By Barbara Karnes, RN

I was talking with someone yesterday about labor. It takes labor to get into this world and labor to leave it. The similarities and the differences when we leave “home” and when we go “home”—-all labor, all hard work. 

Labor to enter the world

I was a nurse’s aide in the ’50s on the labor and delivery floor of a small hospital. They wheeled a moaning, crying, sometimes screaming woman into the labor room. Although they didn’t let me in the room, I could hear the sounds, then the silence, then a baby crying. Later, the new mother woke up, remembered nothing, and enjoyed her baby.

I had my own children in the ’60s. With the first two, I was uncomfortable. Then I was put to “sleep,” woke up with a new baby and remembered nothing. With my last child, I experienced “natural” childbirth. It hurt, it hurt a lot. It was hard work…my belly’s going to explode if I don’t get this kid out, NOW, kind of work.

Labor to leave this world

That is the labor to get into this world. The labor to leave it is similar. There is discomfort as the body shuts down before that final “push.” There is a process.

Labor actually starts weeks before we are “birthed” into another world. Instead of hours of labor to get into this world, it is often weeks of labor to leave it.  When a woman “pushes” to deliver us into this world it often takes minutes. To leave this world the final “push” can take hours.

What about pain?

What about pain?  It looks painful because it is hard work to disconnect, to “push” free of this vehicle. And just like getting into the world some of us arrive more gently than others. Like doctors giving a woman in the ’50s and ’60s “twilight sleep” (which allows them to not remember what happened, to not remember the pain, the struggle) nature gives us a natural “twilight sleep” to leave this world.

Naturally, as we withdraw over the days to hours before death, we begin distancing ourselves. We begin going inward, into a space where there is only room for one. From this inner space, we hear what is occurring around us as if from afar, from a distance. As the veil between the worlds thins, this physical world with its sensations and sounds recedes. The other world becomes brighter and more welcoming.

For more from Barbara Karnes, visit her blog Something to Think About: a blog on end of life – BK Books