What is a Postpartum Doula? Written by: Mary Killeen Pena of DYAD Parenting

Postpartum Doula? You mean like, depression, right?

It’s alright, I didn’t know what a postpartum doula was before I got pregnant either.

I had heard of midwives, but thought that was a profession left behind in the Middle Ages, or something only families with long hair on communes knew about.

But once I got pregnant, by surprise, with my first child, I wore my keyboard out from all of the research to plan my birth. I have always been someone who spends hours researching any, even seemingly meaningless, topic that piques my interest.

When I got pregnant, all the stories I had ever heard about birth came flooding into my brain and body. My mom had been somewhat transparent about her own experience, so I knew that she had not wanted epidurals and wanted as little intervention as possible, and achieved that with three out of four
of her births (I was the most difficult one, and the only one that she wanted an epidural for). I also knew that she breastfed all of us for some amount of time (at least through the newborn stage).

And I knew those things – an unmedicated birth and nursing my baby - were important to me too. I’m not sure why it was important exactly, other than my intuition telling me so. I have historically been a proud person, and dig my heels in when people tell me I can’t do something that I know I am capable of.
So the idea of a male doctor dictating my birth and postpartum experience…did not sit well with me.

I began my Google searches from this vantage point.
“midwives near me”
“holistic perinatal care”
“natural birth options”

I came across lots of blogs…lots of blogs. “Crunchy”, “granola”, “natural”, “organic”. Some were helpful and insightful, and some made me feel overwhelmed by all the toxins I already had exposed my baby to in utero. Okay, so who was going to help me sort through all of this information.

One of the first results for pregnancy care providers (were they supposed to be OBGYN’s? Family doctors?) in my neighborhood were a pair of midwives. They had immaculate reviews online, I perused their website, and then sent them an email. How could I have known that my seemingly simple choice of a care provider would profoundly change my life.

There seems to be a lot of cultural confusion about midwives. Most pregnant people in the United States see an OB/GYN for their pregnancy and birth care.
An OB/GYN is a physician with specific training in pregnancy and reproductive health. They can preform surgery and medical procedures.

Midwives are medical care providers trained and educated specifically for pregnancy and childbirth care, as well as other health care on the perinatal spectrum. They are educated at an accredited school at the
graduate level, pass a national exam, and receive a professional designation (Certified Nurse Midwife or Certified Midwife). They deliver babies in all birth settings: home, birth center, hospital. They serve low risk pregnant patients.

Midwifery is an ancient profession, historically practiced by women. Midwives and women healers were later labeled “witches” and forced out of practice, as the practice of medicine was created to co-opt and monopolize healing modalities by universities in the Middle Ages in Europe.

As the weeks of my pregnancy wore on, I brought my handwritten list of questions to the midwives each week. The appointments lasted for an hour, and once we had checked off the medical to-do’s for the appointment, I asked all my embarrassing and silly questions. My midwives listened. I never saw a hint
of judgment on their faces. They sent me articles and research about the things I asked about. They counseled me through the emotional trials of my first pregnancy, with all of their wisdom and evidence-based information about childbirth.

After my daughter was born, they listened to me try to find the words to describe my overwhelm when caring for a newborn. They said, almost with a shrug, “have you thought of hiring a postpartum doula?”

I still remember that moment with the kind of clarity I can recall emotional childhood memories – like the time my dad explained the phrase “your eyes are bigger than your stomach” to me, and my five year old brain first encountered and tried to understand a metaphor.

It was through the counseling and conversation with my midwives that I arrived at quitting my day job and becoming a postpartum doula myself when my daughter was 4 months old.

When I tell people today that I am a doula, most people show faint recognition on their face. “Yeah, I think I’ve heard of them before…that’s like a midwife right?”

Doula practice is as ancient as midwifery. “Doula” is a Greek word that literally translates to “female slave”, but is understood today to mean a non-medical care provider who supports a birthing person through birth and the postpartum period.

There are many types of doulas – abortion doulas, full spectrum doulas, death doulas, birth doulas, postpartum doulas, and so on. In my view, a doula is a dedicated and non-judgmental support person that dedicates their presence and wisdom to a person as they experience a profound life event.

