As a family doctor, I’ve spent a lifetime at both bookends of life — welcoming new arrivals and accompanying people at the end of their journeys. Over time, I’ve come to see how closely these moments mirror one another. The same emotional currents that Elisabeth Kübler-Ross described in dying — denial, anger, bargaining, depression, and acceptance — also flow through birth and the making of a family. As with the stages of dying, these emotions can appear at any time and in any order.
Denial can appear early in pregnancy—not disbelief exactly, but a protective numbness. “This can’t really be happening.” The enormity of becoming a parent or of adding another child to the family can be too large to hold all at once. The familiar life still feels intact, though it’s already shifting underfoot.
Anger may surface in the discomfort of bodily change, loss of a svelte figure, lost sleep, the vulnerability of dependence. A partner may feel displaced, a sibling worried that this baby will dethrone them as the centre of their universe. For some, anger at the failure of birth control may be something to contend with. Even as joy stirs, there’s irritation at the loss of control — at how life’s script is rewritten without consent.
Bargaining often takes the form of plans and rituals, birth plans or resolutions to be a “better” parent. These are offerings to fate — a way to feel some mastery over the unknowable.
Depression may arrive quietly, sometimes unspoken. The grieving of one’s former self or life as a childless couple is common and understandable. There’s a mourning for the identity left behind, even as love for the unborn grows. And post-partum depression, ranging from mild “blues” to a severe and dangerous mental illness is a very real phenomenon.
And then, acceptance — not a single serene moment, but a gradual widening of the heart. The new family begins to imagine itself as a different organism. There comes a calm curiosity, even reverence, for what’s to come — and for what must be surrendered to make space for it.
In this way, birth and death are mirrors. Each calls for a letting go, a reshaping of self. In tokothanatology, we learn that every arrival is also a departure, and that every goodbye opens room for a new beginning.