Space and spaces
Labour & end of life
Space: /speɪs/
The dimensions of height, depth, and width within which all things exist and move.
An interval of time (often used to suggest that the time is short considering what has happened or been achieved in it).
The freedom to live, think, and develop in a way that suits one.
I am drawn towards the concept of space, towards an abstract sense of freedom, towards peace and solitude. A visceral pull, a yearning for the comfort and containment of space and spaces that hold. It is only now that I comprehend the duality of space, the openness and freedom with the containment and boundaries. Sometimes space feels like solitude, other times like a community. Both are indispensable. Perhaps it is not surprising that space feels integral to both birthing and dying. Today, I am contemplating space in the context of labour and of active dying, of end of life.
When I say labour, I mean the time when a pregnancy draws to a close, when the body begins the process of giving birth. Birth is imminent but for now, the focus is on labour. By active dying, I am drawing the focus to the time very near the end of a life, the end of a period of illness. Death is imminent and there are often clear signs of this. However, just like labour is the time, the space between pregnancy and birth, active dying is the time, the space between serious illness and death. The body is shutting down, closing up, surrendering. Like labour, this is a physiological process. These processes are not always linear but there is a trend, a direction of travel, towards birth and towards death. Both processes occupy a space in time, a temporal space.
It is physical space that comes subsequently, after temporal space. Rooms, corners, beds, floors, locations, homes, hospitals, side rooms, intensive cares, delivery suites, hospices, birth centres, the list could go on.
I remember clearly when I first recognised that the physical spaces of birthing and dying can be mirror images of each other. Before me was a darkened room, adorned with fairy lights. It was calm and soothing. Care and attention, warmth, people. A birthing space, surely? After all, up until that point, I had only intimately known birthing spaces. I had given birth in hospital rooms, in bedrooms, in lounges and living rooms and in pools. All different birthing spaces yet all with some similarities.
But no, I was in a children’s hospice and there were no babies on their way into this world, at least not here. Instead, it was a room awaiting a child. She was on her way from Intensive Care, on her way to the hospice, to spend her final hours. This room was not for my child. My child was over there, in another room, disabled and unwell, slowly dying but also giving the doctor a hard time about something. I could also hear her ordering her lunch from the nurses. Chips, she wants chips, no she doesn’t care that you have mooted the idea of soft food, she wants crunchy chips.
I was merely an observer at this point, on the outside, a brief glance into a possible future reality for myself and my child. A peek through a portal, to a time when a birth room is not actually a birthing room but is instead a room in which my child will die. Does that make it a dying room?
If birth and death are ends of a string, a circular string, perhaps it makes sense that as death completes the circle begun by birth, they will both occur in similar spaces.
Whilst I stayed out of the way to give the family the space and the privacy that they needed, I felt strangely reassured. I questioned this feeling of comfort, of security. How can one glimpse her own future, the pain of the heartbroken mother, the sorrow of a family, the imminent death of a child, how can one see that and feel reassured?
The reassurance came from the clarity, the understanding of reality, the images, the preparation. If we ended up bringing Neve to the hospice to die, I now knew what her room might look like. I don’t think it was something I had ever consciously wondered about but even so, it was filling in a gap. I had an answer to a question that I didn’t know I was asking.
The answer wasn’t scary. It was a comforting space, a calm room, designed to hold love and beauty and sadness and pain. A birth room, which holds love and joy, pain and uncertainty, repurposed for dying.
And so, my preparations, my knowledge, my filling in the gaps around labour and active dying, these brought me comfort. I could see so many similarities between the physiological processes, the bodies that know what to do, that birth and that die.
But space is more than a physical room. When I gave that family space, I was ensuring that I was not physically in their way. But it was more than that. This was a family who needed emotional space, privacy, to allow them to be held and contained by those who could do this. They needed the right people, the wisdom and compassion that skilled palliative care workers can provide. Death might happen even without this but oh how emotional space now could help hold them up, in the weeks and months and years to come, after their child has died.
I am reminded of Neve’s birth, as I ponder space. My beloved sister and brother-in-law were visiting, helping to care for us all. Yet as the days passed and my due date came and went, I began to recognise that I needed space. I needed emotional space. My BIL, ever sensitive and kind, suggested that he go away for a few days. A relief. It's not a surprise that so many second and subsequent children are born at night, with labour ramping up once the other child(ren) are in bed. Somehow, it seems that bodies have a need for emotional space, before they can surrender to the imminent transition. It was then, late at night, as the rest of the house slept, that my body had the space to tiptoe into labour. As the sun rose on a frosty morning in November, Neve was born. The physical space and the emotional space provided the boundaries and containment and the quiet and privacy, to usher this child into the room and into our family.
Just like birth often needs an emotional space, death too may be waiting for a similar emotional space. Neve’s body was actively dying, on and off, for months and months. Yet in the end, on the day that she died, it all changed rapidly. I will always wonder what role space played in this. I left her room, minutes before she died, with no expectation at all that this might be the end. Over the past six months, since her death, I have wondered, again and again, how and why I could have done this. In hindsight, there were signs that the end might be close. Yet I also ask myself whether this was what Neve needed. Was her death a combination of deterioration and illness, awaiting a space?
In all my learning and preparation for her death, I had come across many stories of people whose loved ones had died when the family and friends were not there. Sometimes they had merely popped out of the room for a minute. Like I had done. Of course, knowing this does not take away from the complex mix of emotions that I hold, knowing that Neve was dying without me by her side. I have to reassure myself that Neve was safe in that space, the physical space of her room, with compassionate nurses and the emotional space that she might have needed. She was growing up, maybe this was her need for freedom, to live and to die in the way that suited her. As parents, do we all have to accept that our children grow and that we won’t always be their space, physically or emotionally?
I lie awake at night, thinking about what a privilege it is to know spaces such as these, dedicated spaces, spaces that hold people as they transition in and transition out of life. Birth and death can and do happen without these spaces, this is true. But what a profound underpinning these spaces can provide, when we can feel them and be held by them. I wish for all to know such spaces, to be held through these momentous transitions.
