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Women Take the Lead in “Death Positive” Movement

Mortician and author Caitlyn Doughty is at the forefront of a movement to disrupt the modern death paradigm. (Ryan Orange)
Mortician and author Caitlyn Doughty is at the forefront of a movement to disrupt the modern death paradigm. (Ryan Orange)
September 3, 2019

By Sarah Chavez
Broadcast Version by Suzanne Potter
Reporting for Yes! Magazine-California News Service


On a summer day in 2014, guests arrived at Mitch Metzner and Gabriel Gelbart’s home surrounded by the natural beauty of Topanga, an area nestled in the Santa Monica Mountains that has a reputation as a bohemian haven for Los Angeles artists. The couple had purchased the property with the intention of turning it into a residential hospice where people could spend their final days in a peaceful and supportive environment. A few weeks before, guests had come to celebrate the pair’s marriage, but today they came to attend Gelbart’s funeral.

Gelbart died suddenly of a heart attack, leaving a community of family and friends shocked and reeling with grief. Now they had come together to say goodbye. “It was stunningly beautiful and agonizingly sad,” says Olivia Bareham, a former geriatric nursing and hospice assistant who organized the funeral. “A collision of heaven and Earth.”

Gelbart’s body was brought home, to be washed and wrapped in a golden shroud by Bareham and Metzner. For Metzner, caring for his husband’s body was a natural continuation of the love and care Metzner provided him in life, allowing for a “healing journey through grief that the funeral industry wants to deny us,” he explained. For the next three days, mourners could spend time with Gelbart at the couple’s home.

Bareham has long sought to ease some of the fear and suffering surrounding death and dying that she observed among her patients and their families. In 2005, she founded Los Angeles-based The Sacred Crossings Institute for Conscious Dying, where she educates and empowers families to care for their deceased loved ones and create home funerals like the one she created for Gelbart.

Throughout the couple’s house, Bareham and friends provided a variety of activities for mourners, including the opportunity to decorate the casket with art supplies, or inscribe river rocks that would be used to build a memorial wall on the property. With this funeral, Bareham created a way for people to be truly present, bearing witness to the end of a life, and a space to process the enormity of their thoughts and emotions. Friends played music; dogs wandered among the bereaved, offering comfort. Food, drink, and collective pain were shared among all. For Metzner, it was “one of the most profound and beautiful experiences of my life.”

This is not your typical American funeral, though.

Bareham is just one of many women who are disrupting the death paradigm by challenging our traditional funerary practices and advocating for transparency, eco-friendly options, and family involvement. While White patriarchy has spent the past hundred years shutting the doors and pulling the curtain—obfuscating and profiting from one of life’s most significant milestones—modern women are questioning whom our current system is serving and telling the funeral industry that its time is up.

Make no mistake, the future of death is a feminist one.

Feminist death advocates argue that the $20 billion funeral industry thrives on our society’s reluctance to face, or even think about, death. Although our fear of death is nothing new, our modern denial of death is.

Our current unfamiliarity with natural death has become more informed by horror tropes—including the dead returning to haunt us, or corpses suddenly reanimating to grasp at the living—than by facts. According to Ernest Becker, author of the Pulitzer Prize-winning book The Denial of Death, awareness of our mortality haunts us and motivates us. Becker argues that our actions are motivated by this fear, and in a desperate effort to mitigate our existential terror of ceasing to exist, we seek out distractions. We engage in what he calls “immortality projects” that help us establish legacies that will live on after we are dead, often through our work or by having children.

Because of this fear, and the established systems that shield us from healthy engagement with death, we’ve become death- and grief-illiterate. As a result, we have industry-led funerals that leave little room for meaningful family involvement and require costly products and services that are often unnecessary and can harm the environment.

The median cost of a funeral today is $8,500. The Consumer Price Index for All Urban Consumers recorded a 227.1% increase from 1986 to 2017—almost double the price increase for all other consumer items. As a result, funerals have become a luxury that many families struggle to afford, leaving some in “funeral poverty” to pay for them. Some states offer assistance, such as Michigan’s Burial Services program, which offers up to $455 for a memorial service and cremation payable directly to a funeral director. Such social assistance programs to help with funeral costs vary widely from state to state, but generally cover only a portion of fees. For those without the financial means to pay, responsibility falls to the state, which typically cremates remains or donates the bodies to medical schools.

In contrast, according to the National Home Funeral Alliance, people can expect to pay about $200 for a home funeral, saving thousands of dollars. This amount usually includes dry ice to keep the body cold, gas and permit fees, and a container for the body—such as a simple pine or cardboard coffin—as well as a permit fee for transportation and copies of the death certificate. Costs for final disposition are extra: Direct cremation rings in at $600 to $1,100, and burial varies greatly depending on personal preference.

It isn’t just the industry’s financial costs that are staggering; it’s the environmental ones, too.

Most modern funerals begin with embalming—the practice of injecting toxic chemicals into the body to delay the decomposition process. Embalming is not required by law, yet we place embalming fluid containing more than 827,000 gallons of toxic chemicals into the earth annually.