A postpartum doula is a trained, professional, non-medical care provider who supports families with newborns. A postpartum doula offers physical and emotional support, evidence-based information, and in-home assistance to families when they bring their baby home.

All of my sessions are as varied as my clients, but this is what a typical in-person session looks like: Me, arriving early in the morning, to help parents stay in bed and maybe get a couple of hours of sleep before they start their day. I wear the baby in a baby carrier, or put them in a safe sleeping position close
to me and out of the parents’ room. I do quiet household chores (like dishes or a laundry load, organizing changing tables, meal prep). When baby is hungry, I bring the baby to the parent to nurse or body feed (or bottle feed). I spend at least half of the session sitting and talking with any present family members,
but mostly the birthing person. I practice empathetic listening, answer all newborn care and postpartum recovery questions, and offer resources and suggestions. I hold baby while parents shower or get ready
for the day. Sometimes I take baby on a walk outside. I am trained to look for the typical signs of PMADS (perinatal mood and anxiety disorders).

I serve clients as a postpartum doula by:
 showing them how to wear their baby
 coming to medical appointments with them
 showing them soothing techniques (swaddling, bouncing, rocking)
 answering their questions about which newborn behaviors are normal
 meal prepping family meals for the week
 helping parents give their baby a bath
 taking a fussy baby on a walk to give parents a break
 organizing baby supplies and clothes

Postpartum Doulas receive training on lactation, nursing, and feeding as well. Some doulas get even more training to become Certified Lactation Educators (CLE) or Certified Lactation Counselors (CLC). These are different designations than an IBCLC (a medical care provider who can diagnose and refer). I
am a CLE, which means I have extra training and education in lactation and nursing. One of the main ways I support clients is helping them meet their feeding goals.

I help clients with lactation support by:
 teaching classes to new parents about normal infant feeding
 showing parents, hands on, how to get their baby to latch
 physically helping parents optimal nursing positions
 showing parents Safe Sleep guidelines in their homes
 teaching families how to bottle feed their infant, how to burp their baby
 helping parents use their pump for the first time
 answering questions about normal milk production issues and physical changes for nursing parent
 walking them through the first hours of how to nurse their baby over the phone while they are in the hospital

When a client works with me, they can text or call me at any hour of the day, and expect a response between the hours of 9am-5pm.
Because of the COVID19 pandemic, I have only been serving clients virtually for the time being.

What does virtual doula support look like?
When I finish working with a client, they often say that they are surprised by how much they needed emotional support and someone to just listen and be present during their fourth trimester.

Virtual doula support looks like a zoom call where I listen (without judgment) to your family’s concerns or questions, show you newborn care skills (I can show you how to babywear or swaddle over video, for example), provide emotional support by validating what you are experiencing, offer resources,
suggestions, or referrals, and assess normal newborn care issues.
Virtual lactation support looks like a zoom call where I assess normal newborn feeding concerns or questions, show you nursing or body feeding skills (I use props), and offer resources and referrals if need be.

I have served clients virtually by:
 Showing them how to hold their baby to burp them properly
 Showing them how to wear their baby correctly in their baby carrier
 listening to feeding sounds and cries to assess if they are normal
 counseling family on infant sleep arrangements and difficulties
 helping them create a postpartum plan all over the phone and Zoom

There is no substitute for in-person community and care, but I can come close for the time being. I am currently offering a virtual doula package that combines resources to address all of the most common postpartum support needs that have been sidelined because of COVID19 safety. In this package, The Portal, you get six weeks of one-on-one doula support, 4 live new parent classes (infant sleep, infant feeding, mental health care for parents, and baby wearing), 7 recorded new parent classes (a cooking class, a conscious fathering class, a pelvic floor recovery class, etc), and a private support group to create community with the other families in the cohort. You can learn more about the package and find the link to register here.

I also offer postpartum planning sessions with a customized guide I have created, to make sure that you are prepared to bring a new baby home, beyond the nesting and the baby shower. If you have a family in mind that could benefit from my services, you can email me about purchasing my services on their behalf as a gift.

More questions? I have an FAQ page on my website that should help.

Find me here:
www.dyadparenting.com
email: dyadparenting@gmail.com
phone: 206-321-0894
IG: @dyadparenting

Written by: Mary Killeen Pena