What Do You Do As A Postpartum Doula?

Pretty much everyone I talk to asks me about what postpartum support could be, and this includes questions from every angle. When I explain that it has to do with supporting whole families during the newborn and immediate postpartum phase, I get a lot of the same follow-up questions over and over.

Here are some of the things you should know if you're considering getting postpartum doula support during your own adjustment period, if you want to consider doing this on your own, or if you're just curious and can't imagine how I ever sleep or see my own children.

Adult and baby holding hands, showing support.

"So your job is just snuggling babies- that's so cool! I'd be so good at that!"

I'm going to be completely honest, and tell you "Yes!" Holding babies is a large portion of my job, but it isn't the only thing I do, and it isn't always easy. I hold babies when they are gassy, or colicky, or when they don't know the difference between nighttime and daytime yet. I hold babies who haven't been out of the womb long enough to know or trust anyone but mom, and I help them build that trust. Holding the babies is great, especially when they grab my hand or look at me with their big, sweet eyes, but holding space for the entire family is a better explanation of my job overall. There are so many feelings that come with welcoming a new one into the world, both emotional and physical, and a part of my job is to make sure they whole family knows their feelings are valid and that I can be trusted to see and hear them.

"You get paid, even when you're sleeping?"

Some doulas offer fully-awake care for an increased price. This is usually for multiples, medically-complex families, or parents who may be extra worried about their infant for any reason. For the majority of babies though, there's going to be some downtime during an overnight shift and your doula is still taking time away from their own family to support yours. They are committing to waking up as soon as they hear cues from baby and jumping right into care tasks. They deserve to be compensated for this, even if they do catch a few minutes of sleep. For me, I love a good nap if the baby is napping, but I also love the feeling of knowing that you're well set for the next day, in addition to well rested. I will do several chores at the beginning of the nap to make sure you feel prepared for the day ahead, then, and only then, I might take a quick nap with your sweet, snuggly little one.

"What a spoiled life! Baby never gets put down, and new parents get to sleep too? I wish I had been so lucky."

Every family has different priorities and circumstances. While I do wish that continued postpartum care was available to everyone, I understand that for some people it is just unaffordable. Rather than hating the people who can commit to the cost, let's all work on encouraging the system to continue to change. Some insurances are on board, some families pitch in to pay for services as a baby shower gift instead of clothes that won't fit by tomorrow, and we can keep encouraging moments like this.

1 in 4 birthing parents, and 1 in 10 supporting parents experience a postpartum mood disorder- whether it be mild or severe. That means many sets of parents that you meet have had to deal with feeling unlike themselves at some point postpartum, even if they don't show it. Getting support to sleep, process their emotions, receive education without judgement, or just have another grown-up to talk to can be more than just luck for some of these parents, it can be the difference in getting through these circumstances and being able to return to feeling like themselves and being present for their baby. Sleeping helps moms heal from traumatic birth injuries, it helps consolidate information like how often baby has eaten or pooped, and it can increase milk-production.

Holding a baby when they need it will not spoil them. I enjoy holding the baby, and I enjoy getting to bond with them in a way that shows them they can trust people to take care of them. I also believe that exposing your child, frequently, to their sleep space is key to the success of independent sleep. With my training as a pediatric sleep consultant, I work hard during postpartum shifts to encourage safe, responsible sleep practices for your infant that align with your goals for their sleep long-term. TLDR- I make sure you don't need me to come back to fix sleep habits that don't work for you later on.

"So is it only for bottle-fed babies? You can't breastfeed for mom."

The CDC states that 60% of mothers stop breastfeeding before they intend to. This can be related to many factors, but often it includes a lack of support or education. While I am not yet certified as a CLC (but hoping to start soon!) I can offer breastfeeding mothers encouragement, peer support, and the reminder that this takes work. Sometimes they just need someone to show them what it looks like when they hold a baby in a nursing position, someone who doesn't judge them for using a product that makes them or baby more comfortable (boppy pillow, nipple shield) or someone to talk to while they are breastfeeding, so it doesn't feel so isolating. For some parents, there is a belief that breastfeeding is all or nothing: If you breastfeed, your partner will not be able to feed baby till they start solids, or breastmilk is only effective when it comes directly from a latch to the breast. This simply isn't true. Some parents are able to pump and bottle feed some or all of the time to still fill their baby with nutritious breastmilk without a direct latch, and I can help make that process smoother by bringing you a sizing ruler, reminding you to replace your parts, or simply washing everything for you so you're set to start again in the morning! Lactation is a where a huge amount of my support and encouragement get used up, but it's also okay if you're formula feeding. I can still help you choose bottles, look for hunger cues, and practice techniques like paced-feeding which can help make sure your baby is not only full, but comfortable

"But...I thought the recommendation was for baby to room share with parents for a minimum of 6 months?"