In cemeteries, embalmed bodies are placed in caskets, which use up to 20 million board feet of hardwood and 64,500 tons of steel each year to produce. All of this material is then placed inside concrete vaults to make it easier to maintain cemetery landscaping. And while cremation is more economical, a single cremation consumes as much energy as a 500-mile car journey and emits pollutants such as mercury, carbon monoxide, and sulfur dioxide into the air.

Life might end with death, but the drain on resources doesn’t. Opting for standard burial means you are also expecting to be provided with “perpetual care”—an industry term to denote the expectation that your grave will be tended to, well, forever. This means lifetimes of land and water use, pesticides, and labor to keep the surrounding landscape manicured and attractive.

In other words: We’ve been taking a natural process that unites all living things and making it altogether unnatural.

The corpse has become a vessel for our death anxieties, a stark reminder of our inevitable future. We spend billions of dollars on antiaging products because aging reminds us of our own mortality. Even in death, our denial continues as we opt to appear “lifelike” and seal bodies away in caskets that promise to “protect” us from decomposition.

Is it any wonder many of us are somewhat relieved that the funeral industry is there to help us deny death just a little bit longer?

Today, most of us die in busy hospitals or nursing homes, often in the company of strangers. Funeral homes quickly remove our dead and perform those final physical acts of care in preparing the body. We then go through the motions of performing sterile rituals—devoid of meaning—forced to sum up the significance of a human life during the brief couple of hours the funeral home or church has been rented to us. And in people’s final moments, they are again abandoned to strangers, who will either bury them deep in the earth or, like the mythic Charon, ferry them into the flames.

We can do better for our loved ones. In fact, we have done better.

A little more than a century ago, we died at home. Our bodies were lovingly washed and dressed for burial by our kin. Funerals were individual- and community-centered—and women were typically at the helm of the process.

Before the Civil War, “The Good Death” was an extension of ars moriendi, “The Art of Dying,” a Christian concept dating back to the 15th century. Dying a good death was a universally shared concept that was integral to life, which played out at home, where the dying individual was supported through this important passage by family and friends. It was believed that a dying person, poised on the threshold of heaven, could impart divine wisdom and provide reassurance that in the afterlife all would be reunited in a place free from the pains and sorrows of earthly life.

Then the war came.

Americans greatly underestimated the scale and duration of the Civil War, initially believing it would resolve quickly and with little bloodshed. Instead, according to historian David Blight, it left a culture of death and mourning beyond imagination. Families were forced to contend with the fact that their loved ones were dying far from home, alone on battlefields without the comforts provided by The Good Death.

For those who could afford it, modern embalming was introduced as a solution to temporarily preserve soldiers’ bodies for the long journey home. Embalmers would chase after battles, setting up camp and often propping up real embalmed bodies outside their tents, like storefront mannequins, to advertise their services. A demand for costly cast-iron caskets to transport bodies gave rise to another new venture.

The transition of embalming from wartime necessity to mainstream practice can be traced back to President Abraham Lincoln, whose body was embalmed and placed on a funeral train that toured 180 cities. The tour was a phenomenon, with mourners lining up for hours to catch a glimpse of the body. Lincoln’s embrace of embalming secured its place in American culture.

Now that industrious men had found a way to make death profitable, they did so with zeal and ushered in the modern funeral industry. New enterprises to fashionably accessorize death with elaborate caskets, hearses, and mourning clothing emerged, followed by the relatively new roles of funeral director and embalmer.

The funeral and medical industry paralleled each other in numerous ways by “professionalizing” themselves. They opened schools, embraced new technology, and took advantage of false narratives to position themselves as guardians of public health and safety that alone would restore dignity to the processes of birth and death.

While the funeral industry pushed the myth that a corpse was dangerous and needed to be sanitized through embalming, physicians targeted midwives, whom they labeled “barbaric.” In 1911, one obstetrics professor went so far as to describe midwives as “dirty, ignorant, untrained” and an evil that must be controlled.

Death became a specialized profession solely for men—one that employed the “science” of embalming, a service that separated them from the duties that had previously fallen to women, who were removed from the process.

The next big shift in our modern deathways occurred in 1912, when door-to-door salesman Hubert Eaton arrived in Los Angeles with the goal of creating a cemetery and mortuary completely devoid of “signs of earthly death.” That’s right: a cemetery and funeral home without death. Eaton was a devout Christian who believed cemeteries should reinforce the idea of eternal life.

Eaton essentially rebranded death by using language and aesthetics that were comforting and even glamorous. The cemetery was now designated a “park.” Mortuary “slumber rooms” were decorated to evoke the feel of a Hollywood starlet’s boudoir, draped with pink satin and lush velvet. Speakers piped in the merry sounds of birdsong and species of trees that lost their leaves were banned as symbolic reminders of death. Traditional headstones were replaced with flat markers, set low in the sod so views of the lush lawns would not be inconvenienced by reminders that corpses lay in repose 6 feet under.

