On Postpartum Doulas

Thursday, May 2, 2019

Originally published on November 12th, 2015.

I have been serving new families as a postpartum doula for the last five years but it dawned on me that many of friends, family, and colleagues don’t exactly know what that means. This is what I do:

I work with families immediately after they have a baby. I take care of mom (and the things mom used to take care of) so that she can take care of her baby. I attend to women after vaginal birth or cesarean surgery; while they are still bleeding and aching and leaking. I validate the common discomforts that come from being pregnant and then bringing a small human earthside. I offer remedies, (i.e., cabbage leaves for sore breasts, sitz baths for hemorrhoids) and referrals (i.e., physical therapy for diastasis recti, acupuncture for anxiety). I assist mom in achieving her daily goals: a shower, a meal, fresh air. I cook to provide her with macro and micro nutrients that will replenish her system, balance her hormones, and aid in milk production. I act as a companion; listen to her birth story and make space for the trials and tribulations of her transition into motherhood. I help moms troubleshoot during the early days of breastfeeding until baby has a successful latch and mom is pain-free. We work together on pumping strategies, introducing a bottle, and building a freezer stash. If a baby is being bottle fed, I prepare and wash a lot of bottles!

It is amazing how chaotic life with a newborn is. If you haven’t had children yet, there is almost no way to imagine it. If you have long since had children, it probably seems like a blur. Exhaustion and anxiety are running high. Finding your phone can be a challenge, finding your mind can be impossible. I provide evidenced-based information on newborn care so that parents can find and follow their instincts and make their own decisions. I cover the range of normal for newborn behavior. We discuss all of the things that can be scary and variable: breathing patterns, sleeping arrangements, eating habits, bowel movements. I model all those classic newborn care practices: diaper changes, nail cutting, bath, swaddling, soothing. We practice baby wearing so parents can move around while keeping baby close and using their hands at the same time.

I generally work in three-hour blocks, sometimes one time, sometimes multiple times, sometimes multiple times a week. I do this rather seamlessly, without being an intruder or making it about me. I include mom’s partner and other children whenever they are present.

It is hard to fully understand why this work is so important without understanding the nature of the time after birth. Even when things are going “well” (mom and baby are healthy) surviving the immediate newborn period is the hardest thing everyone will ever do. During pregnancy, a woman is often on the receiving end of excitement and encouragement. Once her baby is born folks tend to disappear. A newborn mother’s needs are incredibly similar to those of a newborn baby. Mom is overrun with hormones, learning a completely new set of skills, easily over stimulated, and needs constant care, nourishment, and warmth. Ancient customs exist around the world to support a new mother emotionally, physically, and spiritually. This period can be cherished. In the Dominican Republic a woman does not leave the house for 40 days; in India 22 days; and China 30 days. Her community takes over the cooking, cleaning, sibling care, and treats mom with herbs and body work so she and her baby are allowed to bond. The United States has no such traditions and as seen with a six-week unpaid maternity leave undermines the importance of this time on a woman’s life and a family’s future. I work to bridge the gap in an unsupportive society.

Postpartum doulas are only one piece of a larger effort to support pre and post natal women. Childbirth educators, birth doulas, lactation consultants, yoga teachers, physical therapists, acupuncturist, massage therapists, chiropractors, nutritionists, and psychologists are hard at work. As a village we need to make sure women 1) know about these resources 2) are encouraged to take advantage of them 3) receive assistance making appointments. Newborn mother’s do not often reach out for help on their own. Please be in touch if you would like referrals for friends or family members. We all play a part in a woman's physical and emotional healing after birth! (At this time Ashley is no longer seeing clients as a postpartum doula but is still happy to guide you through referrals).

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