First PPD Client! Huge Surprise!

truelife · 11-08-2006, 02:27 PM

Just wanted to share that I have my first PPD client!

I never planned on doing PP work but the couple I taught last week asked if I would do it for them. They were telling me how they didn't have any family around...yada,yada,yada.... and I told them about postpartum doulas. At the time I offered to help get them in contact with one but the Dad asked if I could do it b/c they were really comfortable with me.

I'm super nervous b/c it wasn't planned but it kind of came to me. There may be something a "little off" about the mom but I really can't tell. Both her mother (here visiting) and her husband talk to her like she is a child and she kind of falls into that role. They have a 5-year-old autistic son and when I got there today she really didn't seem to know what to do with the baby. The baby was so hungry - I picked her up and she was rooting everywhere. I commented "oh, are you hungry baby doll?" and the mom answered "we're nursing her every 3 hours." I explained that a 5-day-old needs to be nursed more often then that for her weight gain and to establish a good milk supply. Mom seemed so confused.

Okay, I rabbit trailed.... but if anyone has any advice for me I would love to have it.

Rachel G. · 11-08-2006, 02:49 PM

So glad to hear that you got a pp client. That is all I seem to have intrest in not for doula work. Anyway please let us know how it goes.
Rachel

MyDoulaStacia · 11-08-2006, 03:27 PM

That's is so great you have a postpartum job.

With doing postpartum work you either love the set hours or find it too slow paced. It's not the on call excitement of a birth doula but they each have their pros and cons.
It sounds like you will be such a big help and inspiration for the new mom. Keep up the good work!

truelife · 11-08-2006, 03:41 PM

Thank you Rachael and Stacia! Hopefully I will like it. I never considered it to be an option b/c I'm such a birth junkie but I'm excited. I'm a sucker for all things birth related so I'm thinking it will come naturally. It is such a huge blessing!

Anything else I should be prepared for?

sumama · 11-08-2006, 04:17 PM

Cool Nicole! Hopefully the mom is just tired and will come around to her senses soon. Every 3 hours is just not often enough for a newborn to nurse.

truelife · 11-08-2006, 04:53 PM

That's exactly what I was thinking. I am the biggest advocate for on-demand but I know that not everyone goes that route. I am just going to try to be prepared w/a lot of hand outs and info. They are a really nice couple so everything should be fine!

ctowndoula · 11-08-2006, 05:17 PM

What books is she reading? Ezzo comes to mind with the whole 3 hour thing. You might have to do some educating there.

If it is a religious thing, some Christians believe Ezzo teaches a Biblically inspired method, let me know. I have plenty of info to debunk that guy's psudo-religion.

Are there cultural or religious factors for the Mom? I know in some cultures the Matriarch and the Dad have more say than Mom. If not and if Mom isn't responsing to what you tell her...hate to say it but go through Dad. Anything to get that kid feed more often!

Watch how mom is physically handling baby. If she does have some limitations she might need extra education on things like shaken baby and what not to put in the crib. But maybe she just had a sleep deprived day/night...after all trying to calm a baby that is hungry all night...

...

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Best wishes on your new services. The money is good and the hours are regular.

Opps, time to make dinner.

truelife · 11-08-2006, 06:01 PM

They are Christians but I don't think they have heard of Ezzo. A SIL gave them almost all of the Sears books and the Mom really seemed to be into them. The 5-year-old doesn't have a bedtime and the Dad co-sleeps with the son. Definitely a patriarchal relationship but really can't figure it out. It's really not like any other I've seen. I married into a hispanic family, and am Italian myself, so I have witnessed a lot of the "patriarchal" relationships. I am also a Christian and have been exposed to many extremes but it's not like that.

Example:
I was showing the mom how to swaddle. Did it twice and then asked if Mom would want to try and she asked to see it again.

MIL(Mom's Mom): "Niccole as you do each step please say what you're doing out loud. _____ as Niccole does it and says what she is doing you say it after her. We are mimicking now."

_______ (in a real quiet voice): "Okay."

I re-swaddled the baby and the Mom said everything I said. It was so strange! She totally took on the role of a child.

Mom is having hip/back problems and I talk to her about having an adjustment and both the MIL and Dad are answering for her. She looks depressed, acts depressed and seems to just really need someone to be there for her.

I'm not saying all of that to be mean but to explain the situation. I really hope that I can be what this woman needs, but if she is used to having people be "firm" with her I wonder if that's how I will have to communicate her baby's needs. Does that make sense? It is kind of like working with a teenager. I really feel for her and feel honored to be there.

I totally believe that there is a reason for everything - and there is definitely a reason why they asked me to be their PPD - even though they know I don't have this particular background. Insight?

asafepassage · 11-08-2006, 06:31 PM

Hello,

"She looks depressed, acts depressed and seems to just really need someone to be there for her."

