that when those last breaths are taken, they’re less.

A little more prepared and ready for it, but also their, it’s like their internal velvet coded box is filled with memories that they get to take with them that they might not have had if we didn’t have those conversations. So it’s really about creating. An energy and, and a space for people to be who they are and share that.

And then when that last breath is taken, have them take that which is their legacy, right? And, and take it with them. Carry that further. Say their name, tell their story. But if you don’t know the no, their story, does it stop at the last breath? I don’t want it to stop at the last. Yeah. 

Diane Hullet: I love that you used the word choreograph.

I think that’s such a great word. And I think choreograph applies to the birth doula situation, right? Like, what is this birth, how do we wanna choreograph this? And of course you know, we always say to people, yeah, make a plan. And then, you know, how do you make God laugh? Tell him or her your plans, right, because it’s gonna have its own quirky moments that don’t go at all according to plan.

But, but I love, you know, Gabby, you’re really talking about how do you be with someone and sit with someone in order to say to them, you matter. And what you have done and experience matters, and we’re holding that here as, as this life on this earth comes to an end. We’re holding that. And you’re, you’re doing that for the dying person, but you’re also doing it for the family, as you said.

And I, I love that both of you, you real, have really talked about the importance of the, the partners and the loved ones and the sweethearts and. The family or friends who are there are such a big piece of this. And, and so Gabby, when do people typically engage you? Is it similar? Sometimes early, sometimes late?

Gabby Jimenez: It is mostly later, but as of recently it’s been earlier. I also do, which has been really fun for me, is a lot of my doula work is over zoom in with people in different countries. So right now I’m talking to someone in New Zealand, South Africa, Canada, and the. And the reason is, is cuz maybe they don’t have this type of opportunity as accessible, but they’ve heard of me through, you know, online whatever my work that I’m doing.

And so they reach out to me and said, we just could you sit and talk with the family. So I’ll do this like I’m doing here with you guys and I’ll see the family members and I’ll ask them about each other and I’ll get them engaged in conversations. And I love that. And that is usually earlier on. What I get here per in person are people who are very soon to die, and the the partner is scared.

And, and this is what happens when you’re given a diagnosis. You know, you’re, you get all this care, you know, for your, for your diagnosis, for the disease process. But when those six months hit and they realize, okay, now you must start hospice. It’s like sending somebody wrapped in meat into a tiger den.

Like they don’t have the tools, they don’t know what to expect. They’re not prepared. And, and so I, again, I wanna get them sooner, but usually I get them at the fear state. Like, what do we do now? It looks like dad’s gonna be dying soon. What do we do? And, and it makes me sad because some of that fear could have been reduced and, and that that’s what doulas can do.

Doulas can partner with the oncologists and the palliative care department and then the hospice team while also taking the hand of everybody who is preparing to say goodbye. Who has gathered all of these around the person who’s dying, how can we do that? Well, we do it by starting sooner. Mm-hmm. A doula can start from diagnosis to death and then to the grief journey, which is another thing that I really enjoy, is to let them know that they’re supported through that as well, because that’s hard too.

So, most recently, an answer to your question is I usually get them when they’re close to death, and I, I’d really like to change. Yeah. 

Diane Hullet: Yeah. There’s so many gifts to be brought by coming into this education and emotional support process that you’ve both talked about sooner. Yeah. 

Claudia Penate: Yeah. I think it’s just knowing about a doula.

Whether it’s a birth or a death doula, a lot of people don’t know that there are death doulas. And unfortunately, when, when patients go into hospice, a lot of nurses don’t take the time to educate the families. That’s just the truth. Okay. Gabby and I have seen this. We know it is the truth. It is. You know, like, come on.

But unless you have a nurse that says, have you ever thought about a death doula? If not, let me put you in contact with. 

Diane Hullet: Yeah, I’ve been really struck because I’ve just completed some training with a local hospice here in Boulder and, and you know, my new job as a volunteer is going to be one hour a week.

So one hour a week with a person is not very much. And my job as a volunteer is not education and emotional support. You know, it’s really sort of companionship. Mm-hmm. And very simple companionship. So I was sort of struck. Wow, that’s pretty limited in terms of what someone might be needing. You know, you think, oh, I’m with hospice and now I’m getting good medical care and palliative care and some volunteer time.

Well, not a lot of volunteer time. And to that end, like how all consuming is your doula work? When you begin the process with someone, how much are you meeting with them or how much time do they, can they 

Gabby Jimenez: expect? I’ll answer this one. You know, it’s different for each person. I, I just had two. In fact, I was just with a husband and wife.

The husband was choosing to exercise his option to take the end of life medications and they signed up for hospice a day or two prior to taking the medication, so they didn’t have any support. I walk in the door and his wife was in tears, right? I’m walking in the door to be the person there for these medications, right?

