It is the most profound turning point in a person’s life, yet most of the change is below the surface. Mysterious and unknown.

Spiritual, to some.

But if you’re paying close attention, you’ll notice a subtle change spread across the person’s face.

When a new mother holds her baby for the first time, Teresa Robertson sees an unmistakable “mom face;” the woman will never be the same. You can feel an indefinable “miracle energy” fill the room as the new life takes new residence, Robertson says.

And when Robertson sits in the room with someone who is dying, she senses that same energy, albeit a softer and quieter strain. As the dying body melts toward the other end of transition, Robertson says, his or her face changes, too. It’s hard to pinpoint exactly how. But something is different. And just as in childbirth, things will never be the same.

Death and birth: They seem like opposites.

Yet Robertson, of Nederland, says it was seamless to leave her lifelong career as a midwife to become a hospice nurse.

In fact, a growing list of local faces involved with end-of-life care started out working in childbirth and labor, or visa versa. Nurse.com, a national nursing magazine, recently explored the topic, calling it “nursing’s yin and yang.”

Many consider themselves bridges between life and death, whichever way you are walking across the bridge. Because when it comes down to it, as they explain, the transitions of birth and death bring up the same concerns and needs: education, misconceptions, fears, changes in family dynamics, uncertainties, hope, faith, planning, rituals and the loss of control.

And while the popularity of home births continues to grow, so is the choice of home deaths — and even home funerals and burials, although this latter movement remains relatively rare. Both home-based options have battled legal hurdles, societal stigmas and safety concerns.

Robertson says the Hospice-midwife overlap is a growing trend.

She began attending births in 1979. Then, last year, she decided to become a case manager with Family Hospice in Boulder, where she assists and advises families and patients who are planning a death.

As with birth, you never know exactly what’s going to happen, or when, she says. Both experiences are a big life change for the entire family. And while family often gather around for such events, they often melt back into their separate lives when they are over.

The career shift was natural, Robertson says, because both positions have similar requirements.

In addition to medical training, “someone has to feel really comfortable with transition and holding a lot of power in the space,” Robertson says. “Comfortable with a lot of emotion, and creating a safe space and not having to control it. Being a resource and being really calm and supportive.”

Of course, the two experiences have their differences.

“It’s sort of the reverse,” Robertson says. “Birth is a pretty joyous, energized, intense situation, and death can often be quiet. Birth is more opening and it’s bigger. This is big, too, but it’s quieter.”

At its core, Robertson says, her personal goal in attending births and attending deaths comes down to empowering others to do what they already know how to do, in their own way. To feel comfortable sitting by the bedside of a loved one. To accept that it is a natural and normal process.

“There are a lot of misunderstandings about what happens, a lot of need for anticipatory guidance,” Robertson says. “People don’t know what’s normal. … People don’t die like you see on TV and in the movies. I take the mystique out of it. I take the fear out of it.”

Around here, it’s all about transitions. And Terra Rafael, of Lafayette, endured her own series of transitions that led her to leave 15 years of midwifery to become a hospice volunteer.

As she grew older, she says she was no longer up for pulling all-nighters and being on call 24/7. She decided to transfer into general women’s and holistic health care instead.

Then her father was diagnosed with Alzheimer’s. When she visited him, she says she could see the disease consuming him, and soon he could no longer talk. So, hoping to connect with him in some meaningful way, she began massaging his neck and shoulders. She was struck by how well he responded. She had found a way to reach him.

When her father died, Rafael changed her career path to work with Alzheimer’s patients, which eventually led her to hospice work.

That’s when she realized the parallel: Non-verbal communication was key to connecting with the people at major crossroads in life, where words were simply unreachable, too limiting or not relevant anymore.

For her elderly and frail patients, Rafael developed a massage technique that helps soothe the nervous system.

For new babies, communication must be from the heart, she says; being attentive and open.

And when she worked with women in labor, Rafael says she spoke as little as possible; words seemed to slow the process down.

“It’s not a verbal thing, because I feel they’re in a state where they’re using their instincts. It’s a different part of their brain,” she says.

Deanna Elliot also relies on nonverbal communication in her work with infants and people who are dying, or already gone. Elliot, a former Boulder resident who now lives in Crestone, calls herself a “transition guide.”

She performs infant massage to help babies release trauma that she says is imprinted on everyone during gestation and birth. She believes that every experience a baby has is held in its cells and stored as a subconscious memory that affects the child’s future personality and behavior — ultimately, the shape of his or her life.

Elliot also believes that the dying and funeral process imprints on people, affecting the spirit’s ability to transition into whatever is next. She helps people plan funerals, create a dialogue and find closure so they can move on. She works with people who are dying, and she says she can connect people to loved ones who are already gone.

Elliot says her work with death has helped her better understand birth, and the other way around.

“Transition, in either direction, is a stepping-off point to the next form of expression, coming in or going out, and I think we’re becoming, as a race of people, more aware about both,” she says.

Planning for the unknown

That’s why much of the work — in birth and death — is done months before the event.

Rafael now also works with a nonprofit called Natural Transitions, which teaches people about home funerals.

Historically, people gave birth and died in their homes, she explains. The family took care of the body and often buried it in their yard or in the community cemetery.

Rafael, who is also the editor of Natural Transitions Magazine, says embalming became popular in the Civil War to preserve bodies to send them home.

Since then, “the cultural rites that have developed around birth and death have become very commercialized, very cookie-cutter,” she says.

People are often afraid to consider alternatives, like home birth or home death, because the transitions are scary enough in their uncertainty, as it is. People feel a sense of comfort to stick to the more popular route. (And then, if something does go wrong, people won’t blame you, Rafael adds.)

“It’s easy for us to turn to systems, like the medical system or the mortuary system, because it’s set up,” she says. “We don’t have to think or do as much, because we’re so overwhelmed.”

And then there’s the unknown, about almost every aspect. So it’s natural to feel a little scared, Rafael says.

To deal, some lean on spiritual beliefs. Others obsess over it, or don’t think about it until it happens.

Rafael says one way to create a sense of structure and comfort is to create a plan. A big part of Rafael’s job today is to create death plans, just like she used to help mothers design birth plans.

Of course, the plans will change. But she says it helps to have an outline of who will do what, how much medical involvement you want, where you want to be and other rituals.

“It allows something that is really unknowable — in its complexities and what’s exactly going to happen — to feel more safe, in a way. To feel more knowable and controllable, even though, in the end, we don’t really have a lot of control,” Rafael says. “But we can create a structure, like a ritual, to allow the energy to flow. To allow us to relax into what’s happening in a more positive way.”

Contact Staff Writer Aimee Heckel at 303-473-1359 or heckela@dailycamera.com.