All About Postpartum Doulas

A PLANNED versus RANDOM recovery can make a world of difference.

Just as we would follow a care plan after a dental procedure or sprained ankle, we should follow a recovery protocol after birth to re-balance nine months’ worth of physical, emotional, and hormonal transformations.

Postpartum assistance is most often needed in the duration of the Fourth Trimester, beginning a few days after birth (or as early as arriving home from the birthing place) to 12 weeks postpartum. Occasionally additional help is desired beyond this timeframe, particularly among families whose changing circumstances manifest later.

During postpartum, you’ll feel happy, sad, hopeful, lonely, open, raw. At some point you may also feel like modern postpartum is not what nature intended.

It’s true that, historically speaking, the Lying-In Period (40 days after birth) was regarded in many cultures as the most crucial time for newborns to bond with their mother and transition into an Earthside existence. This was also treated as a sacred time for the woman as she transitioned into motherhood, established breastfeeding, grew her baby strong enough to handle contact with the outer world, and substantiated a level of physical and emotional birth recovery that enabled her to rejoin the community with greatly expanded value. This mother had many female attendants within her circle, all commiserating with her, sharing wisdom, encouraging her, keeping her warm and nourished, attending to mundane tasks so she could best nurture the newest community member.

In contrast, modern postpartum is infamous for hasty return-to-work deadlines; unattainable expectations of a new parent’s body, psyche, and household to bounce back; and feelings of overwhelm, disconnect, confusion, and neglect. You might have an increasing number of questions, dwindling time, and friends/family who have overcome the initial excitement of the birth and disappeared to return to their normal routines. Life will feel out of balance for some time, with mood swings, lack of quality sleep, and common newborn worries as the primary perpetrators.

When you’re finally out of the woods and seeing the newborn era in hindsight, you may find much of it to be a hazy blur, and suspect evidence of sweet memories you wish you’d had time to relish.

Thankfully, an unmanageable version of this struggle does not always have to be the case! Did you know the postpartum days can be magical, rewarding, and rejuvenating? So don’t wait until your 6-week check-up to get reinforcement. A strong support network is essential to a new family’s postpartum success, and as part of that team, a postpartum doula might be just what you need to get over the challenges of the early weeks.

What’s a postpartum doula, and what do they do?

A postpartum doula is a person who provides a variety of support to a family with a new baby in the weeks and months following birth. In general, care is usually tailored to an individual client’s needs. Did they have a surgical or vaginal birth? Do they have additional helpers? How about other children? Are they on a deadline for returning to work? Every postpartum doula is different, of course — with different interests, dispositions, knowledge, customs. But the main focus of all postpartum doulas is nurturing the mother so she can adjust, bond with her baby, and enjoy an improved condition.

Here are a few areas a postpartum doula may assist with:

Personal Care

“Mothering the mother” — self-care facilitating (run a bath, foot massage, apply warming aids, fill a peri bottle, prepare sitz herbs, set up essential oil diffuser, etc)

Family Care

Basic baby care (changing, holding, soothing, dressing, playing, bathing, etc.) while you attend to personal needs
Newborn cord care tips
Minding of older children (getting dressed, feeding, helping with homework, putting to bed, etc.)
Occupy baby during doctor’s visits
Helping with introduction of pets to baby
Acting as human ‘baby monitor’ so parents can enjoy in-home date night

Infant Feeding Help

Breastfeeding troubleshooting
Pumping guidance
Set up pump, milk storage, bottles
Have nipple cream, breast pads, and other goodies handy
Nursing bra fitting assistance
Positioning help
Bringing baby to you when it’s time to nurse
General reminders — you can blame ‘breastfeeding brain’!
Bottle feeding techniques
How to choose the right bottle
Supplementing logistics to protect milk supply
Resources on milk donors/donation

Emotional Support

Birth story listening & debriefing
A shoulder to cry on and/or a cheerleader for your triumphs
Discussion of risk factors and/or any concerning symptoms of postpartum mood disorders
Gently suggest to friends/family who have overstayed their welcome to depart
General reminders amid ‘postpartum fog’

Physical Support

Healthy nourishment in the form of a prepared meal
Snacks & drinks brought to you while you rest
Optimal nutrition suggestions
Natural remedy suggestions for common ailments
Reminders to stay hydrated
Assistance with getting into bath or toilet area
May also offer Bengkung Belly Binding, Yoni Sauna / V-steam, Abdominal Therapy, Postpartum Massage, Art Therapy, etc.