And she looked at me and, and she’s just tearful. I just stopped. I put my stuff down and I just held her in the doorway. It’s like, I’ve got you. It’s okay. She, and she looked at me, she goes, I wish you were here earlier. And I thought, gosh, I hear that so often. I wish you were here earlier. I wish we had you sooner.

But they don’t know, you know, they don’t know what that, what that doula can do. And, and so, And then I also was referred to a woman and a hus. Her husband. The husband was the patient and he did not wanna go on hospice at all. He was completely against it. And so I’ve spent the last eight months with them helping them along this journey.

And some days I’d hear from her three times a day. Sometimes I’d wake up in the morning and there’d be a 3:00 AM text that she was up all night writing. And, and so really I was an active listen. She, she shared how she was going through this, how it affected her and what it was like for her. And I validated her words.

Mm-hmm. So sometimes I wouldn’t talk to her for a whole week, but we would communicate via email so that I could just say, oh yeah, thank you for sharing that. Right. And, and so to be able to offer that and to listen is really good. I spend a lot of time doing that kind of communi. This last person I was with as a doula, it took me a little while to encourage him to go on hospice.

So I was very involved and and spent a lot of time with them on the phone, over zoom, over text, and then again in person, and after he died. Now my role is to just check in to let her know she’s not alone, to extend a hand, hoping she’ll take it, but not forcing anything on her. But to take her on this journey too, is just another person she can count.

Diane Hullet: So really you’re saying it’s a range? Like it’s a range. Very much from a little tiny bit to a lot of so-called handholding through months, depending. 

Gabby Jimenez: Yeah. It could be hours, it could be days, it could be months. It’s very, and this is kind of on what Claudia said, it all depends on how familiar they are with what a doula does.

Yeah. Because if they’re familiar, they’re gonna want it sooner. 

Diane Hullet: Yeah. Yeah. Same in the birthing. 

Claudia Penate: Same to an extent. We do, well, I do visits, I do prenatal visits. So, and, and I typically start my prenatal visits in the third trimester. But if I sign a family early on, we do monthly check-ins. I send them supplemental information to.

Researching and getting prepped and, but in the third trimester, we’re in a lot of communication and when I sign families, I am on call from that moment, whatever week they are, and unlimited texts and email support because it’s true. There are some that might need a lot more support than others, but once it gets down close to the due date, I like to check in with my families at least once a week, once or twice a week.

And then, and then when labor begins in early labor, I do a lot of virtual phone and FaceTime support because early labor can be days as well. So there’s a lot of suggestions, reminders. You know, checking in. And then active labors when I really join them, are close to active labor. And that can be anywhere.

You know, I’ve done a 24 hour labor support. I’ve done a five hour labor support. You know, it just really depends. And then I stay after the baby’s born about two hours to help facilitate that golden hour. And, and then I do also a postpartum visit. And I call my postpartum visit a wellness check. I really wanna check on.

Emotionally how she’s doing. That’s my number one thing, baby. I know will be okay. It’s mom that we wanna check on. 

Diane Hullet: That’s so beautiful. I’m so struck by both of these are so individualized, you know, they’re just so individualized and every birth and every death has patterns to it. But they’re also just.

So personal and so can be so supported. And so I think both of you are really talking about how do we add community support to these really important transitions. We’ve, we’ve talked about this some, but obviously there’s similarities in these roles, and what are the differences that you 

Gabby Jimenez: see? Well, I think the difference is is Claudia brings them into the world and I gracefully ease them out.

I mean, really everything else is the same in, in our compassion and our support for both the person going through it and those who love them and how we can offer them the tools to go through it with a little less distress. 

Claudia Penate: That’s it. I, I agree and, and I say this because. I worked as a hospice nurse, so I do a lot of comparison.

I’ve spoken to a lot of providers as well, and I let them know I wasn’t hospice and birth and death is exactly the same, exactly the same. You have to give space, hold space, normalize it, and just let it unfold. We can stand by if necessary, if we need to introduce an intervention, but for the most part, like Gabby said, the body knows what to do.

We’ve been doing this since day one. It’s so similar, and honestly, the only difference is one is coming in and one is leaving. 

Diane Hullet: So beautiful. I just, I love that beautiful people like yourselves are holding space at both of those, those bookends of life that just feels so valuable to me. How, how do people find a doula?

You know, so someone hears this podcast and they go, okay, this sounds amazing. I’m, I’m heading into a birth, or I’m heading into a death. Obviously we’re talking here about slower death. A death where there’s time as opposed to a sudden death. How do they find someone? 

Gabby Jimenez: Well, I, I have no idea. I’m gonna, I’m gonna look very forward to hearing what Claudia says, but for me, it’s very much referral.

A almost every person that I have acted as their doula support has come from somebody who says, you should look up Gabby. But also I graduated from the Conscious Dying Institute, and they have a, well, you know, Diane, what is it? They have, they have a, like a directory of graduates. So if you’re looking for a doula in Chicago, you can go on here and you can find a doula in Chicago.

