Death Doulas: Centering the Sacred in Death and Dying

Mangda had never felt more alone.

She sat by the bedside, watching as her mother’s body slowly shut down. It was 2018, and her mother’s cancer had progressed rapidly. Even though she was now in hospice, Mangda wasn’t ready to be her only support through the process of dying.

That evening, Mangda called the on-call hospice nurses to join her for her mother’s passing. She was in a small town with limited resources, and she was shocked to learn the hospice nurses who knew her mother wouldn’t be available. She would be the one responsible for shepherding her mother through death.

She reflected, “I felt so much confusion, stress, and uncertainty as I’m watching my mother’s body begin to shut down…[it was] jarring and challenging navigating this and not having the proper support at that time.”

Even though she wasn’t sure what to do, she did her best to be present in those last moments, washing her mother’s body and capturing her last breaths with her film camera before she was taken to the funeral home.

An avid artist and a Buddhist by practice, Mangda grew up having open conversations with her Laotian father about impermanence and cycles of rebirth. During her mother’s time in hospice, she tried to draw inspiration and strength from her father’s approach to death and dying. Nonetheless, she was taken aback by the minimal spiritual and emotional support offered for end-of-life care in the small town where her mother was living. The lack of spirituality and embodied community in the healthcare system — and the lack of community in her mother’s final moments — took months to grieve and process.

She shared, “I was in pure shock for some time, and deep, deep grief. And there’s that additional layer of when you’re in a society that doesn’t talk about [death], there isn’t supportive care, which forms another layer of grief and isolation. I felt like I was navigating a lot of this alone because I tried to be part of grief groups, but they were not diverse and didn’t have the spiritual elements I really needed.”

Mangda’s experience is not unusual. Access to hospice care and quality end-of-life support is often severely limited, especially in rural communities. Even though religious and spiritual care is shown to be a critical aspect of ensuring meaningful end-of-life care, structural limitations such as adequate staffing and insurance reimbursement can frequently compound these challenges. Even when services exist, they often fail to address the full emotional, spiritual, and relational needs of the dying and their loved ones, especially for religious and cultural minorities.

While death seems innately intimate, dying is one of two sacred experiences written into every human’s story. We are born, and we die. These are uniquely experienced, yet universally shared. Still, many societal customs treat exploring and discussing death as taboo, and the necessary support systems are often aloof, impersonal, and lacking in spiritual dimensionality. This strips death of its holiness and complexity, rather than embracing the act of dying as a sacred passage; an unwinding of the soul back to the great mystery from which it came.

In the years following her mother’s death, Mangda leaned into creative expressions — art, writing, and her Buddhist spiritual practices — to navigate her grief. Moved by how she transformed sorrow into something meaningful, a close friend encouraged her to explore death doula training.

Mangda laughs when she reflects on this moment, saying, “I always make this joke that I was very resistant [to death doula training] because I don’t really know what this means. Is this going to be like the next yoga teacher? But I found a program that felt relatable to me…I’m so grateful I did that because I was able to understand the actual arc of end-of-life systems and how they all work together.”

Blessings in the End-of-Life Process

A death doula is a non-medical professional trained to support individuals and families through the dying process. This work includes anything from spiritual support to logistics planning and presence in the final hours of life.

In recent years, the death doula movement has grown in response to the overly clinical, often isolating experience of dying in modern healthcare systems. Since April 2024, there are now over 1,500 death doulas across the United States and neighboring countries.

After completing her training, Mangda founded BACII in 2020, just before the pandemic reached New York City. The organization’s name is derived from the Laotian word meaning “blessing” and is inspired by the baci ceremony — a traditional Lao ritual where people wish blessings onto others in an act of true compassion, unity, and sacred connection.

Through Bacii, Mangda offers educational and supportive services, gatherings, and products that guide clients through these inevitable end-of-life experiences, while also helping renew their engagement with life. Weaving together her own lived experience, arts background, and Eastern spirituality practice, her offerings range from one-on-one doula support, to individuals and their families going through the end-of-life process, to communal experiences. One example is her Yu:Exist program, a four-week virtual program centered around exploring death and rebirth. 