Household Chores

Nearby errand running
Light cleaning & maintenance housework (dishes, folding laundry, changing bedding, taking out trash, etc.)
Feeding & walking pets
Organizing clutter zones

Education

Education on basic baby care, baby feeding, techniques for soothing, safe sleep guidelines, navigating pediatric appointments, & more
Knowing what’s normal & what could use an expert opinion
Babywearing assistance
Access to a lending library of relevant books
Local references & resources

A postpartum doula typically does not provide:

Medical advice or diagnoses
Postnatal clinical exams
Surgical wound assessments
Maid services (heavy housework)
Chauffeuring
Babysitting (clients are usually expected to remain in the home)

Who uses postpartum doula care?

Anyone can benefit from postpartum doula care as services are customizable to suit the family’s needs. Sometimes a family only wants one or two visits and other times regular visits over weeks or months are preferred. The most common situations in which a postpartum doula’s services are requested:

Families with other children
Mothers who wish to breastfeed for the first time
Mothers who were on bedrest throughout pregnancy
Recovery after cesarean birth or difficult delivery
Transitioning after loss & grief
First-time parents
Young parents
Families with little local support
Families with non-local or estranged relatives
Parents of multiples
Deployment of partner
Recent relocation
Partner works frequently
Single parent
Illness in the family
Postpartum mood disorder
Premature birth/baby on apnea monitors
Babies with colic, reflux, or special needs

When should I hire a postpartum doula?

Ideally, a planning session would take place before visits begin, so ample time should be provided for all parties to prepare and lock in preferred dates. However, last minute requests may still be possible and can result in very productive visits. Below is a sample guideline of common issues that should be more emphatically addressed in these timeframes, in addition to the topics proposed above.

Postpartum (PP) Week 1: The cornerstone of care rests on getting your family settled at home. You’ll receive reassurance during the phase when milk comes in, and preparatory breastfeeding guidance.
PP Weeks 3-8: In the second month, babies become fussier and sticking to any kind of routine is nearly impossible. You can divert extra consideration to family scheduling and baby soothing techniques.
PP Weeks 10-12: This is a great time to begin making connections beyond the ‘postpartum nest,’ preparing for a return to work, and/or starting to test the progress of your physical and emotional recovery. Your postpartum doula can take care of mundane chores so you can enjoy a more active life in sync with your swiftly maturing baby.

Can you expound upon the baby care a postpartum doula provides?

The intention is to give you more time to foster a deep connection with your baby, not less! You will be able to snuggle more with your baby, languish with more relaxed feedings, and forget worries about household preparations or sibling needs (for example). You will be taught basic newborn care and have the opportunity to practice with trusted support an arm’s reach away. You will be given space, time, and encouragement to learn about and grow into your own mothering style.

When you must take care of personal needs, your postpartum doula can console baby with responsive attention so s/he is not left alone or in distress. An extra body in the room is also a blessing during the witching hour — she can help deflect some of that cranky energy!

In what other ways can this help with cesarean recovery?

Your postpartum doula can ease the transition from hospital to home. Making this adjustment after major surgery is no simple feat; it will behoove you to have all hands on deck. While you rest and recover, your doula will attend to endeavors you cannot physically accomplish. She can also help position baby for nursing in a way that doesn’t compromise your surgical wound.

In what other ways can this help with vaginal birth recovery?

Your postpartum doula can help you achieve an agreeable balance between rest and healthy activity. After any birth, many families wish they’d spent more time savoring their baby, bonding, and soaking in the birth high. Why waste these precious, fleeting moments on monotonous duties when you can outsource help to grant you such liberation?