There’s also a group here locally, which is, I think it’s like the Bay Area doula. Where they can also help pair you with a doula, a death doula. So for me it’s mostly referral and I, I’m super thankful and grateful for that. But Claudia, I don’t, how do they find you? 

Claudia Penate: So when I finished my doula training, I did my doula training at Natural Resources, which is a, a nonprofit community organization.

Based in San Francisco and has been helping families for like over 30 years. So they also have like a network of doulas, right? And they have their leads. And then I partnered up with a lead generating company, golden Gate Doulas. They’re based in the Bay Area. And Jen Darwin, who’s the head, she’s the one who runs it.

She has incredible, like an incredible reputation. Providers. And so that company generates our leads so they can, you know, they can reach out to them. And then I have my website and I get a ton of leads there. And then just like Gabby, I get referrals from, from friends of sisters, you know, you name it. So I think it’s just about getting the word out.

You can have this support if a loved one is dying, or you can have this support if you’re pregnant and, and needing something, especially if you’re like a single mom by choice. I have a lot of single moms by choice or, you know, it, it’s just, it’s just about getting that out there. People need to know that there is this support.

Just like Gabby says, they’re the most life transforming, the most intimate moments of one’s lives. Bringing in a life or saying goodbye to a life that requires a lot of support for not just the person that’s, that’s happening to but everyone around. And it needs to be something that is part of our culture today.

Gabby Jimenez: I know that this, I’m not the question asker, but I have to ask this question to you, Claudia, because I, you know, I have witnessed a thousand last breaths. I mean, so many. I, I can’t even count anymore. But each one strikes me as miraculous. Yeah. Right. And I’m, I’m there and I’m, and now I’m gonna cry because I think, oh my gosh.

This life is. Yeah. Yeah. And it’s so powerful and I, I don’t ever lose that feeling from it. And I, I just sit there and I think, and as that last breath is taken, I think to myself, I’m present for the ending of this human being’s. So I, I have to assume that you must feel that every time you see a baby being born 

Claudia Penate: every time, every single time.

And we call it an oxytocin high. We call it an oxytocin high. And, and I feel like I’m gonna cry to, but I just, I’m so happy for the. Because I know I, I, you know, I have a history in working in reproductive health, so I have a lot of moms that have fought really hard to get to that point. So I look at them all the time and I’m like, you’re a mom.

You’re a mama now. You know, it’s, it’s, it’s such an amazing thing, and every baby born is, I feel truly honored to be part of that room to, to have been invited into that space over somebody’s mother or somebody’s sister. That says a lot to me, and I hold that very close to me, but every single experience is very personal and individual and, and very sacred.

And, and, and I’m telling you, I I, I literally leave that room in a high that you just, you just wanna relish in 

Diane Hullet: that. I love framing these both as miracles because I think in our modern world, there’s this kind of tendency to think of death as the failure and the like, the big problem and the thing. We don’t want that knocking at the door.

And what if there were this reframe and, and not to make it all like. You know, woo woo fakey positive, but like, no, genuinely, this is a miracle that we’re born into this world. We live these lives, and then we exit this world. And to have those two held in such a deep way just seems like a huge gift to me.

I love what you said, Claudia, that these, these these almost like deserve, they deserve the attention and the. Space of additional people who can help families do that because we, we just don’t know how to do it that well. And, you know, it’s not our fault. It just kind of, this is where history has brought us.

And yet there is this opportunity for, I think families to do it a little better, whether they do it on their own or ask somebody in, there’s education that can make it the miracle that it. Well, I just wanna thank you both so much and I want both of you to, to take a moment to say you know, your name and your website and how people can find you or follow you.

Gabby Jimenez: My name is Gabby Gabby Jimenez, and you can find everything that I have on www the hospice heart.net. And that’s will guide you to classes and podcast interviews and blogs. And, and I also have a Facebook page, the Hospice Heart, which is just going crazy right now with the, the compassionate community that it has become.

And you can actually find that link on my website as well. Awesome. Thank. And 

Claudia Penate: mine is my website is just my name. It’s www.claudiapinata.com, and it’s P E N A T e. And you know everything is on there too. You can reach out, connect with me. My Instagram is there. SF doula underscore Claudia. But yeah, I don’t have a blog yet.

I’m working on that. 

Diane Hullet: It’s coming. It’s coming. The babies are keeping me busy. The 

Claudia Penate: babies are keeping me busy. 

Diane Hullet: Babies are getting in the way of the social media. What else is Neil? Well, thank you both so much again. You’ve been listening to the Best Life Best Death podcast, and I’m your host, Diane Hullett.

And you can find out more about the work I do at Best Life. Best death.com. Thanks so much for listening to this episode with these two marvelous women. 

Picture of Diane Hullet

Diane Hullet

End of Life Doula, Podcaster, and founder of Best Life Best Death.

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