Postpartum rescue: Doulas provide support and guidance after childbirth
By Heather Kempskie/ Newborns
Friday, August 19, 2005
For many new mothers, the first, real tinge of motherhood anxiety may occur as soon as the hospital doors close behind them. After months of prenatal support services followed by easy-access to newborn experts in the maternity ward, the burning question hanging on the ride home may be, "How am I going to do this alone?"
Thanks to a growing network of professional postpartum douals, the answer is- you don't have to. Taken from the Greek word for "woman caregiver," doulas provide emotional and physical support to women and their families during the postpartum period. Some doulas are also trained to support a woman during labor and delivery.
"Following the birth of my second daughter, I realized that the expectation and mentality of having to 'go it alone' is not healthy for any mom or baby," said Tammy Paul, a certified birth and postpartum doula, who lives in Walpole. "In our country we expect that a mother will give birth and return to her normal routine often with little or no assistance from outside family or friends.This is not realistic, nor is it sound for creating solid family structures."
Studies have revealed, according to Paul, that help from a postpartum doula significantly reduces the incidence of postpartum depression, increases breastfeeding success during the first six weeks of an infant's life by nearly 50 percent, and that more mothers report having an improved relationship with their partner.Typically, a doula spends three to eight weeks with a family.
Most doulas provide infant care and breastfeeding support while some are also willing to entertain older siblings and tackle some of the day to day tasks like cooking and laundry. Rates for these services are about $20- $30 per hour. Although not typical, some health insurances may cover a part of the expenses.
Jodi Levy, mother of two-week old twin girls, knew she would need some extra help when she returned home. Three days a week, Mandy Dean, a trained birth and postpartum doula from Cambridge, visited the Levy's Sudbury home to help with feedings and other tasks.
"I love having someone to talk to about my concerns," said Levy. "I was worried about a rash on my daughter's face and she was able to tell me it was normal. She's also a great self-initiator. She rearranged the drawers and organized the clothes in the nursery; cut up paper towels that we were using as diaper wipes and so much more. But the best part is she has experience with twins and is knowledgeable about infant care."
National organizations like Doulas of North America (DONA,) offer certification for postpartum doulas. Some of the requirements include: completing a lactation consultant course, current adult and infant CPR certification, and having recent experience caring for an infant. Although, technically speaking, no certification is required to serve as a postpartum doula.
"I don't think a lot of women know that this type of service is available to them but I will say that this generation is definitely growing more aware of it because families are more scattered and women are seeking support," said Dean. "It's a valuable resource that every woman could use especially first time parents. Its part of my job to help them transition into parenthood- that takes time."
Mother of three boys Cynthia Miller, of Norfolk, has hired doulas following the births of all of her children.
"I am a true believer that help during pregnancy and the postpartum period single handedly can be the difference between being of sound mind and health and having a bout of postpartum depression," she said.
Although the doulas interviewed said their services are gaining popularity, they agree that some mothers may hesitate to hire them.
"Women, rightfully so, think of themselves as strong human beings," said Ligea Gallotti, a postpartum doula who resides in Chelsea. "They think that once they're home in their own environment, they will be OK, that they just needed help when they were pregnant but they soon realize when they get home with their infant that that's when the most difficult part begins."
Gallotti worked with one woman who wouldn't eat because she didn't like her husband's cooking. The woman was also suffering from extreme fatigue because her newborn was colicky.
"One day, I told her to take a long nap and I spent a few hours teaching her husband how to make simple, nutritious meals and also helped him make a list of groceries he would need," she said. "It made a big difference for that family."
Any new mother will likely say that the lack of sleep is one of the hardest aspects of early motherhood. That's where Ann Armour, of Newburyport who has 18 years of doula experience, steps in. Armour specializes in providing overnight care. She wakes with baby through the night for feedings and diaper changes.
"The nights can be so daunting for new mothers," said Armour. "Everyone is the world is asleep and there's no one to talk to. Its not just baby care that I do, its family care. Everyone gets sleep and wakes up feeling refreshed."
Although in the doula profession there are no paid vacations or health benefits, the douals interviewed say their job satisfaction goes deeper than that.
"When I leave a family rested, secure, happy and confident in their roles as parents and come back a few weeks later to check in and their beaming with the baby in their arms I know I've done my job," said Armour.
And those who have benefited from doula services wouldn't have it any other way.
"I just want a happy house," said Miller. "Our doula (Paul) helped all of us feel we were okay....good enough. That's what I needed to achieve and I did."
Tips on finding a doula:
It is important to remember that certification does not ensure
that a doula will be a good fit for your family. Look at overall experience in the areas that are important to you, says Paul.
Be sure to check at least two to three references.
Make sure your personalities click. You want to hire someone you feel comfortable with.
Conduct a thorough interview and if possible have your partner sit in. Be sure to ask questions that will give you an idea of their knowledge when it comes to newborns and prenatal care.
Trust your intuition during the selection process. It is always wise to meet with at least a few different doulas before making any decision.
Don't worry too much about the expense. Those families interviewed said the support was absolutely priceless.
Additional Resources:
Doulas of North America-
www.dona.org
Childbirth and Postpartum Professional Association-
www.cappa.net
International Childbirth Education Association-
www.icea.org
National Association of Postpartum Care Services (NAPCS)-
www.napcs.org
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Heather Kempskie is editor of Parents and Kids.
