The Five Phases of Embalming

[CAUTION: Contains graphic images] While the topic is undeniably grim, it offers a fascinating glimpse into a crucial yet often overlooked profession. Although embalming is not mandated by law in many places, it is frequently carried out to help families preserve a dignified memory of their deceased loved ones. The embalming process is both a delicate and responsible task, designed to ensure that the final image of the departed is not one that brings distress to their family. Here’s a look at the five key stages involved in this intricate process.

1. Pre-Embalming Process

At any hour of the day or night, the funeral professional might be summoned to perform their duties. After all, death doesn’t adhere to a 9-to-5 schedule, and morticians often find themselves called out at inconvenient times—whether it's 1 AM or during a holiday—meaning they must always be ready, regardless of the hour or season.

When a person passes away, and after the family, doctor, and/or medical examiner have given their approval, the embalmer is called to perform the removal of the body. Once the necessary paperwork is completed, the embalmer transports the body to the funeral home, where the embalming process will begin if requested or required.

An embalming report is prepared, documenting all jewelry and personal belongings on the body, noting any discolorations, cuts, bruises, and similar marks. It also tracks the procedures and chemicals used during embalming. This report can be crucial if the deceased's family pursues legal action against the funeral home.

All clothing, bandages, IV needles, catheters, and other such items are carefully removed. A strong disinfectant is applied to cleanse the skin, eyes, mouth, and other body openings. If rigor mortis (the stiffening of muscles post-death) has set in, it is alleviated by moving the limbs and massaging the muscles. At this point, if the deceased is male, shaving typically occurs. Razor burn (yes, even in death, it can happen) is minimized before the arterial chemicals firm the facial skin. Women and children may also be shaved to remove the fine facial hair, or 'peach fuzz,' ensuring makeup doesn't settle into the hair and create an uneven appearance.

The next step involves positioning the facial features and the body in the correct pose that it will hold while in the casket for viewing. This is done before the arterial embalming, as the body will become permanently set in place once formaldehyde reaches the tissues.

Great care is taken to ensure the eyes are closed properly. The typical method for this involves placing a small piece of cotton between the eyelid and the eye. Often, after death, the eyes may sink back into the sockets, so plastic 'eye caps' are used on each eyeball. A small amount of stay creme is applied to the caps to prevent the eyelids from becoming dehydrated. Contrary to popular belief, the eyelids are never sewn shut, although in some cases, they may be glued together to keep them from separating.

The mouth is closed by either tying the jaw with a piece of suture string or using a special injector gun. With the suture method, a curved needle and suture string are threaded through the jaw, just below the gums, then through the upper jaw into the right nostril, through the nasal septum, into the left nostril, and back down into the mouth. The ends of the suture are tied securely, but not too tightly, to create a natural-looking mouth.

To complete the closure of the mouth, a mouth former is often used. This device, similar to an eyecap, has a textured side that grips the lips, and it is shaped like the mouth. A small amount of stay creme is applied to the lips to prevent dehydration and help keep them in place. The mortician may also use a mastic compound, a paste similar to caulk, inside the mouth to give it a more natural and pleasing shape.

Arterial embalming begins with the injection of embalming fluid into an artery while blood is drained from a nearby vein or the heart. Typically, around two gallons of a mixture of formaldehyde or other chemicals and water are used. In cases of certain cancers, diabetes, or when body deterioration has already begun due to medication taken prior to death, a stronger or 'waterless' solution is often used for better preservation. Additional chemicals are injected into other parts of the body using a syringe.

As the embalming fluid is injected into the arterial system, pressure starts to build within the vascular system. This pressure helps the fluid spread to all areas of the body and penetrate into the tissues. Bulging veins throughout the body serve as evidence of this process. The jugular drain tube, which is typically closed, is periodically opened to allow excess blood to drain and prevent too much pressure from building up, which could lead to swelling. The blood is drained directly into the sewer system, which may sound unpleasant, but far worse substances are disposed of in sewers.

Once the arterial injection is complete, the arterial and jugular tubes are removed, the blood vessels are tied off, and the incision made to access the vessels is sutured and sealed with a special chemical.

Arterial fluids primarily treat the skin, muscles, and organs. However, the contents inside the organs (such as urine and bile) begin to decompose. This decomposition leads to the buildup of gases and bacteria, which can result in distention, foul odors, and purging, such as brown fluids leaking from the mouth – certainly not the image you'd want to recall of a loved one. These bacteria can spread to other parts of the body, even after arterial embalming, creating further decomposition issues (and sometimes legal complications for the funeral home).

Cavity treatment begins by aspirating (suctioning) fluids from the internal organs within the abdominal and thoracic cavities. This is done using a trocar, which the embalmer uses to puncture the stomach, bladder, large intestines, and lungs. Once gas and fluids are withdrawn, a stronger solution of formaldehyde, known as 'cavity fluid,' is injected into the torso. If necessary, cotton or gauze may be used to pack the anus and vagina to prevent seepage (a close-fitting plastic garment may also be employed).

These procedures apply only to bodies that have not been autopsied. In an autopsy, the internal organs are removed and examined by a medical examiner, then either returned to the body or occasionally incinerated. At the funeral home, the mortician removes the viscera and places them in a 'viscera bag,' where they soak in cavity chemicals. The body cavity is then aspirated with a special instrument, followed by the application of embalming gel or powder. The treated organs are then either placed back into the body or, in some cases, the viscera bag is positioned at the foot end of the casket (so, never focus on the deceased's shoes!).

The body and hair are cleaned again to remove any blood or chemicals, and then carefully dried. Any necessary restorations are performed at this stage, such as reconstructing features or covering up wounds. Makeup is applied to the face, neck, and hands. A translucent makeup is generally used, but an opaque one may be needed if the skin has changed color. The goal is always to make the result as natural as possible, avoiding an exaggerated or unnatural look. Fingernails are trimmed, and the hair is styled either by the embalmer or by a professional stylist.

The body is dressed in the clothing chosen by the family, which typically includes underwear, shoes, and socks. If an autopsy or other complications occur, plastic undergarments are used to prevent leakage.

The final step is placing the body into the casket. The body is arranged in the correct position for viewing. The family typically views the body at this point and may request adjustments. Throughout the viewing period, which could last several days, the embalmer will check the body for signs of decay and take corrective measures as necessary.

Source: Everything you ever needed to know about Embalming. Images are copyrighted Edmond Terakopian