Forest Lawn in Los Angeles was the first to combine a cemetery, mortuary, chapels, and florist under one roof. Convenience, the powerful appeal of being the premier choice for celebrity weddings and funerals, and clever marketing that sold consumers an idyllic Hollywood ending became the industry standard—but death and life are far more complicated.

This commodification of death has resulted in one of the most profound and transformational events of our lives being mediated and staged through two industries—medical and funeral—that were initially created to financially and socially benefit men.

Women have fought for control over their bodies for centuries, in life and now in death, as modern women work to subvert patriarchal systems and once again take up the mantle of The Good Death. While the media’s ubiquitous “wellness” trends and discussions of living healthier lifestyles rarely mention death, the women whose stories follow are a small example of a growing movement to help Americans die well.

Death Cafes

Death cafes are informal, public gatherings for people to discuss all things death, with the hope that those discussions will help them to live better lives. According to the Death Cafe website, 8,848 cafes have been hosted since 2011. The cafes are overwhelmingly hosted by women, including Milwaukee resident Shantell Riley, whose son died from gun violence. After observing a lack of support and communication surrounding loss, she was compelled to become a host. Conversations are guided by the attendees themselves. “We laugh, we cry, but, most importantly, we talk,” Riley says. “It is exciting when you hear about how these conversations influence them and the impact it has on living their lives.”
Caregivers

Most of the 40 million people in the U.S. acting as caregivers for aging family members identify as women. “The U.S. health care system can be incredibly difficult to navigate,” says Aisha Adkins, who in 2017 founded Atlanta-based organization Our Turn 2 Care to fill the gaps. The organization provides information and resources and helps connect marginalized millennial caregivers to each other. “Initially, Our Turn 2 Care was a response to the fear and isolation I felt as a young Black woman,” Adkins says. “Not only was I unprepared to provide the unique medical support my family now needed, I was also unable to plan for my own future.”

Dying Well

In a profession that often views death as a failure—that which is to be avoided—doctors have reported that talking about dying, both with patients and among colleagues, is challenging. Too often the focus is on sustaining life, which frequently comes at great physical, emotional, and financial costs. A palliative care specialist, Dr. Sunita Puri wrote That Good Night: Life and Medicine in the Eleventh Hour, a book to help doctors and patients focus on quality of life in lieu of employing extraordinary measures that only prolong suffering for both the individual and their loved ones.

Puri encourages people not to shy away from talking about death, because it will help to clarify a plan that will augment happiness, comfort, and the things that are most meaningful to a patient in their final days.

Death Doulas

The largest sector of the female-led death revolution is death doulas, women who are reclaiming their role at the deathbed. The International End of Life Doula Association offers training programs that regularly sell out and have trained more than 2,000 people in just under three years. Death doulas are “trained professionals with expertise and skills in supporting the dying person and the network of family, loved ones, and friends, to maintain the desired quality of life during the active dying process,” Seattle-based death doula Lashanna Williams says.

Rest in Peace

Eco-friendly options are gaining ground, including green burial and aquamation. The latter “uses gentle water flow, temperature, and alkalinity to accelerate our ecosystem’s natural method of decomposing organic matter,” providing the same result as flame cremation, says Darci Bernard, co-owner of an aquamation facility for pets in Seattle.

The biggest opponents of aquamation have been men, including casket-makers, conservative politicians, and religious figures.

Another option making headlines after becoming legalized in Washington state is recomposition. Katrina Spade is the founder of Recompose, a public-benefit corporation developing a natural alternative to conventional cremation and burial. Similar to composting, recomposition gently transforms bodies into soil, which is then returned to families who can use it to grow trees or nourish gardens, creating new life through death.

Rethinking the Funeral Home

Bestselling author Caitlin Doughty has been revealing what goes on behind closed doors at funeral homes in her popular YouTube series, “Ask a Mortician” and a podcast, which she co-hosts with me. She approaches death with both humor and sensitivity, making the taboo topic accessible to many.

The heart of Doughty’s advocacy centers on the corpse, which has “served as a vessel for feeling, ritual, and grief, for thousands of years of human history,” she says. “Our recent cultural shift to ignoring or immediately disposing of our dead takes us further away from the reality of death and dying and prevents us from forming a healthy relationship with our own mortality.”

As both Doughty and photographer Paul Koudounaris have observed during their travels to document death practices around the world, the aversion Americans have toward death and corpses is not common elsewhere. Where we’ve created a hard boundary between ourselves and death, for most of the world a softer line exists, creating space for the living to work through their grief, begin to comprehend death, and come to terms with the fact that the bonds we’ve established with others do not dissipate at the moment of death.

In the U.S., we’ve handed over this sacred space surrounding the corpse to the funeral industry. The women reclaiming this space are acting in resistance.

It is clear that our society’s current denial of death is not working. What would our culture look like if we instead met the most mysterious, painful, and transformational aspect of our lives with compassion and clarity?

With women leading the way, we can create a future of death care that will improve not only how future generations die, but how they live. This is a legacy, and a feminist one at that, for which we can all be proud.

Sarah Chavez wrote this article for YES! Media. Follow her on Twitter @sarah_calavera.

Suzanne Potter, Public News Service - CA