Doulas for the Beginning and End of Life

Doulas can support employees through some of life’s most pivotal moments: birth and death.

By now, many employers are familiar with birth doulas – non-medical professionals who assist families during pregnancy, labor and delivery, as well as the postpartum period. Birth doulas have caught the attention of benefits and well-being leaders because of evidence demonstrating that their support improves labor and delivery outcomes, which is particularly important at a time when maternal mortality rates in the U.S. have reached historic highs, with stark racial and ethnic disparities.

Due to  the positive impact of birth doulas, 12% of employers offered  their services to expectant parents in 2022, with an additional 5% adding them as a benefit in 2023 and 27% considering doing so for 2024/2025, according to the Business Group’s 2023 Large Employers’ Health Care Strategy and Plan Design Survey. Walmart is one of the organizations leading the way, providing employees in several states with reimbursement for doula services, as described on the Business Group on Health podcast.

But birth doulas aren’t the only type of doulas on employers’ radar.  Death doulas, also known as end-of-life doulas, are now a covered benefit at Salesforce, which is striving to meet the needs of employees at all stages of life and create awareness of a topic that’s rarely discussed -- but needs to be.

Like birth doulas, death doulas give non-medical support to clients and their loved ones, providing help at the end of life rather than at the beginning. And this support extends beyond the dying process. According to Alua Arthur, death doula, founder of Going with Grace and Business Group on Health podcast guest, “[Death doulas] can be instrumental at any stage in life, really. When people are healthy, we can help them complete comprehensive end-of-life plans. When somebody knows what it is that they're going to be dying of, we can support them in creating the most ideal death for themselves under the circumstances. After a death, we can help family members wrap up affairs of their loved one's life.”

U.S. Salesforce employees and their family members, including close friends and family-like relationships, have access to up to $2,000 per end-of-life circumstance to help pay for eligible end-of-life doula expenses. This is on par with Salesforce’s birth doula benefit, which is also offered to U.S. employees. Salesforce’s caregiving vendor provides guidance to employees about the process of selecting and working with a certified end-of-life doula; the vendor also handles employee requests for reimbursement when end-of-life doulas services are used.

While the end of life can feel like a taboo topic, especially in the workplace, broaching the subject and providing a benefit for this stage of life can be meaningful. As Alua Arthur put it, “I think it's important that we have people there [who] can walk along with family members as they're walking through this really sometimes harrowing experience, which can be made that much more tender by having somebody who's there honoring, validating, acknowledging -- and can just do some practical things too.”

Employee feedback about Salesforce’s end-of-life doula benefit has been positive. In fact, employees outside the U.S. are asking about extending the benefit globally. Saleforce’s hope is that this benefit will continue to reduce stigma and normalize conversations and support about the end of life.

To learn about how doulas can support employees through some of life’s most pivotal moments, listen to The Crucial Role of Doulas for Black Birthing Parents and Transforming the End-of-Life Experience with Death Doulas.