What’s the difference between a postpartum doula & a baby nurse (NCS) / night nanny / home health nurse?

A postpartum doula’s goal is to help a family get back on their feet after birth, so her services are usually not needed beyond 12 weeks post-birth. Though, this may not be true for the other roles listed above.

A baby nurse (also known as a Newborn Care Specialist or NCS) focuses solely on the needs of the newborn, while a postpartum doula balances the needs of the entire family and cares for them as a whole.

A night nanny typically takes over all nighttime care of the baby (including putting baby to bed, diaper changes, pacifying, and feeding) so the parents can sleep.

As mentioned in my response to the “baby care” question, a postpartum doula doesn’t focus her care completely on the baby but rather on building the parents’ confidence to care for their baby independently.

A home health nurse is a clinical role that involves assisting a patient (mother or infant) with their medical needs. As mentioned above, a postpartum doula doesn’t perform clinical assignments or give medical advice.

What’s the benefit of hiring my birth doula for postpartum doula care?

For birth doula clients, requesting postpartum doula care is a wonderful way to bring a natural close to the continuum of your relationship from pregnancy through the Fourth Trimester. A familiar face, a trusted ‘handmaiden,’ one who knows what you’ve been through, might be the perfect person to help you adjust to your new life at home.

Why would one seek support from a postpartum doula even with a vibrant support network of friends & family?

Relatives and friends are tremendous assets to the postpartum support network! But sometimes we may feel obligated to entertain or host guests who arrive in the postpartum weeks, even with the visitor’s good intention to help with everyday functions. Also, we may feel more self-conscious around people we know well, as their opinions matter to us and reacting in an unpopular way might have lasting consequences. Then of course, the logistics: it may not be feasible for friends and family to be present when you need them most, and this is when a postpartum doula care fills in the gaps.

Many new parents have an individual or two in mind who nitpicks about the cleanliness of their home, comments on their appearance, questions their parenting choices, or shares privately discussed information with others. If at all possible, these people should not be given responsibilities within the impressionable postpartum healing space! Just say, “Thanks, but my postpartum doula has that covered. Let’s meet on neutral territory in about 40 days!” (Or something like that :-P).

A few more reasons why hiring a postpartum doula can be a gift incomparable to the value of unpaid friend & family support:

For the especially lucky, friend and family helpers may at first show up in droves to help — but this enthusiasm is likely to wane as the days or weeks pass and the birth high fades. To a postpartum doula, it matters not when you need her. She’ll feel as enthusiastic to care for you & your baby on day 1 as on day 40 & beyond.
Friends/family often default to: “I’ll hold the baby so you can finish chores.” Contrarily, the postpartum doula’s approach is: “I’ll take care of chores so you can bond with baby.”
You are in control! You will have approved your postpartum doula to serve you in your home and she’ll listen to what YOU want.
She promptly takes care of needed tasks as requested.
She knows to approach the sacredness of your postpartum den with sensitivity.
She only visits when you have scheduled a session. There is no feeling of obligation to invite her in, as may be the case with friend/family helpers; you decide upon a mutually agreeable time when you want her to come and that is when to expect her.
She won’t anticipate being entertained or hosted.
You won’t hurt her feelings if you feel the need to shorten the visit.
Her goal is to allow space and time for you to progress along your path of healing and reorganization of family life. This goal is not always the primary focus of friend/family helper’s visits.
She won’t give unsolicited advice in the absence of a problem (you’ll come to a mutual agreement about your education wants). She offers a safe space for asking questions and receiving answers as needed. Whether you follow this guidance is not her business, contrary to a friend/family helper who might feel entitled to know the outcome.
You don’t need to ‘put your best face forward.’
She offers support without judgment & 100% shame-free.

What kind of training does a postpartum doula have?

This differs wildly: training could mean anything from a formal certification program, a single-day workshop, apprenticeship, or simply learning through osmosis by living in a culture that traditionally practices postpartum caretaking. It’s never a bad idea to simply ask your postpartum doula contenders about their background and thinking about what’s important to you in that regard.