One of the people most inspired by Mangda’s work is Yisa, an artistic director and dancer in New York City. Yisa worked with Mangda during her grandmother’s passing and credits Bacii for offering support, community, and presence during a painful time in her family’s life. Yisa’s grandmother was a second mother to her, and her death was the first intimate loss she had experienced.

“My grandmother had endometrial cancer and was given nine months to live,” Yisa reflects.  “That woman never ran late, so she was punctual even with her own death. Knowing that we had just nine months, it felt like it would be simultaneously way too soon and way too fast, almost like a crash course in grieving.”

Even though it’s been years since her grandmother’s death, Yisa still recognizes the long-term impact of working with Mangda, not just for her own grief but for that of her family and for their relationships with each other. During those critical months, she was grateful for both the deeply communal aspects of Bacii’s Death & Rebirth series as well as the individual support, reflective space, and meditations Mangda offered, all of which helped her feel more present with her grandmother in her final days.

“Mangda helped my family and me during an extraordinarily painful time in our lives,” Yisa adds. “She felt heaven-sent. She equipped us with the practical knowledge, recommendations, virtual guidance, and emotional support needed to walk through my grandmother’s transition with a bit more ease.”

Redefining Social Norms and Returning the Sacredness of Dying

Mangda’s work with Bacii expands beyond the individuals she supports as a death doula. She is committed to changing social comfort with the topics surrounding impermanence, death, and dying. 

In collaboration with Erica Hill, founder of Sparrow Contemporary Funeral home, she co-hosted a dinner event called “Dress For Your Funeral.” Dressed in the outfit they would pick for their funeral, attendees attended a dinner party unlike any they had experienced. Entering the space, attendees sat around a bamboo casket set with flowers, and enjoyed a custom menu that embodied the playful spirit of the event, including edible “dirt” complete with mini shovels. 

“Everyone who came was super curious,” Erica shared. “It was people from the neighborhood who weren’t necessarily involved in end-of-life care in any way. It was amazing to have a group that was so diverse and new to the space and new to thinking and talking about these topics. There was one woman who chose to celebrate her birthday at the dinner.”

She hopes dinners like this can be part of a broader societal trend to talk about our mortality with our loved ones before the end of life. If death is the ultimate portal to Spirit and Sacred Mystery, then the work to prepare for the journey may also feel inherently spiritual. Why, then, would we not treat the experience of dying with utmost spiritual care, sacred dignity and reverence for all those involved?

Nearly five years after she started Bacii, Mangda remains grateful for the work she does and the people she has met along the way. She believes that learning to talk more openly about death and dying can transform not just individual experiences, but our broader communities as well.

“Societally, my wish is for us to find our own relationships or understanding of our mortality and the end of life so we can better show up for ourselves and each other,” said Mangda. “The more we are in touch with our impermanence, the more we’re likely to want to give back to others, to support others, and want to contribute to the world. What if that could really create a more loving and more compassionate world?”

Although the pain of her mother’s death remains, Mangda now sees that experience as one of her life’s greatest teachers.

“My mother’s death was not peaceful. It was really challenging,” Mangda said. “But what I realized in that moment was that I felt unconditional love. It is through loss, I am genuinely in touch, the closest I’ve ever been, to such deep unconditional love. That was the greatest gift throughout that entire experience for me.”

Death Doulas address the profound spiritual disconnect in modern society around death, offering a compassionate presence in a time often sterilized by fear, the unknown, and avoidance. Much as birth doulas improve birth outcomes, death doulas empower more positive, supportive end-of-life experiences. 

At its core, death work reconnects us to the mystery and sanctity of dying, countering a culture that hides death with one that honors it as a sacred rite. While the actual circumstances of death may not always be dignified, the act of dying undeniably is. Through death, we witness the uniquely human longing for meaning, intimacy, and belonging in life’s most liminal moments — a spiritual balm for a society that has forgotten how to witness, grieve and release. 

By Anu Gorukanti