It is recommended for baby to share a room with a caregiver for 6 months, but that caregiver absolutely does not have to be a parent. Anyone who can quickly and consistently respond to the baby throughout the night helps to increase the safety of baby. While many parents do choose to have a bed-side bassinet as baby's first sleep space, they can be moved on a night when you just need to get a little extra sleep to be your best self the next day. For my family, it always worked for us to have 2 bassinets anyway, so that baby had a safe sleep space in our living space as well as in the bedroom.

"Is it weird to be there with the parents? Do they watch you?"

I meet with every family who considers me for their services, and we decide, together, if we're going to be a good fit. I will not be the doula for everyone, and that's okay. If we have strong, opposing opinions about caring for children, I will often point you towards a different doula that I think will better suit your needs. I find myself to be a great candidate for people who are motivated to do it alone but need some guidance and education. This means that often they are watching me, but they're watching me because they want to learn from me. I don't find that awkward, I find that to be a rewarding experience. The parents that choose me have chosen me to keep their baby safe, to guide them into keeping their baby comfortable, and have built a relationship with me where we are all confident that baby is getting whatever they need, no matter who is actively caregiving in the moment. Some clients have chosen to stay in touch, sending me updates and cards, and I love getting to be a long-term piece of these lives that I saw from the very beginning (that's why I send birthday cards!)

"What if mom doesn't want to hand over the baby?"

Mom is always entitled to holding that baby she just worked so hard to grow and welcome. I will never push a parent to hand over a baby when they are not ready. In fact, I always start discussions about postpartum support with finding out what I can do for mom to free up her time, so that she can continue to bond with her own baby. I offer support with household and baby related tasks, like laundry, dishes, light cleaning, or meal prep. In doing this, mom gets to snuggle when she needs it.

That isn't to say that the parents can't ask me to hold the baby if that's what they need. Being able to take a shower, brush your teeth, or get a few hours of sleep can really make you feel like yourself, and are a super valid use of your time when you have postpartum care. On occasion there are parents who want to be able to hand over the baby, but are anxious/nervous/scared to do so. It is okay to have those feelings. Again, you just worked SO HARD to bring that baby into the world, they are your whole world, and it can be hard to be willing to hand that responsibility to someone else. If this is you, we will work together to build your confidence and tolerance for letting someone help.

"My mom wants to help me, but..."

When I hear this, I always have follow up questions. Some moms (not grandmas) are amazing helpers, but sometimes they're not. Sometimes they are, but it makes you (the mom) uncomfortable. One thing that I offer, and find deeply important, is a postpartum planning session. It takes place around 35 weeks, and looks at everyone you have on your care-team, and how they can be the most impactful to you. It gets typed into a plan, that I encourage you to share with that whole team. That means if you don't want mom to hold the baby all the time, but you think her mac n' cheese is the best, coziest dish on the planet, I'll be giving the food task to your mom! She'll see on the document how important it is to you that she makes it for you, and she'll know she's helping when she fills your freezer with it, or heats up a bowl. I want you to have as many people on your care-team as possible. I'll help you decide how they can support you most effectively, and I'll fill in the gaps. You deserve well-rounded, full-spectrum care.

"So, no coworkers?"

While I don't typically work a shift with anyone else, and am technically a small business owner with no employees, I never feel alone in doing this work. I know what my scope of practice and my limits are. That means, if you want more overnights than what I feel I can support and still show up for my kids, I'll suggest a team approach. Maybe its me and some other doulas I know, maybe you decide you want someone with more availability. I want you to have what you need. Maybe we've tried some sleep techniques or some coaching through breastfeeding and it still isn't going well. In these cases, I have a list of providers I trust for things like infant massage, cranio-sacral therapy, and lactation guidance who I will suggest you do a consult with and see if you fit.

Haley working on a wiring puzzle during a space-themed escape room.

So, while I may only get to moonlight as a rocket scientist on the weekend and not be one full time, I still think I have a pretty cool job. It isn't for everyone. It requires a lot of background knowledge that took me years to acquire. It can be emotionally taxing. It can absolutely destroy your sleep schedule. It can change your life through the ways you get to change someone elses. It can reward your soul. It can show you that just offering a little bit of support can change everything. (But also, still take breaks to pretend to be a rocket scientist. Also also, if you recognize this puzzle and scored more than a 94, I don't think I believe you.)