Could you explain a little bit about what the signs you are seeing? Are there other potential sources of support in the community that should could be accessing...here we have public health that goes into the home PP as well as homevisitors for high risk women. Are there services other than PP doulas that are available.

If she is indeed depressed, the need to connect with her health provider for support/advice is advisable sooner than later. It is true that often a mom who is depressed can be un-responsive to baby's cues, have no energy for self-care much less newborn care, unable to take in new information and attachment is challenging.

Are there aspects of her birth that she is still in need of processing? Is there a time when you are alone with her to ask a little bit more if she has any issues or concerns that she would like to discuss in private with you.

Hope this helps,

truelife · 11-08-2006, 06:49 PM

Thanks for posting Jodi.

During the CB class I taught she was very mopey, quiet, and shared that she has been on anti-depressants for most of her life but "cut back" throughout the pregnancy. She just looks defeated and on the verge of tears at any second (and did before the birth). Her VBAC labor was 8 hours but there were "issues" with her not wanting the Dad to talk to her or support her. Her MW is like a Mom to me (also delivered my babies) and has been to her house every other day since the birth. She is acting very abnormal for a homebirther which causes some red flags to go up.

I am not afraid to confront (in love) the issues if I need to. I do think that she will most likely need some counseling or interventions of some sort but am not sure. The Dad has handled ALL business with me. Out of 7 phone calls I have yet to talk to her. When we were talking about PP services he asked how long I could continue my services and how long other moms have PP help. I said that I would help until they felt comfortable but if there were signs that some help was needed outside of my expertise that I would refer them out. He wanted to know if 3 months was feasible.

I don't know if I answered your questions or not....

Amydoula · 11-08-2006, 07:54 PM

I would seriously get her some help, sooner rather than later, if she doesn't see it herself appeal to the father. As a PPD survivor and an experienced PPdoula who has worked with clients with postpartum mood disorders this is sending MAJOR red flags my way. She may need different meds/higher dosages and counseling. If it is an ongoing thing a good therapist may definitely be in order. Check around in your area for someone who is a GOOD therapist, preferable one specializing in woman's issues. Also check on here for support groups in your area. www.postpartum.net Please keep us updated!
Amy

truelife · 11-08-2006, 08:26 PM

I should be starting with them next week. She has her mom with her until Saturday and her husband works from home. In her class packet I gave out all of the local resources that I have been able to find and one of them was for a PPD hotline/group discucssion, etc. I'm going to go post on a local board and see what I can find. Thanks everyone for your input.

ctowndoula · 11-09-2006, 12:35 AM

I know I am going out on a limb here; but mom didn't want dad to talk to her during labor, turns in to a child in the face of authority and seems depressed...any hints of abuse going on? Be interesting to see how mom acts when her mom and dh are not there.
Sorry, this is just on my mind b/c of something that just happened to a student of mine.

She does need help, whatever is going on. That is just based on your emails, but something doesn't seem right.

MothertheMother · 11-09-2006, 04:58 PM

I think you should try to talk to them separately and see if there are differences in her actions etc. Talk to dad to get information about mom--I would tell him you feel you are having a hard time connecting with her or you feel she isn't really responding to you...something to get him talking about her. Maybe he'll tell you something that will shed light on the situation. Then just spend some time with mom getting her to talk so you can get an idea of her mental state.
Good luck with this. It sounds like you were dropped into these peoples lives for a very significant reason. She obviously needs your help one way or another.

truelife · 11-10-2006, 09:20 AM

I haven't heard back from this couple over the last couple of days, but this is the same couple that called me to teach their CB class a week before her due date. If I don't hear from them soon I think I will see if the MW will have a talk with her based on what we both have observed and the things that you all have brought to my attention.

I would be uneasy going to the Dad privately b/c if there is abuse there I wouldn't want to cause more problems for her. I see the signs for abuse but it's just a very odd situation. During the CB class Mom was consumed with telling me how she felt responsible for her sons Autism (fillings, vax, c-section - you name it...) and then her husband would say things like "WIthout you ______ wouldn't be at the point he's at today." So I can't tell if they are just so distanced b/c of the attention they have put into their son (12 specialists/tutors/programs per week) or what is beneath the surface. It really is my desire to become this woman's friend through this process. They have said they don't really have time for anything except their son and his treatment.

I have also thought that maybe there isn't abuse but maybe extreme neglect of the relationship (mom and dads)? Maybe she doesn't want to get attached to her daughter out of fear that she too will be diagnosed with Autism? If she does feel responsible for her son's Autism then maybe she fears that she will do something to harm her daughter?